New Teacher Advocate — KDP New Teacher Advocate Fall 2016
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Oh No! One Of My Students Has Head Lice!
Leisa Prasser

Students bring more than pencils, rulers, backpacks, and lunches to school; they also bring head lice, hunger, family and home problems, mental illness, food allergies, and a myriad of chronic health conditions. Trying to teach students with all of these issues is every teacher’s challenge. The school nurse can help!

The school nurse may be the only healthcare professional that many students see regularly. However, most teachers are unclear about when to send a student to the school nurse. These tips will help you decide.

Health Emergencies = See the School Nurse Now!

• Breathing Issues or Asthma: Asthma is on the rise among our youth. A student with a known diagnosis of asthma who is having trouble breathing should always be sent to the nurse, or the nurse can be called to the area where the student is. Other breathing emergencies can occur in students with no known risks, so ALWAYS seek the help of the nurse if you are in doubt.

• Allergic Reactions: The number of children with food allergies is also increasing. Common allergens include peanuts, tree nuts, milk, eggs, soy, fish, and shellfish. If a child has a known food allergy that is life-threatening, he or she should have an epinephrine auto-injector at school and a food allergy management plan. Students who exhibit symptoms after eating ANY food (e.g., breathing difficulty, trouble swallowing, hives or other skin rashes, itching, nausea, or vomiting), should see the school nurse. Don’t wait to see how the student is feeling later! Allergic reactions can progress very quickly. Teachers and other staff members should be trained in the administration of epinephrine using an auto-injector. For more information on food allergies, go to the Food Allergy Research and Education website at

• Seizures: Many students who have seizure disorders attend school and are in regular education classrooms. These students must have a seizure action plan. Work with the school nurse and parents to create one. Templates can be found at the Epilepsy Foundation website, For students with seizures, call the school nurse immediately for any unusual activity, loss of consciousness, jerking movements, or other known signs of seizure.

These are just a few examples of when to get help NOW. As with all emergencies, the teacher must make a judgment call—sometimes calling 911 first is the best course of action, followed by notifying the school nurse for support care. Other health conditions that need immediate attention by the school nurse or other healthcare professional include students with diabetes who have signs of low or high blood sugar, students with major bleeding (especially if known to have hemophilia), broken bones, and head injuries.

Minor Health Issues = The School Nurse Should See These Students

• Nosebleeds: Apply pressure by pinching the nose, but do NOT have the student tilt his or her head back. This can cause stomach upset.

• Scrapes, Cuts, and Bruises: Many of these can be taken care of in the classroom if you have adhesive bandages, soap, and water. Cleaning minor cuts and scrapes with soap and water is sufficient. Many cuts don’t even need a bandage if there is no active bleeding.

• Fever, Vomiting, and Diarrhea: Many students are contagious before they have symptoms. Although the school nurse should see a child with a suspected fever or one who is vomiting or has diarrhea, these are usually not emergencies. The best practice to avoid spreading flu viruses, colds, norovirus, and other stomach viruses is to have students wash their hands with soap and water for 20 seconds several times throughout the day. See the Centers for Disease Control and Prevention (CDC) website at for good resources on hand washing and cleaning surface areas.

Common Health Issues = Non-Emergencies That Need the School Nurse’s Involvement

Many things do not need the immediate attention of the school nurse, especially when more urgent needs arise. Minor headaches, stomach complaints, insect bites, hangnails, pinkeye, and skin rashes—while bothersome and sometimes mildly contagious—do not always require immediate action.

Now, About the Head Lice . . .

The latest recommendations for head lice do not require exclusion from school. The American Academy of Pediatrics (AAP), the CDC, and the National Association of School Nurses (NASN) all discourage no-nit policies in schools. Recent scientific evidence supports allowing students to be in school even with head lice. By the time lice are noticed, the student may have had them for a couple months. Head lice are rarely passed at school. The school nurse should be used as a resource in helping families get the proper diagnosis and treatment, along with the family’s physician, but not in the role of “The Head Lice Police.” For additional, current information about head lice, refer to (AAP), (CDC), or http://bit. Ly/29sfPdX for position statements on head lice and many other issues from NASN.

The school nurse serves the student in many roles. As a teacher, your school nurse will be an educator, a caregiver, and a medical expert—which makes her an invaluable resource!

Mrs. Prasser is a Registered Nurse who works in an elementary school in Crawfordsville, Indiana. Before taking that position, Leisa worked in public health at both the local and state levels. She has a background in public health preparedness and pediatrics and is President of the Indiana Association of School Nurses.

For more information about working with your school nurse, watch the webcast “Providing Healthcare in Schools: The Role of the School Nurse” presented by Leisa Prasser, which can be found in the KDP Resources Catalog at KDPResourcesCatalog