collaboration school counselor & school nurse teaming...

Teaming Up: School Counselor & School Nurse

Collaboration

Paige Schillig Ed. S., LPC & Jennie Olson BSN, RN

During this presentation, we will cover...

❏ School Nurse & School Counselor History❏ School Counselor and School Nurse Collaboration Model❏ Multi-Tiered, Multi-Domained Systems of Supports (MTMDSS) Overview❏ MTMDSS Tiers (Collaboration Steps 3 & 4)❏ School Counselor + School Nurse Collaboration

School Nurse & School Counselor History

Lina Rogers, 1902

School Nurse History

Start of School Nursing• Lina Rogers

• 1902: One month experiment where Lina Rogers, RN provided nursing services in the school setting

• 10,000 to 1 ratio• Drastic drop in absenteeism

• Interventions• Band aid fixes (small bites, cuts, etc.)• Disabilities (vision, hearing)• Contagious conditions (educate hygiene &

prevention)• Barriers (provided food, clothing)

• Within 6 months, absenteeism fell by 90%• School board agreed to supply funds for 27 nurses. • Close to 400 nurses in schools of NYC by 1914

THEN

School Nurse History

• Recommended Student to School Nurse Ratio: 1:750 (National Association for School Nurses)

• Mental Health concerns occupy up to 35% of school nurses’ time (Cogan & Kiefner, 2019)

NOW

School Counselor History

Start of School Counseling• Jesse B. Davis

• Late 1800s & early 1900s: 1st to implement a systematic guidance program in the schools

• Detroit & Grand Rapids public schools• 1960s began shift from primary focus of careers to

include personal & social concerns• 1998: first systemic meta-analysis of school

counseling was published with outcome research• 2014-15: 1:347 average Missouri student to school

counselor ratio

THEN

School Counselor History

• Recommended Student to School Counselor Ratio: 1:250 (American School Counselor Association)NOW

School Nurse & School Counselor

Collaboration Model

School Nurse & School Counselor Collaboration Model

(Tuttle, Yordy, Appling, & Hanley, 2018)

School Nurse & School Counselor Collaboration Model: Step 1

Step 1: Mutual Understanding of Professional Role in School Setting● Schedule an initial meeting to discuss

○ Professional training○ Job roles and parameters○ Areas to provide support to school, staff, and students○ Mandated reporting ○ Identify areas of collaboration

School Nurse & School Counselor Collaboration Model: Step 2

Step 2: Respect for Ethical Considerations ● Discuss ethical guidelines and limitations of sharing during collaboration

○ ASCA ethical standards○ NASN code of ethics

■ HIPAA■ FERPA

○ Maintain confidentiality

School Nurse & School Counselor Collaboration Model: Step 3

Step 3: Establishing Guidelines for Collaboration● Identify how the school counselor and school nurse can work together to best

support all students● Know when nursing initiatives are on calendar (ie-vision, hearing)● Distinguish between each role in certain situations

School Nurse & School Counselor Collaboration Model: Step 4

Step 4: Ongoing Communication and Consultation● Ensures continuity of care

○ Assess progress over time○ Maintain professional boundaries○ Prevents disruption of services to student

● Create intentional plan for ongoing communication and consultation which includes an action plan for follow up

Multi-Tiered, Multi-Domained

Systems of Support (MTMDSS)

Multi-Tiered, Multi-Domained Systems of Support

(Hatch, Triplett, Duarte, & Gomez, 2019)

MTMDSS Overview

Tier 1: Core Program (Universal Supports; 100% of students)● District Core Curriculum● Individual Student Planning 6-12● District/Schoolwide Programs and Activities

Tier 2: Targeted Interventions (Some Students; 20% of students)● Small Groups/Individual/Referral to Resources● Consultation/Collaboration

Tier 3: Intensive Interventions (Few Students; 5-10% of students)● Referral to Resources● Individual Counseling

Common Goals & Framework

Common Goals & Framework

Positively Influence● Attendance● Behaviors (discipline)● Academics

MTMDSS Tiers within Collaboration Steps 3 & 4

MTMDSS Tier 1 within Collaboration Model

District Core Curriculum● School Nurse

○ Role of Health Educator○ Develop & promote health program initiatives

■ Healthy eating■ Hygiene■ Alcohol & Drugs■ Vaping■ Dental health

● School Counselor○ GLEs

MTMDSS Tier 1 within Collaboration Model

Individual Student Planning● School Nurse

○ Technical Centers● School Counselor

○ Middle School■ Career Clusters & Paths

○ High School■ Registration■ Senior Interviews

MTMDSS Tier 1 within Collaboration Model

District/Schoolwide Programs and Activities● School Nurse

○ Screenings■ Hearing■ Vision■ Scoliosis

● School Counselor○ Screenings & Prevention

■ Suicide■ Bullying

● Crisis & Disaster Plans

MTMDSS Tier 1 within Collaboration Model

Advisory Committee● School Nurses are required to have an Advisory Committee as a part of a

“Coordinated School Health Program” ● Consider having School Nurse as part of Counseling School Advisory and vice

versa

MTMDSS Tier 1 within Collaboration Model

Utilize School Nurse Data ● Youth Risk Behavior Survey (DESE, odd years, 9-12)

○ Tobacco use○ Unhealthy physical activity○ Alcohol and other drug use○ Sexual behaviors○ Behaviors that may result in intentioinal injuries (violence & suicide) and

unintentional injuries (motor vehicle crashes)● School Health Index tool

○ Similar info as above

MTMDSS Tier 1 within Collaboration Model

Utilize School Nurse Data (continued)● Department of Health & Senior Services local/county & state data

○ https://health.mo.gov/living/families/schoolhealth/pdf/SHCNSurveyForm.pdf

MTMDSS Tier 2 within Collaboration Model

Group Counseling/Activities● School Nurse● School Counselor

○ Small Groups■ Mental health specific: depression, anxiety, etc.■ Anger management■ Conflict resolution■ Impulse control

Consultation & Collaboration● School Nurse● School Counselor

MTMDSS Tier 3 within Collaboration Model

Referral to Resources● School Nurse

○ Resource Coordinator■ Chronic Illnesses■ Food Scarcity■ Dental Services■ Vision Services

● School Counselor○ Resources

■ Therapy■ Psychiatry■ Substance Abuse Services

MTMDSS Tier 3 within Collaboration Model

Individual Counseling/Activities● School Nurse: Advocate & Mentor

○ Teenage pregnancy○ Abuse/neglect○ Chronic clinic visits○ Anxiety○ Hygiene○ Educational planning

■ Homebound services■ 504 accommodations■ Schedules & changes

● School Counselor: Counseling○ Mental health concerns○ Reentry into school setting○ Interdisciplinary team

■ Scheduled weekly check-ins with interdisciplinary team to discuss students who have been identified as needing additional support

■ Gauge student referrals, visits, and questionable incidents

School Nurse + School Counselor

Improvements in…● Physical health● Mental health● Additional data needed:

○ Attendance○ Behaviors (discipline)○ Academics

Thank you!Paige Schillig

schilllip@platteco.k12.mo.us

Jennie Olsonolsonj@platteco.k12.mo.us

References

American School Counselor Association, & National Association for College Admission Counseling. (2015). State-by-state student-to-counselor ratio report 10-year trends. Retrieved from https://www.schoolcounselor.org/asca/media/asca/Publications/ratioreport.pdf.

“ASCA Ethical Standards for School Counselors.” American School Counselor Association, 2016. https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf.

Cogan, R., & Kiefner, J. (2019). Complementary collaborators: school counselors and school nurses. ASCA School Counselor, 57(1).

Hanink, E. (n.d.). Lina Rogers, the first school nurse providing healthcare to keep kids in school. Retrieved from https://www.workingnurse.com/articles/lina-rogers-the-first-school-nurse.

Hatch, T., Triplett, W., Duarte, D., & Gomez, V. (2019). Hatching results for secondary school counseling: implementing core curriculum, individual student planning, and other tier one activities. Thousand Oaks, CA: Corwin.

Maughan, E., & Troup, K. D. (2011). The Integration of Counseling and Nursing Services into Schools. The Journal of School Nursing, 27(4), 293–303. doi: 10.1177/1059840511407778 Retrieved from https://journals.sagepub.com/doi/abs/10.1177/1059840511407778?journalCode=jsnb

Missouri Department of Elementary and Secondary Education. (2014, June). Manual for School Health Programs. Retrieved from https://health.mo.gov/living/families/schoolhealth/pdf/ManualForSchoolHealth.pdf.

“National Association of School Nurses Code of Ethics.” National Association of School Nurses, June 28, 2016. https://www.nasn.org/nasn-resources/professional-topics/codeofethics.

Pope, M. (2009). Jesse Buttrick Davis (1871-1955): Pioneer of Vocational Guidance in the Schools. The Career Development Quarterly, 57(3), 248–258. doi: 10.1002/j.2161-0045.2009.tb00110.x Retrieved from https://eric.ed.gov/?id=EJ863872

Sloop, K. (2014, December 17). The reality of school nurse-to-student ratios In independent schools. Retrieved from https://web.magnushealth.com/insights/school-nurse-to-student-ratios-in-independent-schools.

Tuttle, M., Yordy, M., Appling, B., & Hanley, E. (2018). School counselor and school nurse collaboration: partnering for K-12 student success. Journal of School Counseling, 16(4). Retrieved from https://eric.ed.gov/?id=EJ1181068