School Nursing

In light of the current Coronavirus pandemic, the way we deliver care through our School Nursing Service is changing. Read more information about this adapted service.

School nurses are specialised qualified experienced professionals that work across health and education boundaries. 

They work with individual children, young people and families, schools and communities to improve health. 

They also provide the link between school, home and the community. They are supported with a team of Registered Nurses and Health Care Support Workers.

School Nursing contact details

 

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Accidents are a leading cause of death and serious injury for children and young people, with many of these accidents being preventable.

The Child Accident Prevention Trust believe that:
 “Accident prevention is not about restricting children or wrapping them up in cotton wool, instead it is about creating safer environments, both in the home and elsewhere, to enable children to thrive and lead a healthy active life.”
 
Children need to explore, experiment and begin to take risks as they grow-up and learn about the world they live in. In time they begin to get better at judging risks but they can sometimes over-estimate their ability and as they gain more independence they begin to challenge things that adults tell them.
 
There are lots of things you can do to help prevent accidents. Check our related information and useful websites for top tips on keeping children safe.

The term Adverse Childhood Experiences (ACEs) is used to describe a wide range of traumatic events that children can be exposed to while growing up but that are remembered throughout adulthood.
 
These include neglect and physical, verbal and sexual abuse along with harms that affect the environment in which the child lives such as exposure to domestic violence, family breakdown, and living in a home affected by substance abuse, mental illness or criminal behaviour.

 
Watch this short video on the Public Health Wales website to gain more information.

Alcohol

Alcohol is considered to be a drug because, when taken into the body, it changes how you feel, think or behave. A drug is any substance that, when taken into the body, does this. When the way a person feels, think and behaves has been changed by alcohol, the new way they feel is called being ‘intoxicated’ or ‘drunk.’

Asthma affects the airways (the small breathing tubes) that carry air in and out of the lungs. Children and young people with asthma have airways that are more sensitive than normal. Although there is no cure for asthma there are effective treatments that can be used to control the symptoms.

If your child has asthma it is important that you speak to your child's teacher so that they are aware of how their asthma can affect them and that they have information about the medication that they need to take. It is essential that your child has their own reliever inhaler and spacer in school so that they can take it when they need it.

“People with Autism or Asperger syndrome may appear to behave unusually. There will generally be a reason for this: it can be an attempt to communicate, or a way of coping with a particular situation.” The National Autistic Society

Bedwetting

Any child over the age of five can be considered to have night time wetting issues if the occurrence rate is more than two episodes a week. Within ABUHB we have a school nurse led enuresis service for children over seven years old, that can be accessed through a GP referral should you require additional support.
 

Daytime Wetting

Daytime wetting can occur due to a number of reasons and therefore, it is important to seek help or advice to resolve the problem.
Causes can sometimes include:
 
  • constipation – when the bowel is over full, it can press on the bladder, causing it to leak urine into underwear
  • bladder infections
  • an overactive bladder
  • stress or anxiety
     
Your GP will be able to check whether your child has an infection or another cause for their wetting.



Constipation and/or soiling

Constipation and soiling can cause children and their family’s considerable stress, however it can be easily treated.
 
A child is considered to be constipated if they poo less than 3 times a week, however, every child is different and some need to go more frequently than others. Some children find passing the poo/stool painful and distressing and stools appear hard and pellet like.
 
Causes can sometimes include:
  • Poor diet or fluid intake
  • Medication
  • Illness
  • Avoidance or withholding a stool
  • Anxiety due to pain.
 
If your child has constipation it is important that they are seen by their GP.
 
Soiling is usually a symptom of constipation and requires treatment to remove the hardened poo in the bowel and to keep the bowel clear. It can also be simply be caused by inadequate wiping after using the toilet.
 

 

How can we help

School Nurses can:
 
  • Offer support and advice to school age children and young people who have daytime wetting or soiling
  • Offer advice to school staff  to manage a child’s continence difficulty in school
  • Refer children and young people to specialist continence clinics (in some areas) or to their GP if necessary.

If you are concerned about a child or young person with an acute illness please contact your GP, or call NHS Direct Wales 

Most children have common childhood illnesses at some point.
 
 

Should I send my child to school today?

When your child is unwell it can be hard deciding whether to keep them off school. Not every illness will prevent a child from attending school. For guidance around whether your child should go to school you may find it helpful to visit the NHS Choices page "Should my child go to school today?"
 
Some infectious illnesses will result in a child not being able to attend school for a short period of time.
 
The Health Protection Agency (HPA) has lots of useful information on common infectious diseases including the length of time before a child can return to school after an infectious illness. 
 

 

Designed to Smile is a national oral health improvement programme to improve the dental health of children in Wales. This programme involves the delivery of School/ Nursery based tooth brushing and fluoride vanish programmes for children aged 3-5 helping establish good habits early on. Also children aged 6-11 will receive a Fissure Sealant programme as well as preventative advice on how to look after their oral health.

 
Daily brushing of your teeth is important because it removes plaque. If the plaque is not removed, it continues to build up, feeding on the bits of food left behind causing tooth decay and gum disease.
 


Advice for Families

  • Brush teeth twice daily for two minutes ( morning and at bedtime)
  • Babies should have their teeth cleaned as soon as teeth appear in their mouth
  • Children over 3 should use a pea sized amount of toothpaste containing 1350- 1500 parts per million (ppm) This can be found on the ingredients on the tube
  • Spit out excess toothpaste but do not rinse. Rinsing with water after tooth brushing will wash away the fluoride and make it less effective
  • Supervise tooth brushing until your child is 7 or 8 years to ensure they are brushing their teeth properly and for about 2 minutes
  • Try and limit sugar containing foods and drinks to mealtimes and not between meals.
  • Ensure your child has a healthy snacks and drinks, choose nutritious foods such as plain yogurt, cheese, fruit or raw vegetables. Vegetables such as celery, help remove food and help saliva neutralise plaque causing acids.
  • Visit a dentist at least once a year. NHS dental care is FREE

You may be curious about drugs and/or feel pressured by friends to try drugs.

 
STOP and THINK as drug use can be harmful to your health. Use our links to find out the facts so that you can make sensible choices.
 
Not all drugs are illegal, but that doesn’t mean that they aren’t harmful. For example, tobacco and alcohol can seriously damage your health. Recently new “legal highs” have been developed to mimic the effects of illegal drugs such as cannabis and ecstasy. These are structured differently enough to avoid being classed as illegal substances under the Misuse of Drugs Act. However, they can still have dangerous side effects. The Misuse of Drugs Act separates illegal drugs into 3 categories:
 
  • Class A eg heroin and ecstasy
  • Class B eg cannabis and amphetamines
  • Class C eg anabolic steroids and benzodiazapines (tranquillisers)
 
Some drugs can be used for beneficial reasons such as prescribed drugs but all drugs can have negative side effects.
 
If you are worried or concerned about drugs either for yourself or someone you know, talk to someone you can trust- this could be your School Nurse, someone at school; home or your GP.

Good mental health enables children and young people to lead happier lives, find it easier to learn, enjoy friendships and ultimately fulfil their potential.

The emotional wellbeing of children is just as important as their physical health. Good mental health allows children and young people to develop the resilience to cope with whatever life throws at them and grow into well-rounded, healthy adults. (Mental Health Foundation 2016)

Childhood, and the transition into a becoming an adult, can often be a challenging time. Young people today can face stressful situations and unfamiliar challenges such as; exams, new relationships and the impact of social media. Many young people feel confused and unsure how to express how they are feeling and where to get help.

Most people experience low moods, from time to time. Occasionally, these feelings may become more intense and may start to impact on their day-to-day lives.    

Your GP or School Nurse will also be able to provide you with further advice on referrals to specialist services and local agencies. If you are worried about your child’s emotional or mental health please speak to your GP.

 

 

It's best to introduce the topic of puberty to your child as young as you are comfortable with, so they know about it before they start developing and may worry about their changing bodies physically and emotionally. Let your child know you’re always happy to answer any questions they have or if they prefer suggest they talk to another family member or trusted adult - maybe an older brother or sister. Children will get information whether it is from the TV, magazines or friends, however this information may be confusing or may be not be accurate.

Ask your child’s class teacher about the lessons they will have on this topic and when they will happen. You can tailor your talk based on what they will learn/have already. If parents are able to talk to their children they can make sense of the information and reduce anxiety.
 
If you have any questions you can discuss this with your child’s classroom teacher or school nurse.
 

Head lice are tiny insects that live in hair. Un- hatched eggs are darker in colour and usually take 7-10 days to hatch. Hatched eggs (Nits) are the empty eggs cases that appear white in colour and attach to hair that head lice hatch from. You only have head lice if you can find a living, moving louse (not a nit) on the scalp. Head lice are a common problem, particularly in school children aged 4-11. They are harmless, but can live in the hair for a long time if not treated and can be irritating and frustrating.
 

Can you stop them?

Combing is an important part of good personal care but head lice are not easily damaged by it. Good hair care may help spot lice early and so help to control them. The best way for families to learn how to check their own heads. This way, they can find any lice before they have a chance to breed. They can treat them and stop them going around the family. The way to check heads is called “detection combing” if a living louse is found on one of the family’s heads the other family members should be checked and those with living lice should be treated at the same time.
 

Childhood is an important time to develop a healthy body and healthy habits.

Eating and physical activity habits are established at a young age and can influence a child's habits as an adult. We all need food for our bodies to work, however if we eat more food than our body needs we will become overweight due to laying down excess fat.
 

Think about portion sizes

It is important to be aware of portion sizes when thinking about a healthy diet. Children have much smaller tummies than adults so they do not need the same size meal as grown-ups. Physical activity and exercise can be helpful to help maintain a healthy weight alongside healthy eating.
 

5 a day

It is recommended that children and young people should have 5 portions of fruit or vegetables a day. Fruit and vegetables contain vitamins, minerals and fibre which are essential for bodies to remain healthy and to prevent diseases in later life. For information on 5 a day visit the NHS Choices website  or the Change for Life website.
 

School lunches

Having a school lunch is an easy way to ensure that a child has a healthy balanced meal that complies with the government's current nutritional standards. It is also a good time for pupils to spend time eating and socialising with their friends at the lunch tables.
 
Free school meals are available for children whose parents/carers are in receipt of certain benefits. Ask at your child’s school for more details.
 

Keeping hydrated

It is important for children to drink around 6 – 8 drinks per day to ensure that they are properly hydrated. Water based drinks are best. Research has shown that children who are able to drink water during the school day have found that they have fewer headaches, are more relaxed and are more able to concentrate. It also helps reduce daytime wetting, bed wetting and constipation.
 

The hearing test on your child in reception class is carried out by the community audiology department. You will be informed of any concerns and a referral may be made for a further audiology appointment.
 
If a hearing problem is undetected it can affect a child’s progress with speech, attention and literacy skills. Noisy environments may mean that it is difficult for the child to hear well.
 
If your child has any difficulty hearing it is therefore important to let your child’s class teacher know, so that that are able to sit them near to the teacher or where there are less sounds to distract them. It may also be necessary for them to have instructions repeated during a lesson. If you are concerned regarding your child’s hearing, you can contact your School Nurse who can refer your child to the community audiology department. You can also speak with your child’s GP who can examine the inner ear.

Spotting signs of a hearing problem

  • Inattentiveness or poor concentration
  • Not responding when their name is called
  • Can the child respond from a different room?
  • Talking loudly and listening to the television at  a high volume
  • Is your child saying “what “or “Pardon” a lot?
  • Does your child appear to hear better when looking directly at their parent?
  • Do they suffer from recurrent colds/ear infections?
  • Is there a family history of hearing problems?
  • Are parents concerned?
  • Is your child’s school concerned?

School Based Immunisations


 

Children's Nasal Flu Spray

Children’s nasal  flu spray is offered  to all children  in schools in Gwent from reception to year 6 in the Autumn term.
 
Please ensure you have returned your child’s consent form when you receive the information pack.
 
For more information about flu please read the Protect Your Child leaflet  from NHS Direct.
 
For great resources about children's flu including videos and information, please visit Public Health Wales .

 

Human Papilloma Virus (HPV) vaccine

All girls aged 12 to 13 are offered HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme. The vaccine protects against cervical cancer. It's usually given to girls in year eight at schools, with a second dose given in year nine.
 
The HPV vaccine is delivered largely through secondary schools, and consists of two injections into the upper arm spaced at least six, and not more than 24 months apart.

Please ensure you have returned your child’s consent form when you receive the information pack.
 
For more information please read Your Guide to the HPV Vaccine leaflet from NHS Direct.
 


School Leavers Booster / Meningitis ACWY

The 3-in-1 teenage booster is  routinely given at secondary school (in school year nine) at the same time as the MenACWY vaccine.

Please ensure you have returned your child’s consent form when you receive the information pack.

For more information please read the Protection against tetanus, diphtheria and polio leaflet from NHS Direct.
 

 

Meningitis ACWY

The MenACWY vaccine protects against four different causes of meningitis and septicaemia – Meningococcal (Men) A, C, W and Y diseases.

The MenACWY vaccine is offered routinely to all young people around 13/14 years of age (school year nine).  

Please ensure you have returned your child’s consent form when you receive the information pack.
 
For more information about the vaccine read Aged 13-18 years? Or Under 25 and starting university?  from NHS Direct.
 


Starting University?

The MenACWY vaccine should also be given to all individuals under 25 years of age who are planning to attend university for the first time or those in their first academic year at university if they have not already received the vaccine. Ideally the vaccine should be administered at least two weeks prior to starting university.

Cases of meningitis and septicaemia (blood poisoning) caused by Men W bacteria are rising, due to a particularly deadly strain.

Older teenagers and first time university students are at high risk of infection because they tend to live in close contact in shared accommodation, such as university halls of residence.
 
For more information about the vaccine read Aged 13-18 years? Or Under 25 and starting university?  from NHS Direct.

For more information on the signs and symptoms of Meningitis go to the Meningitis Now website.
 
 

MMR Vaccine

MMR is a safe and effective combined vaccine that protects against three separate illnesses – measles, mumps and rubella (german measles) – in a single injection. The full course of MMR vaccination requires two doses.
 
Measles, Mumps and Rubella are serious diseases with life threatening complications such as convulsions (fits) and encephalitis (infection around the brain).  MMR vaccine is a safe and highly effective vaccine, it has been rigorously researched.  Worldwide over 5 million doses have been given in over 100 countries.
 
If your child is outstanding the MMR vaccine please contact your GP surgery.
 
For more information read Measles Mumps and Rubella (MMR) from NHS Direct.
 
 
 
 
 

If your teenager is starting University or employment you may be asked to provide evidence of the immunisations that they have received as part of the childhood immunisation schedule. Your GP will be able to provide you with this information. However if your GP cannot help this information please contact the School Immunisation Team on 01633 618038 who will be able to signpost you to the correct service.
 
The childhood Immunisation schedule is designed to provide maximum protection and it is important that young people complete courses, to be provided lifelong protection. Routine childhood vaccinations are highly effective, safe and free.
 
If you think your child or teenager may have missed any vaccinations, please check with their Dr’s Surgery, and book an appointment if necessary, to get them protected.

The up to date Childhood Immunisation schedule and other information about immunisations and vaccinations can be found at on the NHS Choices website.
 

Long-term conditions are health conditions that require ongoing management over a period of years.

Common long-term conditions in childhood include:
 
  • Diabetes
  • Asthma
  • Epilepsy
  • Eczema
  • Severe allergies/anaphylaxis

Around 10-15% of children under 16 are affected by chronic, long term health conditions.
 
Children and young people who have a long-term condition can be at risk of missing out on educational opportunities due to prolonged absences from school, from ill health or multiple appointments. It is therefore important that schools are aware of individual children’s health needs.
 
To ensure that children with health conditions are able to fully access school, many children have individual health care plans that have been supported by Specialist Nurses, Consultants or your child's school in conjuction with parents.
 
 

How we can help

School Nurses can help support schools when they are developing individual healthcare plans.
 

Being active has many benefits including helping to maintain a healthy weight, reducing stress and promoting sleep.

Children and young people between the ages of 5-19 should take part in 60 minutes of physical activity every day.

This may include:

  • Walking to school
  • Playing in the playground
  • Taking a dog for a walk
  • Skateboarding or Rollerblading
  • Cycling
  • Playing a team sport such as football, hockey or rounders
  • Dancing
  • Running

It is important to not sit for too long and to minimise the length of time that children and young people spend on computer games and watching TV.

School Entry Review is part of the Healthy Child Wales Progrramme (Welsh Government WG 2016) which is offered to all children in Wales.

The purpose of the school entry review is to assess the child’s health needs, promote health and wellbeing and to support and enable children to achieve their full potential.
 
During the year that a child enters full time education the School Nurse will offer the School Entry Review to all reception children at school. This consists of:
 
  • School entry health review inform sheet
  • Review of your child’s immunisation status
  • Distance vision screening at schools
  • Measurement of growth at school (height and weight)
  • Hearing screening (undertaken by the audiology department)

It is important for young people to have the right information about how to look after themselves, how to stay safe and make the right health choices.

There are many websites that can offer sexual health information however sometimes it is important to speak to someone individually.
 
Your Specialist sexual health workers GP or School Nurse are able to give advice, information and support. All health professionals are bound by the same confidentiality rules which means that a young person can talk ‘in confidence’ (even if they are under 16) and the health professional will not talk about what they have said to other people or to their school.
 
If the health professional is concerned about a child or young person’s safety they have a duty to tell somebody else however they will tell the young person if they need to do this. 
 
Health professionals will encourage young people to talk to their parents if possible and will sometimes help them to do so. 

Sleep is an important part of a child’s day and a good sleep hygiene routine can be beneficial to a child’s development. There are things that parents and carers can do to improve their child’s sleep.

Be clear about how much sleep your child needs, they may want to stay up late, but, will this impact on their behaviour tomorrow when it’s time to get up for school and will they be able to function to their full potential?

When setting bedtimes, explain these to your child during the day. Don’t wait until the time you want your child to settle and then announce “Bed time!” Give your child a regular routine that will help them to wind down. Ensure your child knows bedtime is not a punishment, make it a calm, enjoyable time with activities such as a bath and or story. Avoid stimulating activities such as TV or computer games.

  • Be consistent
  • Try not to get into negotiations
  • Follow your new routine
  • Use reward charts to demonstrate any progress
  • Be patient, change takes time
 
For further advice and support speak to your school nurse or GP.

Increasingly children and young people are spending a lot of time using the internet to help them with their school work and homework in order to help them learn.

They are using social media applications to chat to their friends and network, and playing online games which require internet access. Internet technology is also developing at a very fast rate, and parents are finding it difficult to keep up to date with what their children are using or doing online.

A lot of parents feel that their children know a lot more about the internet than they do. It is important that parent’s know their child still needs advice and protection when it come to being safe online. Talking to your child is one of the best ways to keep them safe.
 

Smoking is bad for your health and increases your risk of getting many serious diseases.

Your skin will age prematurely causing wrinkles, dull eyes and complexion. Cigarette smoke can also make your mouth and clothes smell.
 
When you smoke, it's not just your health that is at risk, but the health of anyone around you who breathes in cigarette smoke including pets.
 
Breathing in this secondary smoke is known as passive smoking, or secondary smoking. Children are at particular risk from the effects of passive smoking and are at an increased risk of developing chest infections, ear infections and asthma.
 
Babies who are exposed to cigarette smoke are also at a greater risk of sudden infant death syndrome (also known as cot death). 

Being out in the sunshine has benefits for your health. It makes people feel better about themselves, allows them to use vitamin D and gives increased opportunity to take physical activity.

The sun is the main source of vitamin D and vitamin D is essential for healthy bones. The sun can help reduce the risk of developing long term diseases and improves people’s overall physical and mental wellbeing. However, the ultraviolet rays of the sun can burn and in order to enjoy the sun safely there is advice for all the family to follow.

What are threadworms?

Threadworms are small, white worms that infect the intestines of humans. They are between 2 millimetres to 13 millimetres long and look like a piece of cotton thread, hence the name. They are sometimes known as the pinworms. Threadworms are difficult to see and are not visible to the naked eye.

They are the common worm parasite in children in the UK, affecting up to half of all under 10s. The risk to family members getting them from an affected child is as high as 75%.


How do you get threadworms?

Kids can catch worms from coming into contact with anything contaminated with worm’s eggs. That can mean the vomit or poo of an infected dog or cat from a litter tray or soil in the garden.

They are passed on by poor hygiene, not washing your hands after going to the toilet or coming into contact with objects contaminated by the worm’s eggs. It is possible to breathe in the eggs and then swallow them. The eggs are so small that they can become airborne, for example if you shake a towel or bed sheet that has eggs on it.

Children touch and then swallow the tiny worm eggs without realising it. The worms hatch in the gut, then wriggle out of a person’s bottom at night to lay more eggs.

The female threadworm lays tiny eggs around the anus and vagina. It also secretes mucus that makes you scratch the area.

The eggs get stuck to your fingers or under your nails and then they can be transferred to the mouth for the whole process to start again. Or you could transfer the eggs to someone else by touching them or touching a surface, which they then touch.

Threadworm eggs can survive on surfaces for up to three weeks.


Treatment

If one person in a family has them, others may have them too, so it’s best if you treat all the family members to prevent re-infection. Your child can attend school if they have threadworms, but please start treatment early. Please inform your child’s class teacher so that they are also able to take additional hygiene measures in school.

You can get rid of them by following strict hygiene measures for up to six weeks. Ensuring children wash their hands regularly, particularly after going to the toilet and before meals.

You can use treatments from your GP or over the counter from pharmacies.

Treatment alone does not kill threadworm eggs - good hygiene is the one way to prevent eggs from spreading and causing another infection.

Ticks are common in grass, trees, shrubs and leaf piles. Tick bites are often harmless in which case they don’t cause any noticeable symptoms. However, ticks can cause allergic reactions and can pass diseases onto humans and pets when they bite.
 
The longer the tick remains on the skin, the higher the risk of it passing on infection. Lyme disease is a bacterial infection that can be spread by infected ticks. Ensure you seek medical advice immediately if you child has a tick bite.

As part of the School Entry Review your School Nurse will carry out a distance vision screening test.

Once your child’s vision has been checked, it’s important to continue with regular eye tests. Your child should have a check-up at least every two years, as problems can occur at any age. Don’t worry about the costs, as all NHS sight tests are FREE of charge for children under the age of 16 and those aged 16 to 18 in full- time education.

A young carer is a person under the age of 18 years who provides care for another person, most commonly a parent or sibling. This is because that person has an illness, disability, mental health problem or problems with addiction to alcohol or drugs.

Day to day responsibilities often include:
  • Cooking
  • Giving personal care
  • Giving emotional support
  • Shopping
  • Cleaning
 
With so many adult responsibilites, young carers can miss out on opportunities that other children may have to play and learn.
 

It is important that young carers and their families receive support.

It may be reassuring to know that you are not alone.  Around half a million teenagers wet the bed at night – that equals one in 75 teenagers. 

Bedwetting occurs when the bladder empties during sleep. Some teenagers wet the bed once or twice a week, others every night. It can be embarrassing for you and stressful for you and your parents, however it is not your fault.
 
There is always something you can do to help yourself. If you haven’t already you should see a doctor to be assessed and find out why it is happening to you. There are treatments available to help the majority of causes of bedwetting. If you have tried treatments in the past and they didn’t work (such as an alarm), you may find that now you are older they will work.

Domestic abuse also called domestic violence, is when an adult threatens, bullies or hurts another adult who are or have  been a partner or family member, regardless of gender or sexuality. It can happen to anybody.

 

Abuse can be physical, sexual, financial and emotional. You may feel that you are to blame and may feel angry, guilty, insecure and frightened. It is unacceptable for this to occur and so if you or someone you know is affected by this you need to discuss it with someone you trust. Always remember if you are concerned about your or someone elses safety call the police. You can also speak to a health professional or your teacher.

 
  • Just as people’s bodies can become unwell, people’s minds can become unwell too. Mental health problems are more common than you might think - three children in every classroom have a mental health problem (Young Minds, 2017).
  • Lots of young people feel upset, confused and stressed from time-to-time. But when a low mood is impacting on your day-to-day life, it’s important to talk to somebody about it and get some help and advice.
  • If you are finding it difficult to talk to someone or would like some more information on a topic that is worrying you, take a look at some of the links provided on this page.
     
  • Your GP, School or School Nurse will also be able to provide additional support and information on local services in your area.