“I’m a teacher, Jim, not a doctor!”

January 14, 2015 Ian Stewardson

Co-ordination the key to providing for complex medical needs

Over the past couple of years teachers have been expressing a growing concern about the pressure they feel to meet the variety of medical needs of students. Inclusion is a concept that the Alberta Teachers’ Association encourages for the growth of all students. However, dealing with the range of medical needs that exists among a school’s student population is complex. Epilepsy, oppositional defiant disorder, attention deficit disorder, diabetes, asthma and anaphylaxis allergic reactions are but some examples of the conditions that school environments must be equipped to handle, not to mention the social and emotional needs that accompany these conditions. The inherent complexity involved must be carefully considered when developing and sustaining programming — it’s essential that a co-ordinated approach be employed in providing for these students.

Section 8 of the School Act states that every child of school age “is entitled to have access … to an education program.” Section 13(1) of the act stipulates that children between the ages of 6 and 16 “shall attend school.” One implication of these provisions is that children with medical needs are entitled to attend school. Another is that school boards (and probably principals) are obligated to meet the medical needs of these children so that they can attend school and be successful.

It is essential to provide a safe place for children with medical needs. The obligation to provide this safe place is distributed among a variety of people and positions, including school boards together with principals, teachers and support staff. The principal has an obligation to organize teaching and support staff in such a way that medical care is available if a student requires it or if an emergency arises.

Teachers assigned to work with groups of students should not provide medication or treatment to one student while abandoning the other students under their care. It comes down to a question of liability. When teaching a student in a classroom and/or leading a school, teachers face many demands and must follow schedules. Consequently, ensuring a consistent regimen of medication from teachers or administrators can be very difficult. A far superior solution is to assign support staff to distribute, supervise and record the administration of medication as prescribed by the family physician.

It will also be essential for the person with the task of supervising this treatment to have adequate training and an understanding of the symptoms and issues related to the condition or the course of medication.

Effective responses to students with medical needs include educating all staff of possible signs and symptoms of the variety of diseases that students may bring with them to school. There are community agencies that will be more than willing to assist with a professional development day in order to brief staff members. If there is a regular substitute or guest teacher, it would be wise to include that person in the medical sessions.

It is common in staff rooms and offices to post images of students with an outline of the medical condition and the signs of a reaction or episode. These kind of notes should also be left as regular parts of a substitute or guest teacher roster and plans.

Individual program planning can identify different responses for low intensity to high intensity interventions. The advice is to provide the supports that are necessary and revisit plans regularly if there are changes to treatments.

A team approach to providing effective care can limit the concern and worry about meeting students’ needs. Through effective entry meetings with students and parents, expectations can be clearly defined and all forms and policies can be reviewed. Parents can share relevant information and describe the symptoms that would indicate that their child is experiencing a medical situation. If the student is moving grades, the previous teacher and support staff can also be excellent resources. An emergency contact will be a key member of the team as well.

Even with all of the best plans and training, there are times when it is necessary for a teacher or administrator to identify concerns regarding their liability if there are specific unmet needs. Examples of such include time restrictions for essential medical care or severity of responses to allergens. A teacher/administrator must voice these types of liability concerns in writing to the administrator or board levels, and the protest must include the clause, “The writer refuses to accept liability for unsafe conditions resulting from the directives of others.” The clarity of this statement is essential to protect the teacher/administrator.

The advice in this article is like most of the advice that Member Services gives — it is contextual. There are many nuances and complexities that would include the kinds of therapies to the responses from the student and family. Therefore, contacting us with concerns will assist us in meeting the teacher’s or administrator’s needs.

Ian Stewardson is an executive staff officer at the Southern Alberta Regional Office (SARO) of the Alberta Teachers’ Association. 

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