SUMMARY
It is the position of the National Association of School Nurses that the professional school nurse, following federal, state and local laws, be involved in the development of school policy and procedures related to school health nursing services provided on field trips and school-sponsored overnight trips. A comprehensive policy should address the following:
Utilization of the Nursing Assessment
Accommodations as specified in the Individualized Health Plan (IHP)
Emergency Action Plans
Availability of trained staff to provide healthcare services
Legal and safe delegation of nursing services if allowed
Documentation and confidentiality of student information
Reasonable accommodations for students with special health care needs
Options for cancellation or alteration of the trip if all students cannot be reasonably accommodated
School nurses who accompany students on out-of-state field trips must comply with state-specific nursing and education regulations from the state in which they reside and are licensed (Pohlman, 2001).
HISTORY
Field trips or school-sponsored overnight trips are offered by schools to enhance the educational experience of students. A trip may be a visit to the planetarium, an overnight trip to a major city, or an overseas trip to Europe. There continues to be an increased number of students with health conditions that require nursing services in order to attend school. Therefore, it is imperative that school districts develop policies and procedures in order to provide for the safe provision of health services for students while they are away from school buildings for school-sponsored activities.
DESCRIPTION OF ISSUE
Every student is entitled to participate in all educational programs even if unique accommodations are needed to meet her/his healthcare needs. The school district has a legal responsibility to make all activities and programs accessible to every student by providing necessary health services that enable students to safely participate. To deny a student the right to participate in extracurricular activities or field trips discriminates against the student. Section 504 of the Rehabilitation Act of 1973 requires that an individual with a recognized disability should not be excluded from participating in any extracurricular activity (Schwab & Gelfman, 2001). Parents can be invited to accompany their children on field trips, but the school district cannot require that a parent attend the trip as a condition of a student’s participation. The school district must provide a competent staff person to safely provide the care the student needs and, in some cases, this may mean a nurse must attend the event.
RATIONALE
Students with special healthcare needs must be accommodated to ensure their full participation in the educational experience of a field trip. Arrangements must be made with the school nurse in sufficient time prior to the trip so that the need for accommodations can be assessed, adherence to the IHP can be insured, training of district staff is completed, and proper emergency care for the students can be addressed. Delegation of healthcare tasks by the nurse may occur if allowed by the state nurse practice act and appropriate for the particular student using professional standards of care. If it is determined that reasonable accommodations of the student cannot be provided, the trip may need to be altered or even cancelled.
References/Resources:
American Academy of Pediatrics, Council on School Health (AAP/COSH). (Winter/Spring 1998). The school health road show: Field trips and school policy. School Health Resources. Retrieved January 16, 2006, from http://www.schoolhealth.org/article.cfm?contentID=46.
Pohlman, K. J. (2001). Legal framework and financial accountability for school nursing practice. In M. Gelfman & N. Schwab (Eds), Legal issues in school health services: A resource for school administrators, school attorneys, and school nurses. (pp 99-101). North Branch, MN: Sunrise River Press.
Schwab, N., Gelfman, M. (2001). Discrimination in school: 504, ADA, and Title IX. In M. Gelfman & N. Schwab (Eds.), Legal issues in school health services: A resource for school administrators, school attorneys, and school nurses (pp. 335-371). North Branch, MN: Sunrise River Press.
U.S. Department of Education. (1998, August). Student placement in elementary and secondary schools and Section 504 and Title II of the Americans with Disabilities Act. Washington, DC: Office for Civil Rights (OCR). Retrieved January 16, 2006, from http://www.ed.gov/about/offices/list/ocr/docs/placpub.html.
Out-of-School Education: Field Trips and Camps:
Adopted: June 2000
Revised: April 2006