School Nurse Services

It is recommended that, if your student has been diagnosed with asthma and requires the use of an asthma rescue medication, parents/guardians submit metered dose inhalers or albuterol vials for the school nurse to administer based on physician’s orders. Each school clinic has a nebulizer to administer these medications, if needed. Please plan to provide a mask and tubing along with a current prescription to your school nurse upon submitting the vials to the nurse. 

Metered dose inhalers will accompany students on field trips if submitted to the school nurse. 

Nurses will administer medications for asthma according to the order/prescription from the physician. Nurses can only give medication as indicated on the label.  If after the second dose of medication the student’s symptoms are not improving, the parent/guardian will be contacted to pick up the student from school.

All prescription medication must be in the original labeled pharmacy container with written healthcare provider request for administration including: student name, medication name, qualified healthcare professional name, dosage and route of administration, date, time or indication of administration.

No student in the Thomas County School System shall be permitted to self-carry any type of medication without a parent/guardian and the student’s physician having signed the Written Authorization for Self-Administration of Medication by Minor Children at School.

If a parent or guardian wishes for their student to self-carry their medication, please complete and submit this form to your school’s nurse. 

self-carry consent form

Medication authorization form

sample asthma action plan

Each school year, parents/guardians should complete the student’s Clinic Card at the start of the year or at the time of enrollment. This card may be provided during Open Houses or sent home during the first week of school. The Clinic Card provides important information including the students allergies, medications, and medical conditions. In the case of serious illness or accident the school nurse is authorized to provide this important information to Emergency Medical Services. Clinic Card information must be as accurate and up to date as possible. Parents/Guardians are responsible for reporting changes to the Clinic Card directly to the school nurse via telephone call or written letter. 

If you need a new Clinic Card, please contact your school’s nurse.

School employees shall be alert for signs of illness and communicable disease and shall refer students showing such symptoms to the school nurse. Guidelines from the Georgia Department of Public Health on communicable disease surveillance and reporting will be observed. A school nurse may request written documentation from the student’s health care provider that the student is free from disease or is under treatment that prevents contagion, and is eligible to return to class. 

All communicable diseases of students or staff occuring in the schools including but not limited to chickenpox, scarlet fever, measles, whooping cough,meningitis and TB must be reported to the school nurse, who is required by law to report to the local Health Department. 

Staff members or parents/guardians who become aware of a communicable disease in their classroom or home are required to notify the school nurse as soon as possible. 

The school nurse will communicate with the parents/guardians and work with the Thomas County Health Department to determine when the student is able to safely return to the classroom.

Thomas County School Nurses are skilled in the care of students with diabetes. Our school nurses perform functions including, but not limited to, responding to blood glucose levels that are outside of the student's target range; administering glucagon; administering insulin, or assisting a student in administering insulin through the insulin delivery system the student uses; providing oral diabetes medications; checking and recording blood glucose levels and ketone levels, or assisting a student with such checking and recording; and following instructions regarding meals, snacks, and physical activity. 

School nurses should be made aware of students with diabetes in schools. It is suggested that parents/guardians arrange to meet with your student’s school nurse prior to the start of the school to discuss the student’s Diabetes Medical Management Plan (DMMP). 

The parent or guardian of each student with diabetes who seeks diabetes care while at school shall submit to the school a DMMP, which shall be reviewed and implemented by the school upon receipt. The school district is required by Georgia state law, O.C.G.A. § 20-2-779, to follow a written DMMP completed by the student’s healthcare provider. DMMPs must be renewed at the start of each school year. Please plan to have your student’s DMMP completed by their physician prior to the start of school. Nurses will be unable to administer medications, insulin, or otherwise provide nursing services to the student without the physician’s orders as indicated on the DMMP.

Necessary Components of the DMMP:

A DMMP shall be signed by a health care professional or a certified diabetes educator (once a health care professional has signed the initial plan) and the student’s parent or guardian. A DMMP should include the dosage, delivery system, and schedule for blood glucose monitoring; insulin/medication administration; glucagon administration; ketone monitoring schedule and amounts of meals and snacks; physical activity and instructions to address blood glucose levels; the symptoms of hypoglycemia and hyperglycemia and their recognition and treatment; emergency contact information; and address the student’s level of self-care and management. 

A DMMP should be completed and submitted to the school annually or when changes are made by the student’s health care professional.

Parents/guardians are responsible for supplying all necessary supplies including but not limited to glucometers, ketone strips, Glucagon, hypoglycemia snacks/glucose to the school. 

All school nurses have a system-issued device to monitor Continuous Glucose Monitors (CGM) for students, if the parents/guardians request it. Please contact your school nurse for further information. 

If a student is to self-carry their Glucagon OR Insulin Pump with responsibility to self-dose with insulin, a Self-Carry Consent Form is required to be submitted.

In accordance with AJ’s Law/Senate Bill 45, Seizure Action Plans (SAP) are required to be renewed and signed by the student's neurologist (or the physician prescribing the seizure rescue medication) at the beginning of each school year and submitted with the student’s seizure rescue medication. Seizure rescue medication can not be accepted without a physician signed and up to date Seizure Action Plan. A new Seizure Action Plan must be provided if there is any change in the student’s seizure type, change in medication or dosage, or any other change regarding the seizure disorder. In the absence of a submitted and reviewed SAP, school personnel are authorized to initiate emergency procedures, which include contacting emergency medical services (911) in the event of a seizure on campus.

All prescription medication must be in the original labeled pharmacy container with a written healthcare provider request for administration including: student name, medication name, qualified healthcare professional name, dosage and route of administration, date, time or indication of administration. 

The school nurse is required to strictly adhere to the prescribing information on the prescription label  and is unable to administer medication in any way other than that indicated on the label without a new written prescription from the healthcare provider.

Further information regarding the requirements for seizure monitoring in schools: https://www.legis.ga.gov/api/legislation/document/20232024/217212 

Sample seizure action plan

Medication authorization form

The following guidelines have been established regarding exclusion and readmission to school due to illness in an attempt to reduce the spread of illness within the school system. 

1. Diarrhea or Watery Stools
   1. Students will be sent home from school for:
      1. More than one episode of diarrhea occurring during the school day. 
      2. One episode of diarrhea with other symptoms present (e.g. fever, abdominal pain, vomiting).
      3. If they have soiled themselves or their clothing.
   2. Students will not be dismissed to the bus and parents/guardians will be notified for prompt pick up.
   3. Students may return to school 24 hours after the last diarrhea stool if they have no other symptoms present. 
2. Vomiting
   1. Students will be sent home from school for:
      1. More than one episode of vomiting during the school day.
      2. One episode of vomiting with other symptoms present (e.g. fever, abdominal pain, diarrhea).
   2. Students will not be dismissed to the bus and parents/guardians will be notified for prompt pick up.
   3. Students may return to school 24 hours after the last vomiting episode if they have no other symptoms present. 
3. Fever
   1. Students will be sent home from school for:
      1. A temperature obtained by the school nurse’s thermometer reading over 100.3.
   2. Students will not be dismissed to the bus and parents/guardians will be notified for prompt pick up.
   3. Students may not return to school until free of fever for at least 24 hours WITHOUT the use of medication.
4. Drainage
   1. It is not necessary to exclude every student from school who has drainage from the nose, eye, ear or open sore. 
   2. Exclusion from school will be at the discretion of the school nurse, and/or the principal based on the following criteria:
      1. Color of discharge
      2. Student’s personal hygiene skills and need for assistance
      3. Classroom setting
      4. Additional symptoms present 
5. Head Lice, Fleas, Bedbugs
   1. Students will be sent home for: 
      1. Any live lice, fleas or bedbugs found on the student or their belongings. 
   2. Parents/Guardians should remove the insects in a manner of their choosing. 
   3. Students will receive one excused absence day to have the lice or fleas removed. Further absences beyond one day will be considered unexcused. 
   4. Students will not be permitted to ride the school bus or return to the classroom until the school nurse has re-checked the student to ensure they are clear of lice, fleas, or bedbugs. A parent/guardian or their designee will accompany the student for the re-check with the school nurse.
6. Rashes
   1. Exclusion from school will be at the discretion of the school nurse if there is a possibility that the rash is a sign of a contagious illness. 
   2. Students may be sent home with a Skin Clearance Letter at the discretion of the school nurse. This letter must be signed by a physician, NP, or PA after the student is seen for the rash. This letter must be returned to the school nurse before the student is readmitted to school.
7. Pink Eye
   1. Students will be sent home for:
      1. Redness of the whites of the eyes, drainage from the eyes, swelling of the eyelids. 
   2. Students should see their physician and, if pink eye is diagnosed, students may return to school after 24 hours of treatment.

Students entering Thomas County School System for the first time, whether at Kindergarten or through transfer from another school system, will be required to present an immunization certificate, a medical exemption form, or a religious exemption form. 

Each certificate must: 

1. Be signed by a physician, APRN, or PA licensed in Georgia. 
2. Include the printed, typed, or stamped name and address of the physician, APRN, PA, health department, or Georgia Registry of Immunization Transactions and Services (GRITS) issuing the certificate.
3. Have a complete date of issue AND expiration date (Month, Day, and Year)

All immunization certificates with an expiration date must be replaced no later than 30 days after the expiration date. 

Students whose immunization certificates have expired past the 30 day waiver period cannot be allowed to attend school until a current certificate is submitted.

Georgia Immunization Requirements for Child Care & School Attendance: https://www.gritstest.state.ga.us/docs/Summarychart3231REQ_rev01232014.pdf

Additional Immunization Requirements

1. 7th grade- All students who are entering 7th grade OR are new entrants into a Georgia school between the grades of 8 and 12 must have received 1 dose of the TDAP vaccine and 1 dose of the Meningococcal Conjugate vaccine prior to the start of 7th grade. Please make arrangements to have your rising 7th grader receive these vaccines prior to the first day of 7th grade.
2. 11th grade- All students entering or transferring into 11th grade will need to provide proof of a meningococcal booster shot (MCV4). Please make arrangements for your rising 11th grader to receive this vaccine prior to the first day of 11th grade.

*Georgia Law requires that students be vaccinated against these diseases unless they have an exemption.

Many students have allergies that require the use of epinephrine (Brand: EpiPen). If your child requires epinephrine to use in the event of an anaphylactic reaction, it is highly recommended that you submit a current epinephrine prescription to your school nurse along with an Allergy Action Plan signed by the physician. Allergy Action Plans must be renewed each school year. With the epinephrine stored at school, school nurses and other trained staff members are able to administer the medication to the student in case of anaphylaxis and send the epinephrine on field trips with a staff member who has been instructed on the use of it. 

All prescription medication must be in the original labeled pharmacy container with written healthcare provider request for administration including: student name, medication name, qualified healthcare professional name, dosage and route of administration, date, time or indication of administration. 

No student in the Thomas County School System shall be permitted to self-carry any type of medication without a parent/guardian and the student’s physician having signed the Written Authorization for Self-Administration of Medication by Minor Children at School.

For more information, please contact your school’s nurse.

Benadryl (Diphenhydramine) can not be administered at school except in case of emergency. After administration, the student will be required to be picked up from school in a timely manner.

Self-administration form

Medication authorization form

sample allergy plan

Whenever possible, medications should be administered at home before or after school.  If scheduled medication administration at school is medically necessary for the student’s health, safety and optimal learning, a parent/guardian may submit the medication to the school nurse. Authorization for Medication Administration forms will be submitted to the school nurse at that time. Only parents/guardians are authorized to request medication administration at school.

Only the school nurse is authorized to administer medications to a student. Teachers and staff members are not permitted to administer, store, or transport medications for students with the exception of off-campus trips.

Prescription Requirements

All prescription medication must be in the original labeled pharmacy container with a written healthcare provider request for administration during the school day including: student name, medication name, qualified healthcare professional name, dosage and route of administration, date, time or indication of administration. Nurses are unable to administer medication in any way other than that indicated on the prescription label or on a signed order from the physician.

Medication should never be transported to school by a student.

Staff members responsible for the administration of medications on field trips will be trained in the proper administration of each type of medication. 

End of Year/Medication Pick Up

All medication remaining at the end of the school year should be picked up by the parent or guardian. If a parent/guardian requests that another individual pick up the medication, the school nurse must be notified prior. Medication may not be released to anyone but the parent/guardian or their designee.  All medications not picked up by the last day of school will be destroyed as they can not be stored over the summer break.

Refills

It is the responsibility of the parent/guardian to ensure that medications refills are supplied to the school nurse in a timely manner and that medication doses are not missed. 

If a change occurs with the student’s medication, it is the responsibility of the parent/guardian to immediately notify the school nurse. 

Non-Prescription/Over-The-Counter Medication

Non-prescription medications requested by the parent/guardian to be given on a scheduled basis will require a health care provider order if the medication is to be given for more than one school week. 

Self-Carry Medications

No student in Thomas County School System is permitted to self-carry any medication with the exception of asthma inhalers, single-dose epinephrine pens, insulin pumps, or digestive enzymes for Cystic Fibrosis. If a student needs to carry one of these medications with them at any time during the school day, parents/guardians and the physician must complete and submit the Self-Carry Authorization form to the school nurse.

Self-carry consent form

Some students need special procedures that are required/physician ordered to take place during the school day. All procedures (e.g. gastrostomy feedings, special nutritional needs, catheterizations) will require physician orders. 

Parents/guardians will be required to provide all supplies necessary for the procedure to take place. 

For gastrostomy feedings taking place in school, a new feeding order form will be required at the start of each school year and as any changes take place throughout the year. Please plan to have your student’s physician complete these prior to the first day of school. 

Please contact your school nurse for further questions.

G Tube feeding orders

Diet order form

authorization for management of clean intermittent catherization