1997
1997 The 25th anniversary of PL 94-142, saw the law amended as the Individuals with Disabilities Education Act (IDEA).
The law stated that children were to be educated in the least restrictive environment. Students who may have previously been considered as candidates for a special school would now be attending their "home school."
A treatment or procedure for a medically fragile student needed during the school day would be provided in the school setting. This increased the need for nursing services, and clearly dictated the need for privacy in the health office. Some students attending neighborhood schools needed special services, like catheterizations, tube feedings, tracheostomy care and other procedures on a regular basis. Health office bathrooms were adapted for handicap use and ramps for wheelchair use were added as schools adapted to the changing needs of students. A major influence on practice was the increasing emphasis on special education and the nurse’s role in these students assessment.
The passage of Individuals with Disabilities Act (IDEA) in 1997 greatly increased the role of the nurses in assessment and planning for special needs students.
Yet, no limits were set on how many students each nurse served. This workload was eased when the district began to budget for more nurses and implemented a more comprehensive new nurse orientation program.
The Path to School Nurse Certification
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The path to certification was slow. In 1959, when Genevieve Arensdorf chaired the public health section of the Nevada State Nurses Association (NNA), she worked to set standards for school nurse certification in Nevada. A committee surveyed and reviewed available information from other states to compare requirements.
In the mid-1970s, the National Education Association (NEA) adopted a definite position that coincided with nursing goals of the National Association of School Nurses (NASN). They saw that certification would insure appropriate nurse academic and clinical preparation and provide assurance that only qualified professionals serve in the schools.
The guidelines recognized school nursing as a dynamic discipline that embraces a variety of functions and requires a scope of preparation that is broad and varied.
In addition to the professional knowledge required to qualify school nurses for their expanding role and ongoing independent judgment, both the NEA and the NASA recognized the need for nurses to be aware of social and cultural diversity of students and their families. Cooperative efforts between the NSA and the Nevada Department of Education made it possible to adopt the professional standards of practice developed by the National Association of School Nurses.
Nursing developed updated procedure manuals with guidelines and standing orders for general practice, specific clinic services, specialized procedures, and training for first aid safety assistants. Professional development brings new information to school health personnel. Five hundred plus nurses and health aides provide needed aid to a special population of CCSD students.