Consulting with Schools on Health Issues

A. THE BASICS OF CONSULTING WITH SCHOOLS ON HEALTH ISSUES

SLIDE II-2

Consulting with schools is a request of pediatricians and many already have experience in this area. Pediatricians who are considering consulting with schools should: 1) identify local health issues; 2) enhance their general consulting skills; 3) follow the 10 Commandments for consultants; and 4) inventory personal skills.

1. Identifying local health issues and school staff

Pediatricians who are interested in consulting should become knowledgeable about the school or school district and about the community in general.

  • Do you know how your school and school district function?
  • Have you met the key personnel, such as the superintendent, principal, school nurse, and physical education instructor?
  • Do you know the key health issues and needs in your community?
  • Are you familiar with the other health care professionals who might be involved with the school?

(More information on understanding school culture can be found in Section I.)

Pediatricians who are interested in consulting with schools should consider their personal interests and goals before contacting the school or school district personnel.

  • Do you want to consult on individual student cases?
  • Do you want to consult on groups of students with particular needs, such as children with disabilities or athletes?
  • Do you want to consult on programs and policies?
  • Do you want to consult on particular situations or events, such as crisis management or athletic events?

2. Inventory Your Skills as a Pediatrician

In general, pediatricians have unique abilities and backgrounds to offer schools:

  • Skilled at physical examinations and screening.
  • Expertise in evaluating growth and development, as well as evaluating acute illness.
  • Familiarity with most common behavioral problems that cause difficulties in the classroom and school environment.
  • Experience in case management and working closely with parents, particularly those whose children have special health care needs.

Prospective consultants may want to develop new skills to facilitate their involvement with the schools. In addition to becoming familiar with the school culture and key figures (see Section I), pediatricians may want to enhance their expertise in the following areas:

  • Crisis management and planning
  • Environmental medicine
  • Public safety
  • Issues for children with disabilities, including special education and federal regulations such as the Individuals with Disabilities Education Act (IDEA) and the Americans with Disabilities Act (ADA)
  • Substance abuse prevention, identification, and treatment
  • Health education curricula and instruction, including family life education
  • Staff health promotion and education
    The hiring and supervision of school nurses, health aides, and other school health staff

3. Enhancing Your General Consulting Skills

Some basic skills are needed to be an effective consultant no matter what the profession or issue.

Attention to detail in structuring the consultation relationship.

  • Always negotiate a formal agreement.
  • Allow the person or organization receiving the consultation services to determine the structure of the relationship; share control of the relationship, and avoid dictating.
  • Understand the limits of your responsibility and power, and be prepared to end the relationship when necessary.

The ability to manage personal interactions or interpersonal communication.

  • Be nonjudgmental, and respect the rights and needs of others.
  • Accept that the person or organization receiving your services has the freedom to welcome or reject ideas.
  • Encourage your client to contribute suggestions and make decisions.
  • Emphasize the contributions of the person or organization receiving your services and their ownership of all ideas generated as a result of the consultant relationship.

The ability to maintain effective communication.

  • Be aware of the differences between you and your client.
  • Be understanding of your client's frame of reference.
  • Use active listening and problem-solving skills.
  • Manage personal anger and frustration.
  • Help your client and other parties involved learn to negotiate and interact with each other.
  • Understand the political nature of interpersonal communication.

The ability to collect and analyze data.

  • Be consistent in observing and recording data.
  • Analyze and translate the data into understandable and usable terms for your client.
  • Assist your client to translate the data into functional recommendations.

Strong personal commitment to the client or issue.

  • Generate genuine enthusiasm and interest in your consultation responsibilities.
  • Manage your time commitment and level of involvement.
  • Be willing to learn how to work with diverse groups of people and understand their unique perspectives about issues and relationships

SLIDES II-3 & II-4

4. The 10 Commandments for Consultants

  1. Know why you are being consulted.
  2. Communicate in a personal and accessible manner.
  3. Determine whether orders or recommendations are requested.
  4. Formulate specific input.
  5. Support your input.
  6. Educate your client.
  7. Maintain follow-through.
  8. Be brief.
  9. Be charitable.
  10. Be honest.

5. An Exercise for Potential Consultants: Case Scenario for Discussion

The following can be used didactically or as a focus for brief (5-10 minute) discussions in small groups of 4 to 6. Used in this manner, it is a good ice breaker for members of the audience. Speakers may choose from the following menu of scenarios based on their knowledge and expertise.

The following are some scenarios to generate discussion based on what you already know and what you have learned so far. The scenarios may also highlight stimulate interest in learning more about some topics.

PROVIDING A RESPONSE TO THE 3:00 PM FRIDAY AFTERNOON PHONE CALL

Asthma: A parent has requested that a nebulizer be available at school for her son with asthma.

Athletic Injury: A student playing football may have broken his leg.

Drug Screening: The guidance counselor is concerned that a student is using marijuana.

Eating Disorders: The school nurse thinks that a group of female students all are anorexic.

Food Poisoning: Within several hours of a school picnic, many students are vomiting.

Frequent Visitor to the Health Office: A 3rd grade boy who goes to the school nurse's office complaining of headache several times a week.

Lice Infestation: The principal calls because parents are concerned about several cases of head lice in the kindergarten class.

Medication in School: The school nurse is concerned because the parent of a 7th grade student wants him to carry his inhaler with him. It is school policy to keep prescription medications in the nurse's office.

School Avoidance Syndrome: The principal is concerned that a 5th grade girl is missing a lot of days from school. The student's mother claims that the child's physician approves of the absences,.

Suicide: The superintendent calls because she has just become aware of the suicide of one of the high school students.