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Health services and procedures employed by the health office personnel at John Muir Junior High School.

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Health services and procedures employed by the health office personnel at John Muir Junior High School.

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Content HEALTH SERVICES AND PROCEDURES EMPLOYED BY THE HEALTH
OFFICE PERSONNEL AT JOHN MUIR
JUNIOR HIGH SCHOOL
A Project i
Presented to
the Faculty of the School of Education
The University of Southern California
!
In Partial Fulfillment
of the Requirements for the Degree
Master of Science in Education
by
Elsa W. Hollberg
August 19$3
UMI Number: EP49558
All rights reserved
INFORMATION TO ALL USERS
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In the unlikely event that the author did not send a complete manuscript
and there are missing pages, these will be noted. Also, if material had to be removed,
a note will indicate the deletion.
Dissertation Publishing
UMI EP49558
Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author.
Microform Edition © ProQuest LLC.
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unauthorized copying under Title 17, United States Code
ProQuest LLC.
789 East Eisenhower Parkway
P.O. Box 1346
Ann Arbor, Ml 48106- 1346
Bd '51 ^737 ^^
This project report, w ritten under the direction
of the candidate’s adviser and approved by h im }
has been presented to and accepted by the fa cu lty
of the School of Education in p a rtia l fu lfillm e n t
of the requirements fo r the degree o f M a s te r of
Science in Education.
A dviser
Dean
TABLE OP CONTENTS
CHAPTER PAGE
I* INTRODUCTION . . . .................... 1
Purpose and Need * 1
Purpose of the project • •••••••• 1
Need for the study . . .............. 1
The School and Its Setting • •••••••• 2
Nature of the school • •••••••••• 2
Nature of the community • ••••«••••
Organization of the Project ..••••••• 6
II . THE SCOPE AND POLICIES DETERMINING THE
PROCEDURES OP THE HEALTH SERVICES.......... 8
The Scope of the Health Services • ••••• 8
Policies Determining the Procedures of the
Health Services • .••••••••..•• 10
III. HEALTH SERVICES POLICIES AND PROCEDURES
PERTAINING AT JOHN MUIR JUNIOR HIGH SCHOOL. . 15
The Scope ........ • 15
Health Education Opportunities Afforded in
the Health Services Experiences ...... 21
Personnel Interrelationships •••.•••• 2 l j .
IV. SERVICES AND RESPONSIBILITIES OP THE HEALTH
OPPICE PERSONNEL.......................... 36
Services and responsibilities of the
_______ school physicians . . . . ._• ... 36'
CHAPTER PAGE I
i
Services and responsibilities of the
school nurse....................... 38
Services and responsibilities of the
health coordinator........... l j - 3
Services and responsibilities of the
speech correction and the lip reading
teachers..................... I 4 . 8
Services and responsibilities of the
sight-saving teacher............... I 4 . 9
Duties and responsibilities of the
student service monitors......... • 50
V. DETAILED HEALTH SERVICES ROUTINES AND
PROCEDURES.................................. 55
First W e e k ....................... . . . 55
Second Week ...... 67
Third W e e k ................... 72
Mid-Semester ••••••• .......... •• 77
Eighteenth Week •••••••••••••• 80
Nineteenth Week •••••••••••«•• 8J 4.
Twentieth Week •••«*•*•»•»••• 88
Routine Procedures Common to the Entire
Semester •••*••••••••••••• 91
Procedures Related to the Special Health
Services Testing Programs and Surveys . • • 105
iv
CHAPTER PAGE
VI. HEALTH SERVICES ACTIVITIES FOR FUTURE
CONSIDERATION................. ....... 113
The case study conference.............. 113
Faculty health committee . ............ 113
Adult clerical time.................... 113
Screening of pupils for extra-curricular
activity............................. 113
Health films........................... l l £ | ~
School-sponsored trips with the Health
Club * . . . ..................• • • • lll|
Health requirements and health awards for
graduating pupils........• ......... lllf
Health awards .•••*.............. l l l f .
List of dental defects to homeroom
teacher • .................. • • • • . 115
Health appraisal information to homeroom
teacher . . • . ................• • • • 115
VII. SUMMARY AND CONCLUSIONS .................... 116
Summary •••••.« ................ 116
Conclusion •••••••••••• ... Il6
BIBLIOGRAPHY....................................... 118
CHAPTER X
I
IMTRODUCTIOH
I i
The health services policies and procedures in the
junior high schools of the Los Angeles city schools are
very similar* This is probably due to the fact that they
originate from a common source, the Health Education and
Health Services Section of the Los Angeles City Board of
i
Education* Each school, however, has its own unique setting!
and must gear its services to the needs of the community.
I. PURPOSE AM) HEED
Purpose of the project. It was the purpose of the J
i
writer to present a running account of the health services
| i
program as it is operated in a typical semester from the j
health office at John Muir Junior High School; to delineate |
the specific duties and responsibilities of the health
services personnel and to present pertinent laws and
policies which serve as a guide to action.
Heed for the study. In order to make the best
possible contribution to the continuing health of the
school, Its established, workable policies and procedures
should be written out to be certain that all are covered.
IFor example, much that occurs in the health office is more
op loss in the nature of an emergency and requires direct
and accurate action only possible with adequate organiza
tion of that phase of the health services program*
With each school semester, certain situations and
functions occur regularly* A ready reference to the
machinery of operation should promise smoother function,
efficiency, and the elimination of needless duplication and
overlapping of the health services efforts (1:7)•
IX* THE SCHOOL AND ITS SETTING
To understand the needs of the pupils and to better
help them solve their health problems, the health personnel
working with the pupil should know something of the follow- j
ing elements of the school and the community* !
j Nature of the School
Size and location* John Muir Junior High School is
located at 5929 South Vermont Avenue* Los Angeles i|4,
California* It covers half the area of a city block* It
is bounded by Vermont Avenue on the east and by 6oth Street
on the south* It shares the west boundary with Budlong
Avenue Elementary School which faces Budlong Avenue. Its
northern boundary is 59th Street*
Personnel* The school enrollment numbers 1,1|.75
pupils. Approximately 855 of the student body is Hegro,
the remainder white, Oriental, and Mexican. The teaching
personnel numbers sixty-seven and the administrative staff
consists of the principal, a girls’ and a boys’ vice
principal, a guidance director, and a registrar. Directing
the health services are a boys’ and a girls’ school
physician who are assigned to the school for eight hours
every week. A school nurse is shared with Budlong Avenue
i
Elementary School— Tuesdays, Wednesdays, and Fridays being
allotted to John Muir Junior High School. A health
coordinator is assigned for three periods a day. Lip
i
reading classes are conducted by a Lip Reading teacher for j
three periods each Monday morning and Speech Correction
classes by a Speech Correction teacher for three periods
each Tuesday afternoon. j
Health office. A classroom adjacent to the attend- j
ance office and across from the guidance office was recently
converted into the health office. A rear quarter of the
i
room has been partitioned off as the physicians ’ examining
room. It is also used by the school nurse and the health
coordinator for health counseling purposes. Facilities for
rest and for temporary isolation of pupils suspected of a
communicable disease are afforded by two cots-separated by
folding screens. Records are readily available in metal
filing cabinets. Two closets store surplus first aid
supplies, posters, and health literature. One wall supports
the first aid unit equipped with a sink and running water.
The office is also equipped with a scale, an illuminated
Snellen eye chart, and two telephones.
Nature of the Community
Size and location. The area feeding John Muir
' i
Junior High School extends, roughly, along i j . 8th Street on
the north, along Western Avenue on the west, along 77th
Street on the south, and along Main Street on the east. It
covers an area of about sixty-four city blocks and Is
approximately four and one-half miles square. In the 1
i
immediate neighborhood of the school are many small homes,
i
|fairly well maintained. The largest business center within
the school* s boundaries abuts the northern bound sir y of the
school and includes the area surrounding Slauson and Vermontj
Avenues. There are many poorly kept rental homes extending
back from both sides of the small shops lining some of
Vermont Avenue. Eight elementary schools send graduates to
the school.
Churches and playgrounds. Numerous small churches
and several modestly large churches are scattered through
the area. Three playgrounds, one with a pool, lie within
5
or close to the boundaries feeding the school*
Social agencies* Within or close to the area are
the Florence Avenue Health Center, the Manchester Dental
Clinic, and the P*T.A. Health Center all under the juris
diction of the Los Angeles City Board of Education. Others
include the Southwest Community Health Center, the Central
Receiving Hospital, the Orthopedic Hospital Clinic, the Los
Angeles County General Hospital Clinics, the School
Children’s Dental Clinic, the Robert L. Taylor Dental
Clinic and the District Office of the State Relief Associa
tion*
The people* This is a very transient community with
a growing Hegro population from the southern states* Many
of the pupils come from broken homes and from large
families* The parents are often domestics, factory workers
and many are on the rollis of the County and the State
i
Relief Associations*
Conclusions reached* Physical examinations of the
pupils at the school reveal many physical defects and poor
health habits indicating that a considerable number of the
pupils probably are not well cared for. The community
appears to be adequately supplied with cultural, recrea
tional, and social agencies. Subjective observation would
6
indicate that the community has changed with the turnover
of residents of the area and has contributed to the present
health status of the pupils*
III. ORGANIZATION OF THE PROJECT
In Chapter I the problem has been introduced and the
need for the study discussed. This is followed by a
description of the school and its setting*
Chapter II presents the scope and policies of the
health services. Four subdivisions of the health services
are presented, namely: health appraisal, emergency care
for sudden illness or accident, communicable disease
control and the health counseling and follow-up measures* ’
i
This is followed by the health services policies stemming
t
from the state, county, and city boards of health and the
state, county, and city boards of education* I
Chapter III is concerned with the health services !
policies of the local school, including the health educa
tion opportunities afforded in the health services experi
ences of pupils and the personnel interrelationships
existing*
Chapter IV delineates the duties and responsibilities
of the following health services personnel: the school
physician, the school nurse, the health coordinator, the
lip reading teacher, the speech correction teacher, the
sight-saving teacher, and the student services personnel.
Chapter V presents a detailed running account of the
health services procedures and routines of the local school.
The periods include the first three weeks of the semester,
the middle of the semester and the last three weeks of the
semester. Included also are the routine procedures common
to all weeks of the semester and the procedures for the
speeial health services programs.
i
Chapter VI deals with health services activities for
further consideration by the school.
Chapter VII summarizes the project in terms of its
value to the health coordinator assigned to this specific
school.
A bibliography, which also serves as a footnote
!reference, concludes the project.
CHAPTER II
THE SCOPE AM) POLICIES DETERMINING THE PROCEDURES
OF THE HEALTH SERVICES
I. THE SCOPE OF THE HEALTH SERVICES
This section describes the four subdivisions of the
health services as conducted through the health office at
the school for the protection and improvement of the
physical, mental, and emotional health of the pupil
( 2: 86-88) , ( 3: 1-2) .
Health appraisal* The school physician determines j
the health status of pupils in the school* He examines
I
pupils newly entering the school, pupils with special
health problems, athletes participating in competitive !
t
sports, and pupils applying for work permits* Certain j
i
measures such as the following assist the physician in his
health appraisal to identify health problems: health
histories, screening tests of hearing and vision, measure
ment of height and weight, teacher and nurse observations,
previous dental, medical and psychological examinations*
Health counseling and follow-up measures* A home
notice follows the school physician fs health appraisal
examination* When a health problem has been discovered,
j the nature and significance of the physician*s findings are
i
interpreted to the pupils and parents on an individual
basis* It is recognized that the final solution of the
problem is the privilege and responsibility of the parent,
but aid is given by the school nurse in formulating a plan
of action (l6:ll)* Adequate facilities for securing the
needed care through community agencies are brought to the
attention of the parent who may need help* Continuing
effort is made to encourage action until the needed care is !
received*
Emergency care for sudden illness or accident*
Every attempt is made to give proper and prompt first aid
when needed* Printed directions are posted in a prominent 1
place in the health office and in the first-aid kits j
located at strategic spots about the school where special
hazards exist* An emergency card is on file for each pupil !
indicating whom to call and where to take the pupil if the
parent cannot be reached*
Communicable disease control* All school personnel
are alerted to discover and to exclude the pupil who shows
signs of communicable infection* Care is taken that he is
not readmitted until all signs of the disease have disap
peared* Parents and pupils are encouraged to take advantage
of the immunization programs and of the tuberculosis
10
ease-finding programs in cooperation with the local public
i
health department#
II. POLICIES DETERMINING THE PROCEDURES OP
THE HEALTH SERVICES
Policies pertaining to the health appraisal, follow-
up measures, emergency care for sudden illness or accident,
and communicable disease control measures extend from the
state, county, and city boards of health and from the state,'
county, and city school districts to the individual school.
Here local policies are determined by the administrator of
the school and of necessity differ ..according to the nature
and size of the school and community*
!
Health services policies originating with Los Angeles
■ " ——— — — (
County and the State Boards of Education and Health. !
ffCompulsory school attendance laws bring with them a
corresponding responsibility to protect the health of the
i
student while in the classroom. This protective phase of
health services Isa definite responsibility of school
officialsn (lj.:12)*
Provision for the physical examination of pupils
through the Education Code is established primarily for
health protection. It does not give the authority to
practice medicine or surgery or to treat or cure diseases.
11
A home notice must be sent to the parents if a health defect
was found. However, a parent may legally request the
exemption of a pupil from periodic health appraisal (5*13)*
i
The state has subsidized funds for the compulsory
education of the handicapped child in a special school, a
special class, or in the home primarily on a referral basis,
to the California State Welfare Board, the Los Angeles
County Welfare, or to the County Medical Association.
!
Conditions include speech, blind and parti ally-seeing, deaf
and hard of hearing, heart, tuberculosis, malnutrition,
epilepsy, post-polio, cerebral palsy, posture deformities,
multiple sclerosis, emotionally disturbed, and mentally j
retarded.
Control of communicable disease, including immunize- \
tion for smallpox is under the direct control of the State j
!
Board of Health. Exclusion from public school of pupils j
with any contagious or infectious disease is provided for 1
|through the Education Code which also makes the provision
that the pupil may not return until school authorities are
satisfied that he is free of said disease or infection even
though the parent has filed a statement that he will not
consent to the physical examination of the pupil (5*9)•
Absence due to illness or for dental, optometrical or
medical service are not considered an absence in computing
the average daily attendance.
Health services policies of the Los Angeles City
Health Department# The school physician is responsible for
the inspection of school cafeterias and for the medical
examination of the food handlers# He must also make a
periodic survey of the sanitation of the school plant#
Pre-service education in the observation of sanitary pre
cautions must be provided by the local district#
Certain communicable diseases are directly reportable
i
to the Public Health Department, namely, poliomyelitis, ;
scarlet fever, diphtheria, and food poisoning and readmis
sion to school is subject to their release# For other
| communicable diseases, it is mandatory that provision for i
readmission by a school physician, a private physician, or
I
a public health nurse be made after a pupil has been absent
five days or more# !
Immunization programs for smallpox and for polio- ;
i
I
myelitis are carried into the schools at regular intervals# j
Vaccination is permitted only by the written request of the
i
parent* In cooperation with the Dos Angeles Tuberculosis
and Health Association, tuberculosis case-finding programs
are conducted in the secondary school#
"Policies should be developed in each school In
regard to emergency situations, defining responsibilities
of various personnel involved" (3*2)#
13
Health services policies of the Los Angeles City
Board of Education* "In the absence of specific objection,
a physical examination is given if it is a part of the
school program" (6:29)* It is recommended that the
physical appraisal be done in the following order: screen
ing of B7 pupils and pupils new to the school, examination
of those who expect to participate in strenuous competitive
sports, a re-evaluation of special cases for Physical
Education assignment, followed by the routine examination
of B7 pupils and pupils new to the school* Before a work
permit is granted a pupil, he must present the record of a
satisfactory physical examination* For permanent exclusion
or exemption from school the physician may issue an exemp- :
!tion certificate for physical or mental disability. Schools
i
are required to have on file a health card for every pupil 1
in attendance at the school, this record to be transferred
with his other records as the pupil transfers to another
school within the district. A "pink" card (Form # 3i| . EH-18)
is filed in its place for the pupil who has an exemption
certificate.
"Follow-through" procedures commence with the home
notice to the parent advising them of the defect observed
and recommending that attention be given the pupil by the
family physician (7*8f>). The school nurse will encourage
the parent in the correction of defects by referral if
needed to one of the welfare agencies helping the schools.
. 1
Volunteer services of certain of its specialists is afforded
by the Los Angeles County Medical Association to the school
health centers. Hospital clinics available through the
Community Chest are also at the disposal of the schools
(3:!}.). The school personnel is informed of a defect which
requires special programming or preferential seating. When
recommended by the school physician, provision is made for
adjusted part-time attendance; the required Fhysieal Educa- j
ition period is fulfilled in a period of rest at the home.
The school is required to post in plain sight Form
i
#33.367 which describes first aid procedures, Form 7 ^ 4 - * i j - T j
which is an accident instruction and Forms and
i
t
which lists the emergency hospitals in the district. Hon- ,
t
imedical employees are held responsible by law if they are i
I
negligent in providing appropriate care for an injured
pupil or if they fail to take reasonable steps to prevent
accidents (9*252).
Form #33*21 listing the communicable diseases and
quarantine regulations should be available in the health
office.
CHAPTER III
HEALTH SERVICES POLICIES' AM) PROCEDURES PERTAINING
AT JOHN MUIR JUNIOR HIGH SCHOOL
Sine© schools differ so widely in basic organization
and in time allocation for health services personnel, each
school must establish its own workable policies in an effort
to make the health services program function effectively*
The four general areas of health services activity as they
are conducted at John Muir Junior High School, the health
education opportunities they afford and the inter-office
land department relationships that ensue are described in
detail in the remainder of this chapter*
The activities essential to the school's health
service program are:
Health appraisal and health records* Medical
examinations are conducted as recommended by the Health
v
Services Section of the Board of Education* These recom
mendations are found in Chapter II. The school physician
also assists with emergencies and with exclusions and
readmissions when he is in attendance. Referrals by non
medical personnel come to his attention when a pupil is not
I* THE SCOPE
16
making satisfactory scholastic progress, is not well-
adjusted in school or if he is frequently absent due to
illness. A resume of pertinent information on problems
i
fathered through home visits by the school nurse, teacher
observations and by telephone contact with the parent often
help the physician in making his recommendations. In this
school requests for the health cards of pupils transferring
from junior high schools in the district are sent out
i
immediately during the entire semester. They are sent to
the health office as recorded by the guidance office
personnel. Temporary health cards for pupils new to the
district, as well as those transferring from within the
1
district, are made out in the guidance office when the j
pupil is registered and programmed, thus keeping the health'
card file current. At this time he is also given a health
history form and an emergency card to take home for signa- 1
i
i
tures. These too, when they are returned, are sent to the
health office. As a pupil transfers, the health card,
i emergency card, and health office visit card are sent to
the guidance office to be deposited in the cumulative
folder. The pupil’s program card is retained in a transfer
file for future reference.
Individual counseling and follow-up. Unless there
is a planned follow-up program, the health appraisal is of
17
little value* Counsel concerning the early care of physical
j
impairments is given as recommended in the chapter preced- I
ing. School personnel are notified early of a pupil’s need I
for special handling# The pupil concerned circulates a
health information card to all of his teachers for
signature* Later his name will appear again on an overview
of pupils with health problems which is distributed to all
school personnel each semester* This list records the
hearing loss of more than 15 per cent in either ear,
vision loss of 20/lf0-20/l|.0 or poorer, and of those pupils
who have a history of epilepsy, diabetes, a chest condition
under observation, or of heart disease. The health
information card may state information and recommendations
similar to the followings "John Smith needs special
attention because oft Impaired vision, 20/50 right eye j
and 20/70 left eye. He would probably benefit by being !
seated forward." Or, "Mary Jones needs special attention
because of: A hearing loss of 80% in the left ear. She
would probably benefit by being seated in the center and to
the left with the good (or right) ear closest to the
teacher." Or, "Lane Smith needs special attention because
of: A history of seizures. Please seat near the rear exit
away from radiators and windows. He should avoid high
places and the use of gym apparatus. Ho school trips.
Please advise the health office personnel if he appears to
18
be having an attack*” Or, ”George Brown needs special
attention because of: Malnutrition* His accuracy may be
retarded and he probably tires easily* When tired he may
become irritable.” The follow-up card pertaining to
recommendations regarding seizures, diabetes, and malnutri
tion are marked, 1 1 Confidential” and are not circulated by
the pupil but rather by means of the teachers1 boxes*
A tickler file is maintained in the health office for
the purpose of having it as a reminder of pupil clinic
appointments or of a re-examination due at a later date or
well in advance of coming special health services programs*
Emergency situations: accident or sudden illness*
Legal aspects regarding emergency situations are covered in
the chapter preceding. Following are the regulations as
they are fulfilled in this school* Unless the accident or
illness poses an emergency, a note from the pupil’s
teacher for each referral to the health office is required.
From the health office visit card file, the monitor pulls
the pupil’s card, entering the date, class period, and reason
for the visit. The nurse or the health coordinator render
the necessary first aid according to the posted first*aid
procedures* A notice of first aid is filled out in
duplicate, the original to be given to the student for
parent signature on the tear-off portion and the duplicate
19
retained for th© records. When the first aid rendered has j
been entered on the health office visit card and on the
pupil’s note, he returns to class. If it appears that the
i
injury is of a serious nature, first aid is rendered, the
pupil is made as comfortable as possible on a cot, and
further care and disposition are transferred to the parent.
Contact is made with the parent, the accident is reported
in as tactful a manner as possible, and the parent is
requested to come to the school or to suggest an alternate
procedure. She may wish to send a taxi for him or she may
i
direct the school to call an ambulance from th© Central
Receiving Hospital. If an ambulance Is called, the princi-
t
pal will delegate an adult to accompany th© pupil and to j
stay with him until th© parent arrives to assume further
responsibility. If th© parent cannot be reached, which is
often the case, the pupil’s emergency card Is consulted for i
authorized personnel. If it is not possible to contact
anyone, and the emergency warrants it, an ambulance is
called and the pupil is accompanied by an adult to the
emergency hospital which then assumes charge. A continued
effort to reach the parent to inform him of this actiqn is
made. In case of dbgbite, notify the parent immediately
and apply Zephiran. Inform the City Health Department as
soon as the following Information has been gathered:
name and address of the pupil bitten, name and address of
20
the owner of the dog and the whereabouts of the dog if
known# In case of any injury which might necessitate the
pupil’s absence from school the following day, an accident
report is filled out in duplicate# The original is filed
with the principal to be followed up within ten days#
In case of serious illness necessitating hospital
treatment the procedure is similar to that for a serious
accident as explained in the paragraph above. The princi-
j
i
pal is always informed in case of an emergency# When a
pupil is excluded, the registrar is notified of the time
and circumstances*
i
When a pupil Is referred to the health office with a
i
complaint which, after inspection and questioning, does not
t
appear to be of a serious nature, he may wish to return to (
i
his class after a short rest period# At the discretion of !
i
the health office personnel, his Physical Education
i j
jactivities may be modified for the day# I
! After reporting to the attendance office, absentees
are referred to the health office for readmission if they
have been excluded by the health office personnel, if they
have been absent due to an accident or have been absent
three days or more because of illness. If the pupil feels
and appears well and his temperature is normal he is
readmitted. He is advised to modify his activities at
noon and is excused from physical education activities
21
for a few days at the discretion of the health office
personnel* A physician fs request for limitation of Physical!
Education activities is honored, but must be confirmed by
the school physician on his next visit*
Communicable disease control♦ Since it is the
schoolfs responsibility to protect pupils from exposure to
communicable disease, the school personnel is supplied with
a chart outlining the suspicious sighs and symptoms as a
guide in their observation of the pupil in the classroom*
When the teacher detects any deviation from the normal
appearance or behavior, the pupil is referred to the health
office. Here the pupil is excluded promptly not only ^
because of the danger of exposing other pupils, but because !
he may then recover more rapidly* Parents are encouraged j
to refrain from sending a pupil to school when he is ill. i
They are also urged to make full use of the preventive |
measures for communicable diseases when they are available
at the school or in the community.
i
II. HEALTH EDUCATION OPPORTUNITIES AFFORDED
IN THE HEALTH SERVICES EXPERIENCES
All health services experiences may be viewed as
health teaching and may be the basis for effective health
instruction (11^:232). Every contaet the pupil has with the
physician, dentist and nurse, at the school or at the
clinic, influences his attitudes in relation to them,
fostering the idea that a competent professional person
should be consulted in health matters* Some of the specific'
opportunities for health education afforded by the health
services experiences follow:
1. Preparation of the pupil for the health
appraisal: what it consists of, the necessity for it,
information to be gained concerning health assets and I
liabilities, and the opportunity it affords for an interview
with someone who wants to help him*
2* Follow-up procedures: why the corrections j
should be made, what steps should be taken for remedial
t !
care, and how the pupil can assume some of the responsibility^
for arranging for remedial and preventive measures (13:10)* !
t !
3* Curiosity and interest may be aroused by comments!
• I
made during the processes of weighing, measuring, and test
ing the vision and hearing*
If* Inspection of food handlers points up the
importance of clean habits (protecting food against dirt
and flies) in controlling communicable disease*
5* School lunch supervision is an opportunity to
advise concerning menu selection and good eating habits*
6. The nurse’s home visit to the pupil and to the
iparent in helping him solve his health problem*
23
7. First aid car©: the reason for that particular
procedure; how the accident may have been prevented.
8. Visits to the health office with complaints of
headache, toothache, stomach-ache, dizziness, colds: the
opportunity for influencing future behavior in relation to
sufficient rest, good dietary habits, dressing for the
weather, regular dental care, and assuming the responsi
bility for the protection of others when suffering from a
cold or other contagious disease.
9. Before the special health services programs:
information to the student body by means of lecture, film,
i
and literature on what the procedure is, what to expect,
and why it is being done (13:10) .
10. l!he Health Club, formed of a representative
from each homeroom, as a link between student body and the
I
health services: reports on student and school health
problems and on school health and safety hazards are brought
to the meetings for discussion; reports from the meetings
reach the homeroom in the form of a bi-monthly health
bulletin; sends for and distributes authentic health litera
ture; accepts responsibility for the healthful environment
of the homeroom. Representative bulletins: ”How Are Your
Health Manners?1- f , Gare, Use, and Abuse of Your Rest Rooms.*
MColds Are Catching, Keep Your Cold at Home lt t
2l\.
Ill. PERSOHNEL IKTERBELAT10NSHIPS
Good rapport and harmonious relations between the
health office personnel and other personnel of the school
”• • ♦ is of vital importance in uniting the health
resources of the school In educational guidance of the
student” (19*30)*
Relations between health services personnel and the
administrator* ”The responsibility for the school health
program is delegated to the administrator by the governing
board of the school district” (10:3). administrator
in turn delegates certain functions of the health program j
j
to the vice principals, the school nurse and the health j
coordinator and retains others. The principal:
i
1. Directs and guides all phases of the school !
i
health program.
i
2. Initiates new health policies and modifies old
policies.
3. Arranges space and department allocation for the
immunization and testing programs.
I j . . Authorizes the vice principals and health offiee
personnel to exclude and to readmit for communicable
disease.
Authorizes the ordering of additions and replace
ments in the health office including first .'Aid supplies and
25
equipment*
6* Administers the first*aid procedure when trans
portation for a serious accident is required*
i
7* Makes recommendations regarding health and
safety practices, health and accident hazards including
adequate physical facilities for health*
8* Requires that an emergency card be on file for
all adults as well as for all pupils*
/
9* Arranges for follow-up interviews on all
accident reports.
10* Arranges for an orientation session with the
Jnew teaching personnel on the health policies of the school*
11. Delegates to the vice principals the adminis-
t
j tration of welfare aid when eligibility for need is
i
established by confirmation of the school physician. ;
f
i
Relations between the health office and the attend
ance off 1 ce* Close rapport is necessary between the health
office personnel and the registrar* An understanding must
be fostered in regard to the undue emphasis which is
usually placed on the perfect attendance regardless of a
pupil’s condition (9*300)• Important relations include the
following:
1. The registrar is notified when a pupil is
excluded by the health office personnel, when a child is
assigned to rest In the health office for more than one
period and two days In advance if a pupil will be absent
due to a clinic appointment*
2. A pupil is sent to the health office for readmis-r
sion if he has been absent three days or longer because of
a communicable disease, if he is wearing a cast, brace, or
using crutches, if he has been absent because of an accident
or if he has been excluded by the health office personnel#
3# When a pupil is excluded from the school to !
attend a special school for the handicapped or will be
assigned a home teacher, the school physician’s recommenda
tion is filed in duplicate with the registrar for further
disposition#
i
I 4 . * The registrar reports a change of address in
i
order to keep the emergency file current# I
i
5# Notes from parents or physicians which may have
a point of interest to the school physician are sent to the
health office for his attention#
6# Transfers are handled through the registrar who
requires a signature from the health office personnel to
facilitate the transfer of records for the pupil#
7# When the registrar requests a home visit by the
nurse to verify illness absence, a written report is
supplied to him.
8# Conferences between the registrar and the health
27
service personnel reveal significant findings in the rela
tion between truancy and poor attendance on the on© hand
and health and social factors on the other. Available
statistics indicate that the majority of absences are due
to illness and that the majority of illness is due to
respiratory infections.
Relations between the health office and the guidance
off!ce. Significant records regarding the "whole child*
are of necessity centered in one place in the school,
preferably the guidance office. Health reeords are in a
sense "loaned* to the health office while the pupil is in
attendance but are again returned to the cumulative folder
when the pupil transfers or is graduated. Records in the
cumulative folder are "borrowed” when a study is made of
j
I
'the cause and background for the pupilfs health problem.
This relationship between the two offices involves the
followings
1. As it is discovered, health information which
will make health a functional part of the guidance program
is posted to the cumulative record card by the health
office personnel.
2. The health card is consulted when a case study
or referral to the child guidance clinic for a pupil with
emotional or mental problems is being considered. A health
28
appraisal of the child may be requested of the school
physician by the guidance director.
3. When the list of special health problems for A6
pupils is forwarded to the school by the elementary school
nurse, it is screened for facts of significance to the
guidance director# The same procedure follows the screen
ing of A6 cumulative cards and health cards when they are
received by the school*
If. The guidance director has been made aware of the
health needs before programming in the case of B7 pupils
and the past semester fs pupil personnel. As the medical
appraisal of new pupils is completed, the guidance director
makes necessary adjustments in the modification of the
program if this has been recommended.
j?. Before programs have circulated at the beginning
of the semester, the guidance director makes available the ;
programs of pupils who must be summoned by the health
office personnel.
6. The guidance director initiates a temporary
health card, an emergency card, and a health history form
for all transferees and new enrollees for the health office
personnel•
7* All health records, including the emergency
card, are supplied the guidance director when a pupil is
transferred from the school. (In this way the health cards
29
are kept current with the cumulative folders).
i -
8. At the time the cumulative folder is requested
for a pupil, the guidance director also Includes a request
i
for the health card. i
i
9* The nurse contributes significant welfare findings
from her home visitations which may affect the pupil progress.
Relations between the health office and the Physical
Education departments. The health status of each pupil is j
»
the determining factor in the assignment of the pupil to
the Physical Education classes* For the protection of the
pupil the assignment must be modified from time to time as
the need is determined by the health office personnel or
t
by the Physical Education teacher. This fact, necessitates |
frequent communication in regard to the following: [
m !
1. The Physical Education teachers assist the ;
I
school physician in the screening of all B7 students for j
Physical Education assignment early in the semester.
2. Any modification or adaptation of the Physical
Education activities of a pupil, permanent or temporary, is
communicated to the teacher concerned in writing and a
duplicate is retained in the health office.
3. At the beginning of the semester a compilation
of the names of the pupils who were restricted in their
Physical Education activities at the close of the last
semester is made for the Physical Education department.
30
i j . . The Physical Education teachers assist with the
operation of the tuberculosis case-finding program, the
smallpox vaccination program and the poliomyelitis immuni
zation program when they are scheduled for the school, The
attendant programs of films and lectures are also conducted
through the Physical Education classes,
5* The health office personnel assist with the
girls’ annual posture contest*
6, Both departments share in the supervision of the i
lunch period, encouraging good dietary and eating habits
and promoting a sanitary eating area*
Relations between the health office and the cafe
teria personnel*
1* The school physician makes a medical appraisal
of the adult personnel early in the semester* Permission !
to work is denied if there is evidence of communicable
disease present*
2* Pupil food handlers are inspected and instructed
by the school nurse before being granted permission to
serve the school.
3* A first aid kit is supplied by the health office
personnel and is replenished at the beginning of each
semester as needed*
J|* Appropriate posters for the cafeteria are made
available.
31
5* Ice Is supplied by the cafeteria personnel when
needed for first aid in the health office*
Relations between the health office and the class
room teacher* The classroom teacher occupies a strategic
position as a connecting link between the pupil and the
school health personnel because he has almost unbroken
contact with the pupil (12:168). This applies especially
to the homeroom teacher who has an excellent opportunity j
in his three years contact with the pupil to observe and
detect early si ©is of a physical defect or of emotional and
social maladjustments (2:135)* The teacher’s assistance
and cooperation are invaluable in the following respects:
1* The homeroom teacher sends a homeroom represent- i
i
ative to the Health Club meetings and assists him to j
i
interpret the Health Bulletin he is given there to his
classmates* j
2* The homeroom teacher distributes and collects
parent request slips for the special immunization and case-
finding programs, distributes and interprets the heal
education literature preparing the pupils for the program*
3. The homeroom teacher delivers the clinic slip
reminders to the teachers concerned.
I j . * The B7 homeroom teacher distributes and collects
the temporary health card, the emergency card and the
health history, checking for parent signatures before
32
delivering them to the health office.
5. The Science, English, and Social Studies teachers
cooperate with the personnel administering the audiometer
testing and dental programs by preparing the pupils for the
program and by accompanying the class to the appropriate
room to preserve order.
6. All teachers attempt to correlate health
instruction with the special health services programs.
7. Some health education units in the curriculum
have a particular contribution to make to the health
services program. Physical Education teachers help in
forming habits of cleanliness, regular outdoor exercise,
safety, and posture. Industrial Arts classes stress safety
measures. Homemaklng teachers help in forming good eating
habits, good grooming, and in meal planning. Science
classes study how to prevent communicable diseases and of
the community sources for medical care.
8. The health services personnel acquaint the
| teaching staff with the functions of the health office and
its services, with routine procedures regarding accident
reports, with the signs and symptoms for the early recog
nition of illness and maladjustment and with the health
status of pupils in their classes.
9* Teachers cooperate with the school physicians*
recommendations regarding preferential seating and modify
33
the program for pupils with, hearing and visual defects.
They encourage the pupil to accept aids, such as glasses,
when they have been recommended.
10. Teachers relinquish class time for pupils who j
must attend speech correction and lip reading classes.
11. Teachers honor the office summons slips request
ing the pupil for the medical examination or for individual
counseling in the health office.
12. Teachers are alert to the need for adjusting
the ventilation, lighting, and seating in the classroom for
the protection and promotion of the pupilsf health.
13. First aid kits are distributed to Homemaking,
Science, Industrial Arts, and Arts and Crafts teachers and j
to the cafeteria manager for use in case of minor accident.
l l | . The health office personnel arrange the
j
schedule for the chest X-ray for adult personnel when the j
1
service Is offered, attempting to accommodate those who
have requested a preference of period.
Relations between the health office and the commu
nity. ”Community groups may be led toward consideration of
health matters through interest generated by school proee-
dures1 1 (9:5>)*
fGoing to school * becomes an experience in community
living, and school life becomes filled with problems
which are real, which have come from life as it is
being lived in the nation (llsij.19)#
The school, the home, and other agencies in the community
must be concerned with cooperating with each other in their
efforts to solve the health problems of pupils* Opportu
nities at hand are:
1. Cooperation with the Los Angeles Board of Health
by assisting with immunization programs for communicable
disease control in the temporary loan of facilities and !
personnel and with publicity; reporting suspicious cases of
the communicable diseases which are reportable: namely,
diphtheria, scarlet fever, poliomyelitis, and food
poisoning*
2* Cooperation with the Los Angeles Tuberculosis |
and Health Association by assisting with tuberculosis case- !
i
finding programs in the temporary loan of facilities and |
i
personnel and with publicity*
3. Cooperation with the home in acquainting them
with the health needs of the pupil, encouraging them to
improve the health status and assisting them to find
community resources when needed*
If* Keeping parents informed of school health poli
cies, of available health services, of communicable disease
control and special health services programs; supplying the
parent with current health literature.
1
35
5. P.T.A. medical clinic and guidance clinic
I
facilities are available to pupil personnel in need of
clinic care*
6* The use of welfare agencies as sources for
a
referral of indigent pupils*
7* The us© of the help of service agencies in
securing needed braces* glasses* and dentures*
8* The use of Community Chest agencies (Childrens1
Hospital clinic and Orthopedic Hospital clinic) as sources
for referral*
9* Referral of pupils in need of a private physician
or dentist to the Los Angeles County Medical Association,
local hospitals and the Los Angeles County Dental Associa- |
tion who will supply the names of three specialists in the
area* 1
j
10. Acquainting the Health Club with activities of
a health center by field trips* j
CHAPTER XV
SERVICES Am RES POSSIBILITIES OP THE
HEALTH OFFICE PIRSOOTEL
In order to function most efficiently and success
fully it is important that the personnel who work together
through the health office have an under standing of each
other’s services and responsibilities.
All associated with the health services program
should maintain a friendly and sympathetic attitude and
relationship so they can give effective and acceptable
counsel and guidance . . « regarding health problems
(17:56).
The services and responsibilities vary with each school
setting but in general are similar throughout the Los
Angeles school system.
Services and responsibilities of the school
physicians. ”The first requirement of a school physician
serving the schools is that he should above all be a fine
human being and a good doctor” (15*77) • Assignment to the
sehool is on the basis of four hours a week. The physi
cian’s activities in directing the program are:
1. Screens B7 pupils and pupils new to the school
for assignment to Physical Education.
2. Examines athletes before they engage in strenuous
sports.
37
3* Examines pupils who had a modification in the
Physical Education assignment during the past semester due
to a health problem*
if. Makes a routine examination of pupils entering 1
the B7 grade and of pupils new to the Iios Angeles City
School District to identify those needing further examina
tion, needing treatment or for whom the school program
needs to be modified*
Examines pupils who have returned to school
without a medical certificate following a long illness
jabsence, an accident, or an operation* Advises needed
[adjustments in the school program to safeguard the pupil.
|
6. Examines pupils to establish eligibility for aid j
from the P.T.A. welfare fund (lunch and/or milk)* !
7* Examines referrals on the basis of a health
problem, absenteeism or scholastic failure*
!
8* Examines referrals to establish eligibility for
exclusion for a physical handicap or for emotional instabil
ity.
9. Examines pupils for eligibility for Corrective
Physical Education*
10* Examines adult food handlers.
11. Examines pupils for eligibility for a work
permit.
12. Makes the medical examination an educational
38
experience in that the pupil learns about his health assets ■
and liabilities and becomes interested in following up the
findings.
13♦ Hotifies the parent of the defects which have
been found, (Gives no medical treatment as it is the
proper function of the family in cooperation with the
family physician (718$).
I J 4 . * Holds a conference with the parent who is con-
1
{
cerned about the pupil’s health needs; explains the reasons
for early follow up of the recommendations made.
15. Beports suspicious cases of reportable communi
cable disease to the Dos Angeles City Health Department.
16. Hotes and reports the school’s sanitation and j
safety hazards in periodic surveys. !
17. Advises school personnel in regard to a pupil’s[
health problems by requested conference (10:3-18),
(15*77).
Services and responsibilities of the school nurse.
The school nurse serves as an interpreter between school,
home, and the community. She understands the health needs
of children, serves on the school team and with a wide
variety of community agencies and groups in getting health
needs met (11:381). Assignment is on the basis of three
days each week. The major services and responsibilities of
39
the school nurse are: j
1* Assists in the maintenance of the health records?
keeps them up to date* Interprets records for the school
personnel as a tool in guidance*
2. Assists the teacher in the techniques of
observation.
3* Assists with following up problems in keeping
with the school physician’s findings; arouses a feeling of
responsibility on the part of the parent to get serious
defects corrected and the problem solved* Explains the
relationship between optimum health and intellectual
achi evement (13:5)*
if* Uses the school and community resources in j
1
counseling with parents and pupils to meet the health ;
needs of the pupil.
5* Counsels those pupils with defects for correc
tion, encouraging them to accept the responsibility for
their own health problems but helping them to face and
solve them.
6* Helps the pupil to learn to live with his
physical limitations and to accept recommended aids (such
as glasses) without developing an inferiority complex.
Counsels the pupil’s teachers to help him in this.
7* Acquaints the vice principal with vital informa
tion gained from counseling with parents and pupils when it
1*0
would holp in understanding behavior problems.
8. Makes home visits for the attendance office to
verify illness absence; visits the home of the maladjusted
pupil where it will be of advantage to know the home
environment •
9. Assists in stimulating faculty interest in
recognizing the values of school health services*
10. Assists in selecting and in preparing the
pupil for the medical examination, explaining the purpose
of the examination and the procedure to be followed.
11. Transfers health information from the health
history form to the health card in preparation for the
medical examination.
12. Assists in initiating health follow-up cards
to inform teachers of health conditions requiring special
attention in the classroom*
13* Screens the pupil’s vision and records the
height and weight in preparation for the medical examina
tion*
l l j . . Eeeheeks the vision of pupils referred by the
teacher.
15. Follows up pupils who have hearing and vision
loss, arranging with the parents for further testing as
needed*
16. Assists in interpreting the health services
41
program to the P.T.A.
17* Inspects and excludes pupils and school person
nel with suspected communicable disease and arranges for
transportation to the home*
18* Encourages teachers to be on the alert to
observe signs ordinarily associated with colds and to report
abnormal conditions*
19* Readmits pupils following absence due to
illness, accident, or suspected communicable disease and
informs teachers of recommendations for temporary readjust
ment in the classroom by means of the health information
card*
20* Assists in making the arrangements for the
isolation of pupils who show signs of illness and who are
awaiting removal to the home.
21* Selects pupils to be immunized and assists with
the immunization programs when they are conducted at the
school. Interprets immunization procedures to the school
personnel*
22. Interprets to the community policies of the
school and City Health Department relative to communicable
disease control* Encourages parents to keep pupil’s
immunizations up to date*
23* Informs pupils and teachers of community
resources for dental care and encourages pupils to make and
keep dental appointments*
Benders first aid and converts the incident
into a safety education experience*
2jJ. Arranges satisfactory facilities for the care
of the ill and the injured pupil*
26. Screens student food handlers for cleanliness,
dental decay, and the condition of the nails, advising them
of the importance of cleanliness in the handling of food*
27* Teaches nutrition in contacts with pupils in
the health office*
28. Assists in surveys of the environment; if not
safe and sanitary, reports health and accident hazards to
the administrator*
29* Makes each conference with pupils a learning
experience, working to make health education functional in
the life of the pupil.
30* Cooperates with other health services personnel
in the organization and follow-up of school-wide health
programs.
31* Secures the social histories for pupils to be
referred to welfare agencies*
32. Arranges for group counseling with A9 pupils,
stressing the importance of entering senior high school with
all remediable defects corrected.
33. Arranges for group talks to B? pupils stressing
i» 3
personal hygiene and health habits including menstruation,
staying at home when ill, reporting accidents, calling the
school when absent, eating breakfast before coming to
school, and getting sufficient rest at night*
3 l j . # Assists in gathering all health records for the
pupil who is transferring*
35* Participates in relating the school health
program to the total health program of the community*
36. Assists in interpreting the health services
program and pupil needs to school personnel, pupils,
parents, and interested community groups*
37* Assists in the training of the health office
monitors (10:4~19)» (11:391).
Services and responsibilities of the health coordi-
health education problems within the school itself and the |
I
need for coordinating these with the home and community lead!
to the need for a coordinated approach to develop and
articulate the entire program. ”In the solution of these
problems, the health coordinator should not be responsible
for initiation of policies but only for their smooth
functioning” (18:7)* assignment to the health office
of the school is for three periods of the school day. The
main functions of the health coordinator follow:
nator* The increasing complexity of health services and
X. Prepares for the health specialists, arranging
the details associated with them, aiding with the selection
of the pupils to be examined, preparing the examining room,
and arranging for pupils to be available at the appointed
time*
2. Assists in maintaining the health records,
program cards and emergency cards, taking the responsibil
ity for their being current, orderly, and accessible to all
concerned* Processes all records for new pupils and trans
fers all records to the guidance office for transferring
|pupils.
3. Keeps the school personnel who are concerned
with the pupil informed of the health specialists * findings
and recommendations regarding preferential seating in the
| classroom, assignment to a modified program or to a special
(class such as lip reading and speech correction,
j I 4 . . Forwards selected health information to the
guidance office for recording on the cumulative record.
5. Forwards the home notice of physical findings
Initiated by the physician and records the information on
the health card.
6. Initiates the circulation of the confidential
health information card to the personnel concerned with the
pupil•
7. facilitates the follow-up program by reminding
pupils of their clinic appointments several days in advance.
8. Confers with pupils regarding their health
problems and arranges consultations with the nurse or
physician.
9* Arranges the details for the school-wide pro
grams of health specialists such as for the dental survey,
tuberculosis case-finding, and audiometer testing programs.
10. Coordinates the health services of all health
services specialists in their relations with the pupil, the
teacher and the home.
11. Assists in promoting good public relations in
contacts with the home and with community organizations,
12. Makes periodic surveys of pupil cafeteria
habits, stimulating good eating habits. Refers those who
appear malnourished or fatigued to the school nurse for
individual guidance*
13. Assists with the supervision of safe and
sanitary environmental conditions arranging for periodic
surveys by the school physician and nurse.
l l | _ . Reports health and accident hazards to the
administrator.
15. Assists in promoting the coordination of the
health instruction program, helping each department to
develop the health education values inherent in that area.
16. Develops all health services activities so that
¥>
they help improve health practices.
I?. Helps teachers relate health instruction to the
school-wide special services programs by supplying appro
priate, up-to-date, and approved health instructional
material.
18. Develops a file of informative health material
and instructional aids* Orders health periodicals for the
school library. Compiles an abstracted list of films
related to the field of health for department heads.
19* Assists in interpreting the health services
program to the faculty.
20. Assists in training the student service
monitors for the health office in their established duties.
21. Attempts to stimulate healthful attitudes and
practices on the part of pupils by developing a positive
and dynamic health program.
22. Attempts to stimulate the interest of the
community in public and school health problems through
P.T.A. contacts.
23. Promotes active pupil participation in school
health problems by means of the student health club,
2 i | . . Assists with the orientation of new teachers by
interpreting the school health program and pupil needs.
25* Informs students of community resources for
dental care and encourages pupils to make and keep their
1 * 7
dental appointment s•
26. Coordinates the health services activities of
the City Health Department with those of the school as in
the school-wide immunizations programs. Cooperates with
these health specialists in assisting in organization and
follow-up.
27• Coordinates the efforts of the school and the
community by attempting to work harmoniously and without
overlapping and by cooperating with the home and with the
family physician.
28. Assists with the school and the community edu
cation in relation to the immunization, testing, and case-
finding programs. J
29. Cooperates with the policies for the exclusion
I
and readmission of pupils with communicable disease when the
school nurse or school physician are not in attendance.
30. Arranges for the isolation of pupils ill with
communicable disease while awaiting removal to the home.
31 ♦ Interprets the procedures for the special
services programs to the school personnel and informs them
of the results.
32. Cooperates with the policies for emergency care
of accidents or sudden illness and assumes direction when
the school physician and nurse are not available.
33. Periodically inspects the first aid kits
distributed throughout the school. Maintains first aid |
supplies and health office equipment.
3^.. Promotes health knowledge tests at the 7th
grad© level to determine the level of ensuing health
instruction (18:7)> (2:9^) *
Services and responsibilities of the speech correc
tion and the lip reading teachers. In their function at the
i
school the lip reading and speech correction teachers 1
i
render an important psychological service in
straightening out ©motional problems associated with
variants” (11:285)• They are licensed for their professions
and must meet the qualifications set for them by the state. ^
i
Assignment to the school is on the basis of need insofar as |
the district budget will allow.
Bach teaches classes at the school a half day a week.
Classes are formed of pupils who were in attendance at the j
close of the past semester and are still in need of the
service. Additions are made from a screening of the B7
health and cumulative cards and from the health cards of
transferees as they are received by the school. Throughout
the semester recommendations for the services are made by
the school physician from his routine examinations, by the
observation of the classroom teacher, and following the
audiometer testing program.
During the first two visits these specialists j
i
counsel with their prospective pupils on an individual
basis* After consulting the health card and cumulative
card for causative factors, they revise their class rolls
from the previous semester’s lists to include the new
referrals*
Services and responsibilities of the sight-saving
teacher* This particular school is one of five junior high
schools in the Dos Angeles City School District which serve
I
as centers for classes for the partially seeing pupils in
scattered areas throughout the district* A school bus
transports the pupils from within the adjacent junior high j
school’s boundaries* The sight-saving program is supported |
by the state program for the handicapped child and serves '
I
pupils whose vision is between 20/70 and 20/200* |
| The sight-saving teacher is given specific help from !
a trained teacher of the partially-seeing who makes
periodic visits to the classroom in which the partially
seeing pupils are enrolled (9*186).
The pupils remain in the classroom for the full school day
except for the Physical Education class* Material helpful
to the class are textbooks printed in large, clear type,
pencils with thick soft lead, and unglazed paper* To
further save the eyesight, all have the opportunity to
learn to type written assignments on the primary type
writers provided*
50
Duties and responsibilities of the student service
monitors* The health office is burdened with clerical
duties, many of which can be delegated to pupil personnel#
i
Five weeks before the close of each semester pupil programs
for the coming semester are circulated by the student body#
Except for the incoming B7 pupils, all have the privilege
of selecting an elective, one of which is "Student Service1 1
in an office* From a list of applicants and from those
f
recommended by the guidance office, two pupils are signed
up by the health office for each of the seven periods*
They are selected on the basis of scholarship, citizenship,
j i
attendance, and a satisfactory health record* Hear the j
f
i
close of the semester each pair is summoned to the health
office for orientation during the class period in which j
i
they will serve during the coming semester* They are |
I
"indoctrinated" by the monitors in office and take part in ;
i I
j
the customary activities of that class period#
In addition to these two monitors each period, two
pupils are requested to assist with the readmission proce
dures during a part of the homeroom period. They enjoy the
"privilege” of entering the building fifteen minutes before
the opening of school to prepare the health office for the
dayfs activities.
On the first day of the semester the monitors are
"briefed” on what is expected of them. They are cautioned
i
not to repeat what is seen or heard in the health office
just as they would wish their own problems to be held in
confidence by others. The importance of cleanliness,
courtesy, awareness, and industry are stressed. Each day
they are acquainted with a new process until all techniques
have been covered. The specific duties for each period are
posted on small cards inside the door of the first aid unit.
A typewritten list of the general responsibilities is given
each monitor for her notebook. It reads as follows:
All Health Office Monitors
G-eneral Responsibilities
1. You are cautioned not to repeat what is seen or
heard in the health office.
i
2. After putting away your wraps and books, wash your j
hands and wipe the first aid unit with the damp
towel• j
3. Thermometers are cared for first unless asked to do j
otherwise.
i
I
if. When sent on an errand, report back promptly with a j
reply even if it is only ’Mission accomplished.’ I
5. Caution waiting pupils to sit quietly. Suggest the
reading material on the shelves. If the pupil
becomes disorderly, ask him to kindly sit on a cot
across the room. -
6. File any unfiled health office visit cards and
emergency cards behind the letters assigned to you.
7. Ask pupils who are still waiting in the health
office at the close of the period to report to the
next teacher to check attendance, then to ret urn.
8. Deliver summons slips and clinic slips courteously
and return to the health office without delay*
52
Cots are straightened after use and forgotten
towels placed in the waste basket.
When a pupil leaves the doctor ’s office, sign the
time on the pupil’s summons slip and ask him to
return to class.
Stamp any material left for you at the reception
table and return the assignment (finished or not)
to the health coordinator at the close of the
period.
Piling:
a. Health office visit cards
b. Program cards
c. Emergency cards
Pilling out summons slips for doctor and nurse.
Keeping pencils for the health office sharpened.
Stamping all printed forms: name of school,
principal, and ’Health Office.’
Folding health history forms.
i
Clipping folded health history forms to emergency t
cards (for new BJ pupils). !
Clipping completed health history forms to health
cards.
Pulling emergency card, health office visit card
and program card for students transferring out.
Cleanliness and order of the first aid unit.
Cleanliness and order of the two cots.
Attention to the ventilation of the health office
and adjoining doctor’s room.
Cleanliness and order of magazine rack.
Houtine Clerical Duties
Housekeeping Duties
53
5 >. Dust doctor’s desk and chair with damp towel the
morning of the visit.
Duty as the Receptionist
1* Screen students who visit the health office:
a. Request a written pass from the teacher or a
note from home.
b. Pill out the health office visit card for
required information:
1) Date
2) Period of the day
3) Reason for the visit
4) Number of days absent (only if to be
examined for readmission after absence)
c. Seat the pupil who will be hold ing ’ no t o " and i
health office visit card. (If an emergency, j
call nurse or health coordinator’s attention). I
2. Screen phone calls for the doctor, nurse, or for
the health coordinator.
Nursing Procedures
1. Thermometer cleansing techniques. j
2. Cut 2mx2m cotton squares to fill three cotton (
pledget jars. j
3. Cut appropriate lengths of paper toweling for use I
on cots; fold and store.
I
4* Assist with measurement and/or recording of height
and weight of students.
5. Use and care of hot water bags and ice caps.
6. Sterilization techniques of equipment used in
first aid capacity.
7 . Make cotton swabs.
8. Keep first aid unit supplied from first aid supply
closet: green soap, alcohol, absorbent cotton,
band-aids, Karo s^rrup, paper cups, and tongue
blades.
Messenger Service
Deliver summons for health office personnel*
Pick up health office mail from mall room and
deposit it in tray on top of files.
Mail home notices in school mail bag*
Deliver clinic visit reminder slips*
Deliver health office records of transferrees to
guidance office.
Deliver ’Health News’ to teachers’ mail boxes.
CHAPTER V
i
DETAILED HEALTH SERVICES ROUTINES .
AMD PROCEDURES
In order that all processes are covered in this
description of health services policies and procedures,
those procedures peculiar to a particular time of the
semester are described separately from the routine proce
dures. Of necessity some overlapping in the description of
the first and last weeks of the semester occurs because much
of what ^occurs during the first week depends upon what has
been previously prepared for it during the last week.
I. FIRST WEEK |
i
i
It is often necessary to be able to "locate” a pupil j
during the first few weeks of the semester. This is a j
i
little difficult since there Is not an alphabetized file
available until permanent program cards are made out during
the third week of the semester. There are, however, four
sources from which to draw: (1) The permanent homeroom and
grade are available from the program file of the semester
preceding. The health office has such a file. (2) The
student fs new program is kept on file by the homeroom
teacher and is available after the first day. (3) A master
program by grades may be consulted In the guidance office.
56
( I f . ) Homeroom lists for all pupils are available in the
attendance office at the end of the first day of the
semester*
I
i
Monday J
The school is notified by the first day of the
scheduled visits by the school physicians for the semester.
For the first two weeks they are scheduled to screen the
incoming B7 class and all other new pupils for assignment toj
i
the Physical Education classes, screening out those for whom1
a modified form of Physical Education is advisable. These
screen examinations commence for the girls* physician on
the first day. The Physical Education department is
immediately advised of the schedule since it is through j
their classes that the major portion of the screening is i
done. A Physical Education teacher records the physician’s :
recommendations for the B? boys and the recommendations for j
the B? girls are recorded by the health coordinator. All
new pupils are sent to the health office by the Physical
Education teachers for screening. A nrunning listM of
these is kept by the health coordinator. Available to the
physicians is a previously prepared list of the pupils from
the contributing elementary schools with known health
problems filed in the health coordinator’s workbook.
1. Prepare the physician’s desk, as described in
the last section of this chapter entitled, ’ ’ Routine Pro
cedures,” with the metal card file boxes marked, ”B7s -
Girls” and ’ ’ New and Transfers - Girls” and with the list of
known defects for these groups. She will wish to check
these.
2. Screen any B7 health cards and elementary
cumulative records which have arrived since the main group
was received at the close of the past semester: (a)* For
defects: these are to be examined earliest following the
screening examinations; flag with a white and a red flag;
add to the list available to the physicians. (b) For
i
i
recency: those for whom a routine examination has not been |
i
made since the third grade, flag with two white flags; those1
who have had a routine examination since the third grade, !
flag with one white flag. (c) For lip reading, speech
correction, and sight-saving classes: add these names to a
previously prepared list and send the duplicate list to
these specialists through their school mail boxes.
3. ”Confidential” health information cards, (which
have been circulated during the previous semester) are re
circulated through the teachers1 boxes. This information
alerts the teachers of students who need special attention
because of a history of a heart condition, diabetes, hernia,
epilepsy* recent operation, chest condition, or an ortho
pedic condition. A list of these cards is previously
58
prepared so that it may be checked against any which have j
not been returned to the health office within three days.
If. Prom material prepared and in the B? homeroom
teachers1 boxes on the opening day, B7 pupils will fill out
a temporary health card, and will take home for signature
an emergency card and a health history form.
5* Prom material prepared and in the hands of the
guidance director on opening day, new pupils will fill out
a temporary health card and will take home for signature an
emergency card and a health history form.
6. Have prepared and in the boxes of the speech
correction and lip reading teachers lists of B7 pupils for
whom a speech or hearing loss was recorded from the health j
cards or cumulative cards. i
I
7. Make arrangements with the girls* physician and j
i
I
the cafeteria manager for the physical examination of adult j
food handlers. (The school nurse makes the same preparation
for the inspection of the pupil food handlers.)
8. Prepare a list of the Mpink card” pupils and post
inside the door of the first aid unit. Also, flag the
health office visit card to alert health office personnel
to call parent before administering first aid should it be
needed. These pupils have filed a parent request to be
excused from physical examination and from health instruc
tion concerning disease. I
59
9. Through the teachers* boxes, supply each teacher
with a few health office visit forms to be used when a
pupil is sent to the health office for care in case of
sudden illness or accident*
10* All teachers will find in their mail boxes
prepared emergency cards of those pupils whose cards are
missing from the emergency card file and are to be taken
home for signature.
11* Request a clerk in the principal’s office to
type a health office schedule on a 3f f x5" card for each
office in the school, information to include: (a) dates of
the physician’s coming visits, (b) the nurse’s schedule,
(c) the health coordinator’s schedule, and (d) the period
during which the health office is closed. Request that the
same information be placed in the bulletin for the second
day*
12. Consult the tickler file for clinic appointments
and for requested rechecks by the school physician which
have come due that month. Prepare the health cards for the
physician and a list of the clinic appointments for the
nurse.
13. Health office monitors are requested to leave
a copy of their programs with the health office personnel
at the close of the day. At that time they will be given a
copy of the "General Responsibilities"of a service girl
6o
and a short orientation session*
l i j . * Hold an orientation session with the health
office monitors*
15* Significant findings and recommendations made
by the physician will be communicated to teachers concerned
by making and circulating a health information card. A
separate form is sent to the Physical Education teachers
notifying them of restriction in the Physical Education
1
1
activities* Note these findings in the health coordinator’s
workbo ok*
16 • If the doctor has indicated that she wishes to
see a pupil early following her screening session, flag the
card appropriately; if at a definite time, drop a reminder
1
into the tickler file* ;
i
17* Make copies of the B7 homeroom lists found in
the attendance office* j
18* Alphabetize, screen, and delete from the lists
the temporary health cards which have come in from the B7
homeroom teachers. Plag them as described in (1) above.
Attach a blank health card to the temporary health card for
those pupils who are from out of the Los Angeles City School
District* Place them on the doctors1 desk in front of the
metal card files marked, ”B7 - Girls" or T t B7 - Boys" for
inspection by the physicians*
19. Alphabetize, screen, and flag any health cards i
I
61
which have com© in for new transferred pupils* Place them
on the doctors1 desk in front of the metal card file
marked, "New and Transfers - Girls" or ! 1 New and Transfers ~
Boys1 1 and record significant findings in the health j
coordinator’s workbook. This is a routine procedure for the
remainder of the semester.
20. Prepare the doctor’s room for the screening
session for boys the next day.
!
21. Be-order emergency cards, health history
forms, and temporary health cards in the amount used for
this first day.
22. Bequest the boys’ Physical Education teachers
to send to the health office a list of new pupils in their
I afternoon classes. Prepare summons slips for them.
Tuesday
The boys’ physician (whose schedule is from 8:00 a.m.
to 12:00 noon will screen B7 pupils in the gym during their
third period. New pupils from the first and second periods
will be sent by their Physical Education teachers to the
health office for screening. Send out the summons slips
made for the boys whose Physical Education period falls in
the afternoon as time permits. The doctor will leave a
list of the pupils with health problems. Prom this list,
the health coordinator will flag the cards appropriately,
62
notify the teachers concerned and record the health prob
lems in the workbook.
1. Health information cards, which had been
circulated by the pupils previously grouped by homeroom
numbers, are placed in the homeroom teachers’ boxes to be
distributed during homeroom period the following day. A
bulletin is prepared (before 1:00 p.m.) explaining this
procedure and requesting that the cards be returned to the
health office at the close of the day.
2. Delete from the list and file the "Confidential1 1
health information cards which have been returned after
circulation yesterday.
3. Health cards are filed in the regular health
card file by the health coordinator alone as she is
responsible for locating any card at any time. When the
nurse or others who pull a card from the files have finished
with it, it is placed in the space provided behind the first
section of the health card file drawer. Before filing it,
the health coordinator screens it for notations made by the
nurse and posts any change in health status in the workbook.
If a clinic appointment has been noted, the health coordina
tor prepares a clinic reminder and places it within the
leaves of the desk calendar two days before the date of the
appointment. If it is noted that the P.T.A. clinic has
requested that a return appointment be scheduled for the
following year, for example, the information is dropped
into the tickler file#
If. Sort, screen, and delete from the lists the
health history forms and emergency cards which have come in !
from the B7 homeroom teachers# Clip the folded health
history forms to the temporary health cards on the doctorsT
desk and flag with red flag if pertinent information was
found on the health history form. File the B7 boys f cards ;
i
in the ”B7 - Boys” card file, since they have been screened
by the boys’ doctor# File the emergency cards.
5. Delete from the list and file emergency cards
1
which have come in from the homeroom teachers for pupils |
whose cards were missing from the emergency card file# .
6# Hotify the classroom teachers and the Physical j
Education teachers concerned of significant findings and of
jrestrictions in the Physical Education activities.
Wednesday [
t
1. Health information cards are being circulated by |
certain pupils and will be returned to the health office at
the close of the day#
2. From a list of first aid stations posted on the
inside of the cupboard door of the first aid unit, call in
all first aid kits by sending a monitor. Check and
replenish the contents as needed#
3. Delete from the list and file any "Confidential" i
i
health information cards which have come in* i
If. Delete from the list and file the health informa-1
tion cards returned to the health office by the pupils who
circulated them today* Prepare summons slips for pupils
whose cards are missing*
5>. Sort and screen the temporary health cards,
emergency cards, and health history forms which have come in
t
for new pupils through the guidance office* Process them !
similar to the procedure for the B? material described for
Tuesday, sections If, 5, and 6. Cards for those on the
"running list" of new pupils already screened are filed
in the appropriate metal card files and the rest are placed 1
on the doctors1 desk for their inspection. }
6. Delete from the list and file any emergency
cards returned by pupils whose cards had been missing* j
Prepare summons slips if cards have not yet come in.
7* Prepare the boys’ doctor’s room for his visit on
Thursday.
8. Hotify the teachers concerned of significant
findings from the doctor’s examinations.
Thursday
1. The boys’ doctor will examine the B7 boys in the
gym and new pupils in the health office as on Tuesday.
Summon boys whose Physical Education period falls in the
afternoon as the time permits*
2. Circulate a duplicate “Confidential1 1 health
information card for any card which has not been returned i
to the health office by this time. Alternate action: have
a conference with the teachers concerned*
3* Prepare a mimeographed bulletin of the semester’s
health Institute programs for all school personnel.
I 4. . Delete from the list and process any emergency
cards, health histories, and temporary health cards whieh
have come in* Place on the doctors’ desk*
5* From the doctor’s findings, circulate health |
information cards to the teachers concerned*
f
6. File the temporary health cards inspected by the ■
1 1
j doctor* |
i 7* Notify the teachers concerned of significant -
I
findings*
1
8* Prepare the doctor’s room for her visit on
Friday.
9* From the cards placed on his desk for inspection,
place cards which the doctor ha3 inspected in their
appropriate file boxes.
Friday
The girls’ doctor will screen B7 girls in the gym
and new girls In the health office during their Physical j
Education periods throughout the day.
i
I
1* Summon adult food handlers for examination as 1
previously arranged.
2. Summon pupils who have not returned the health
information card. Make a duplicate card if necessary.
3* Summon pupils who have not returned the emergency
card. Give a duplicate card if necessary.
1 | . . Prepare summons for B7 pupils and new pupils for
I
whom it has been found that a health problem exists. The '
health cards will have been flagged in red. Sort the slips
by homeroom number. Consult one of the four sources
(mentioned under the procedures for Monday) for the pupils.
The school nurse will probably commence screening the
i
I vision and the height and weight for these pupils on
i
[Wednesday of the following week. J
5. Prepare the doctor’s room for her visit on
Monday.
6* Consult the vice principals with lists of the :
pupils who have not as yet turned in the material sent home
for signature.
7. Prepare summons for all pupils who were
restricted in their Physical Education activities at the
close of the past semester*
8. Place the cards which were put on the doctor’s
desk for her inspection in the appropriate file box.
67
II. SECOND WEEK
I
Monday
1. The girls1 physician will probably finish the
screening process for each class before the close of each
period* If so, from the prepared summons slips, summon
pupils who were restricted in their Physical Education
activities at the close of the past semester for a re-
evaluation of the health status* Health cards for these
pupils will be pulled from the regular file (flagged in red)
as the pupils arrive* There may also be time to commence
summoning B7 and new pupils for whom it has been found that
a health problem exists*
j 2. Prepare a tear-off bulletin to be read in the I
homeroom period on Tuesday requesting the homeroom to j
select/elect a representative to the Health Club, returning i
the tear-off to the health office at the close of the home
room period*
3* Screen the health cards of the pupils who were
examined for re-evaluation of the health status for
Physical Education activities and for the cards of B7 and
new pupils with health problems. Post significant health
information in the workbook.
i | . . Remove the white clips from the health cards for
those B7s and new pupils for whom the doctor has completed
the routine examination.
5. Notify the Physical Education teachers of the
i
doctor’s recommendations concerning the Physical Education
assignment of each of the pupils examined for re-evaluation.
Post the information in the workbook if any change in
health status is noted.
6. Notify teachers concerned of significant find
ings so that preferential seating may be arranged. If lip
reading or speech correction have been recommended, inform
the appropriate specialist* !
7* Prepare envelopes to enclose any home notices
which the doctor may have initiated, noting the information
on the health card.
8. Place the health cards of the above groups on 1
I
the nurse’s desk for her processing, recording, copying of
the health history and follow-up procedures. When finished
with them, she will place them in the appropriate spot for
filing by the health coordinator.
9* Procedures 3 to 8 above are routine procedures
for the semester.
10. Prepare the doctor’s office for his visit on
Tuesday*
Tuesday
I
1. The boys’ physician examines B? boys in the gym
and new boys in the health office until noon. Prom the
69
prepared summons slips, summon boys whose Physical Educa
tion periods fall in the afternoon as time permits.
2. From the tear-off slips sent to the health office*
i
by the homeroom teachers, prepare a roster of Health Club
members by homeroom number. Hule a section for tallying
the attendance for eight meetings during the semester.
Prepare a Health Club membership card for each pupil.
3* Hotify teachers concerned of significant
information revealed by the doctor’s examination.
I j . . From the group of cards placed on the doctor’s
desk for his examination, place in the appropriate boxes
the cards which the doctor has inspected.
t
Wedne sday j
1. By this time, requested health cards for new j
i
pupils from within the Los Angeles City School District j
will be arriving in the guidance office. These are !
i
screened, processed, and recorded by the health coordinator
as they are received from the guidance office. The tempo
rary health card is pulled and clipped to the health card.
If there has been no examination made while the pupil was
in attendance in a junior high school, a white clip is
added to the card, indicating that he should be examined
early. Place these cards on the doctor’s desk for
inspection.
j
70
2. Prepare the doctor’s office for his visit on
Thursday#
3# Prom the attendance office secure a list of the
pupils who have not returned to the school this semester as
expected# Pull all cards— the health card, health informa
tion card, emergency card, and the health office visit card
and send them to the guidance office to be placed with the
cumulative folder.
i
J ^ . # Prom the summons slips prepared, the school
nurse will probably continue screening the vision and
measuring the height and weight for all new and B7 pupils
flagged in red and who have been found to have a health
problem. This procedure is in preparation for the doctors’ 1
routine examinations# j
5# Sort and screen the health cards used by the
nurse, recording those with significant findings in the j
workbook and notifying the teachers concerned where there
is need for preferential seating# Pile all cards bearing
the white clip back in the files on the doctors’ desk#
Thursday
1# The boys’ doctor will probably finish the screen
ing of B7 and new pupils. Prom the prepared summons,
summon students as on the girls’ doctor’s previous visit.
(See section for Monday of the second week.)
71
I
2* A previously prepared list of A9 pupils is given
the school nurse* For her attention, the names of pupils j
i
in need of a conference or follow-up regarding a health '
problem are starred in red* She will make an effort to
create a desire on the part of the pupil to graduate with
all correctible defects cared for and will offer the
service of the available welfare agencies if this is
needed. This procedure is commenced early so that the pupil
will have the time to complete the attention he needs beforej
graduation plans occupy much of his time and energy*
3* Of the cards placed on the doctorTs desk for his
inspection, pull those with white clips and place in the
box marked, ! t New - Boys." Place the rest on the nursefs
[desk for her inspection*
j I j . , For processing the eards examined by the boys1
i
doctor use the same procedure as on the girlsr doctorfs
previous visit on Monday of this week. j
i
Friday
1. Prepare a bulletin to be read on Monday notifying
the homeroom representatives to the Health Club of a meeting!
i
in the auditorium at 8:00 a.m. Tuesday*
2. Prepare to have mimeographed seventy copies of
Health Office Bulletin #1 for distribution to the homerooms
by the Health Club representatives on Tuesday. It will
describe health office procedures pertaining to the student
body.
3. Prepare summons slips for the girls* doctorTs
visit on Monday. All pupils with health problems and
flagged in red will be summoned earliest for the routine
examination. However, pupils referred by school personnel
will always have priority throughout the semester. Check
with a red pencil the summons slips for which the vision
screening and height and weight have been recorded by the
nurse.
I j . . Prepare the doctor^ room for her visit on
Monday. She will now resume her regular scheduled visits
from 8sOO a.m.-3:00 p.m. on the first and third Mondays of
the school month.
III. THIED WEEK
Monday
The school doctor will finish with the screening of
B7 and new pupils, will finish the re-evaluation of pupils
for a modified form of Physical Education and will commence
the routine examination of all pupils new to the school for
whom it was found that a health problem exists.
1. Prom the summons slips prepared, summon pupils
for the doctor. Of this group, those checked with red
pencil should be summoned first since the vision screening
and measurement of height and weight have already been
finished by the nurse.
I
2. Prom the health cards of pupils examined by the j
doctor during the day, remove all white clips to indicate
that the routine examination has been completed and that
the cards may eventually be filed in the regular health card
file.
3. Process the cards as usual as described for
Monday of the second week, sending the home notices and
circulating significant information to the teachers when
necessary#
If. Prepare the doctor fs office for his visit on 1
i
Tuesday. 1
5# Prepare for the Health Club meeting on Tuesday j
morning by assembling the mimeographed copies of Bulletin
#1, a stack of 3nx5r f note slips and the Health Club member
ship cards.
Tuesday
1. Hold the meeting of the Health Club in the
auditorium at 8:00 a.m. Distribute slips of paper on which
the pupil records his name and room number. Distribute,
discuss, and explain that Health Bulletin #1 is to be read
in the homeroom that morning. Distribute the Health Club
membership cards.
2. The procedures followed in connection with the
doctorfs visit on Monday will be repeated*
3* When the group of summons slips for pupils with I
a known health problems numbers only twenty-five for each ofj
the school doctors, commence preparing summons slips for the
pupils new to the Los Angeles City School District, for the
pupils who have not been routinely examined since the B3
grade and the pupils who have transferred from a junior
1
high school in the city but have not had a routine examina- ,
tion since the elementary grades* Their health cards will
bear two white clips*
I j . * Since the boysf physician examines only in the
mornings, the school nurse will probably continue with the
i
summoning of pupils for her screening procedures* j
1
5* Monitors will record the attendance of the |
Health Club representatives on the Health Club roster and
will distribute Health Club Bulletin #1 to the boxes of the
teachers whose homerooms were not represented at the meet
ing.
6. Follow the usual procedures for processing the
health cards of pupils examined by the school doctors.
7* Follow the usual procedure for screening,
recording, and filing health cards to be filed in the
1
regular health card file.
75
Wednesday
Four sets of permanent programs are being filled out
by the pupils during a long homeroom session. They are
sent to the guidance office where they are sorted, one set
to arrive in the health office by the end of the week,
1, Commence the preparation of the ”Confidential"
health Overview of Pupil Health Problems” to be distributed
to all school personnel during the fourth week of the
!
semester. It is a summary of all health problems which have!
a direct relation to the activities carried on in the class
room, namely: advantageous seating for poor vision and for
a hearing defect, cautionary reminders for the special
handling of those pupils with a history of hernia, heart 1
murmur, epilepsy, diabetes, orthopedic conditions, and !
i
chest conditions. The list also carries the names of
pupils who must wear glasses for elasswork. This informa- i
tion has been gathered from semester to semester in the
health coordinator’s workbook,
Thursday
For the remainder of the semester, program cards
will come in to the health office from the guidance office
attached to the other health material (the health history
form, the temporary health card, and the emergency card)
which has been gathered by the guidance office when the new
76
pupil was programmed* j
i
1* Prepare for the B? grade counselor a list of the !
B7 pupils for whom it is already known that a health prob
lem exists* This may serve to alert her for the possibility
of health implications if a guidance problem should develop.
When B7 routine examinations have been completed, prepare a
similar list including the names of those above*
2. Correlate the program files with health card file
with the assistance of a monitor.
3* At the administrator^ request, meet with him
and with all new teachers for an orientation session regard
ing health office procedures and policies*
1
i f . . Prepare for the P*T*A* meeting honoring B7
I
parents to be held during the fourth week* Bequest a |
committee from the Health Club to prepare health literature I
from the supply in the health office and distribute it to j
the B7 parents at the P*T.A. meeting.
Friday
It is quite safe to assume by now that the enrollment
is comparatively stable* A check may be made that there is
a health card for every program card which will come in to
the health office today. While most of the health cards for
B7 pupils and new pupils are still separate from the main
health card file, it is fairly simple to check all health
77
cards against the program file.
1. Monitors will alphabetize and file the permanent
program cards into the boys r and the girls’ program card
I
files.
2. Monitors will assist the health coordinator in
correlating the program file with the health card file.
3. Make a list of missing program cards and a list
of missing health cards, following through by checking with
the attendance office and the guidance for non-returnees
and for recent transfers from the school.
I f . . Have mimeographed copies made of the ”Confiden
tialM Overview of Pupils with Health Problems for
distribution to the school personnel. These will be
distributed through the school mail boxes by the health
coordinator as soon as prepared.
5. Consult with the principal’s secretary regarding 1
1
the causes responsible for the major accidents of the past
semester. Use this information as material for Health Club
Bulletin #2 which will deal with Safety Education.
IV. MID-SEMESTER
1. On Wednesday of the ninth week, report cards are
circulated by all pupils for grading in each class through
out the day. At a special homeroom at the end of the day,
the report cards are returned to the homeroom teacher. All
failures are recorded by the homeroom teacher and the list
I
is submitted to the guidance director at the close of the
day* The health coordinator grades the monitors for
”Student Service - Health Office” as they report to the !
health office each period*
2* Blankets, pillow slips, and cot pad covers are
changed and the soiled linen laundered through arrangements
with the principal’s secretary*
3* The girls1 Physical Education teachers begin
their program on the Physical Efficiency Certificate for A9
girls* Among the items included in the requirements is one
stating that all correctible physical defects must be cared i
i i
for* A list of the A9 girls is sent to the health coordina-;
I
tor requesting a statement of the physical status as
interpreted from the health record* An A9 follow-up list |
on which the nurse has been working is also consulted to j
i
add the follow-up progress that has been made to date* The
Physical Education teachers then add their encouragement
from the standpoint of physical efficiency in the coordi
nated effort to stimulate desirable action on the part of
the student.
]+• Prepare a bulletin to the A9 pupils to encourage
them to follow through on all health recommendations mad©
by the medical specialists before entering high school.
f>. The program file of pupils who have transferred
79
is correlated with a similar file in the guidance office. !
|
If an omission has been made, all cards for the pupil are 1
pulled and delivered to the guidance office* \
6. The supply of referral slips to the health
office for the use of each teacher is replenished*
7♦ Check the health office visit card file for
cards revealing frequent visits to the health office,
complaints similar in nature or visits repeated during a
I
certain period* Place a blue flag on the card and call to j
the attention of the nurse or physician to ascertain whether
due to a health factor or to malingering. Follow up.
i
8. Place a blue flag on health office visit cards I
!
j
of pupils who need follow-up of any nature (sleep habits,
breakfast habits, frequent colds, etc.) This affords the
opportunity to follow up again on his next visit to the
health office. i
i
Counsel the registrar again to ascertain which
pupils who have attendance problems may have health impli
cations*
10. At the close of the eleventh week consult with
the guidance director regarding pupils who had reports of
failures on the ten-week report cards. Request a list of
these to be checked for health implications. Type a
duplicate and follow-up sheet to the guidance director when
completed.
11* Five weeks before the close of the semester,
pupils have the opportunity to select student service in
the health office for the coming semester* At a Health Club(
»
:meeting explain the scope of the service, pointing out the
opportunities it affords pupils interested in the field of
medical services.
V* EIGHTEENTH WEEK
< Monday
By this time written health reports on the incoming
B7 pupils with health problems will have arrived from the
school nurses who serve the elementary schools which feed j
the individual junior high school* '
1* Screen the B? list for pupils who will require
special programming because of organic heart murmur or
i
orthopedic condition, or whose notations indicate that
there may be a guidance or an attendance problem. Notify
the guidance director and the registrar.
2. If a hearing or speech difficulty have been
noted, notify the appropriate specialists.
3* Correlate the lists; alphabetize a list for boys
and one for girls; copy the nurses ’ notations and place the
lists in the health coordinator’s workbook for use by the
school physicians on the first day of the new semester.
! } _ . Prepare the doctor fs office for his visit on
I
»
81
Tuesday.
$. Prepare summons slips for B? pupils who will
have the routine B7 examination.
6. Prepare a bulletin announcing the Health Glub
meeting at 8:00 a.m. on Wednesday.
7. Assist the nurse in compiling a list of the A9
pupils with special health problems for forwarding to the
high schools to which they will transfer.
Tuesday
The boys’ doctor will examine B? students for the
routine B7 examination.
t
i
1. Secure a list of the A9 graduates from the
guidance office. This list will be divided into a section |
for boys and one for girls and will indicate the high j
schools to which they will be transferred. i
2. Pull the A9 health cards and place in two shallcW
metal trays marked, ”A9 Boys” and ”A9 Girls” above the
regular health card file.
3. Check the A9 health cards to be certain that
none is missing and that each has had a physical examina
tion at some time during the junior high school attendance.
i | . . Prepare the materials to be used at the Health
Club meeting on Wednesday.
5. Process the health cards for pupils examined
82
today and place on the nurse’s desk for follow-up.
Wednesday
Hold the Health Club meeting at 8:00 a.m. Distri
bute and discuss the bulletin on "Summer Safety" if in
June, and on "Don’t Let A Cold Catch You" if in January.
1. Place a red check mark before the names of A9
pupils on all lists in the health coordinator’s workbook;
namely? the speech correction list, the lip reading list,
I
i
the sight-saving list, the modified Physical Education list
and the "Health Overview of Pupils with Health Problems."
2. Prepare a bulletin announcing the dates of the
school physician’s final visits. Invite pupils who have
personal health problems they would wish to discuss to j
communicate with the health office personnel for an appoint
ment. Pupils desiring work permits should arrange with the
health office personnel for the physical examination. '
Thursday
Begin to assemble the materials to be distributed by
%
the new B7 homeroom teachers on the opening day of the new
semester.
1. Consult the guidance office for the number of B?
homerooms apportioned for the coming semester and the names
of the teachers assigned to each.
2. Monitors will count and stack forty of each of
83
the following for the required number of homerooms:
temporary health cards, emergency cards, and health history
forms. Health histories are folded and the three items
clipped together for each homeroom.
3. Prepare an opening day bulletin to explain that
the temporary health cards will be filled out in the first
homeroom, collected and sent to the health office at the
close of the first day. The health history forms and the
emergency cards are to be taken home for parents1 signature
and sent to the health office as they come back from the
home.
1
Friday
Assemble the materials to be distributed by the
guidance director to all pupils other than B7 pupils who
are new to the school.
1. Consult the guidance director for the approxi
mate number of new pupils expected to enroll for the coming
semester.
2. Monitors will count and stack the required
number of temporary health cards, emergency cards, and
health history forms for the guidance director's use with
new pupils.
3. Prepare summons slips for the girls* physician
for By routine examinations, A9 pupils who may not have had
8k
jan examination during their attendance at any junior high
school and A9 pupils who were restricted in their Physical
Education activities— for a re-evaluation to determine the
Physical Education activities in the high school*
I ) . * Prepare the doctor’s room for her examination on
Monday*
VI * NINETEENTH WEEK
i
i
Monday
The girls ’ doctor will probably finish examining the
B7 pupils for the routine examination and will examine
selected A9 pupils needing an examination to determine
i
their Physical Education assignment for the high school* ;
i I
I
1. Prepare a bulletin announcing the final meeting ,
i
of the Health Club at 8:00 a*m. on Wednesday* Bequest j
pupils to bring a pencil*
i
2. Alphabetize and screen the health cards for the
incoming B7 pupils most of which will have arrived by this
time. When a special health problem requiring early exam
ination by the school physician is noted, clip a red flag
to the health card. Such problems may consist of a heart
disturbance, a crippling orthopedic condition, vision
poorer than 20/50-20/70, hearing poorer than a 15 per cent
hearing loss in each ear, a history of diabetes or epilepsy,
or a chest condition. Speech and hearing losses are
communicated to the appropriate specialists. The guidance ;
[director and the registrar are notified of pupils with
guidance or attendance problems. Health cards are placed
in metal file boxes marked, nB7 - Boys" and f , B7 - Girls" in
preparation for the doctor’s screening and routine B7
examinations. Record this information on separate lists in
the health coordinator’s workbook. This list serves as an
"overview” of the B7 health problems for follow-up for the
new semester.
3. Process the health cards of the pupils examined
by the doctor. Place the cards on the nurse’s desk for her
1
follow-up procedures. !
1 | . . Prepare the doctor’s office for his visit on
1
Tuesday.
! !
5. Prepare summons slips for B7 pupils for routine j
1
1
examinations and for selected A9 pupils needing a re- j
evaluation examination for Physical Education activities in
the high school.
Tuesday
The boys’ doctor will examine B7 pupils for their
routine B7 examination, selected A9 boys for re-evaluation
of the Physical Education assignment for the high school
and boys who are applying for a summer work permit (if in
June).
86
1* Health information cards which had been circu
lated by the pupils during the semester are prepared for
re-circulation during the following semester to the new
teachers* Check the cards with the "Health Overview of
Pupils With Health Problems" for omissions and with the
health cards for an error in recording correction by
glasses. Type a list for the workbook to check their
return to the health office. Monitors will record the
homeroom numbers on the lists preparatory to grouping them
by these numbers.
‘ 2. Prepare a stack of 3"x£" note slips to be used
as ballots when electing the new officers for the Health
Club for the coming semester*
3* Process the health cards of the pupils examined j
by the doctor and place on the nurse’s desk for her follow- |
i
up procedures*
I
Wednesday I
i
1. Hold the meeting of the Health Club at 8:00 a*m*
to elect the new officers of the club for the coming
semester.
2. "Confidential" information eards which had been
circulated through the teachers’ school mail boxes during
the semester are prepared for circulation on the first day
of the coming semester* Place the card in a new envelope,
87
mark "Confidential” in red pencil, fill in the names of the
pupils1 new teachers (obtainable from the guidance director),
t
provide a place for signatures and direct to the health
office after the last signature. Type a list for the work
book for checking as they are returned. Clip those cards
of A9 pupils to the A9 health card.
3. As soon as cumulative cards are available in the
guidance office, screen them for health information. This
information is added to the data already gathered from the
lists sent the school by the elementary school nurses and
from the screening of B? health cards compiled on a list in
the workbook. Place a red flag on the health card if there j
is one; if not, fill out a temporary health card and flag I
it.
1
1
1
Thursday j
1. The names of the A9 graduates are deleted from I
all of the lists. (The names have already been checked in
red pencil.)
2. Program cards for B9 students are turned on end
by the monitors. Prom this group a list is prepared in
duplicate. Correlate the list with the "Health Office
Overview of Pupils With Health Defects” to discover which
pupils are in need of a conference in regard to a correct-
ible problem which has not yet been cared for. Star these
88
names with red pencil and note the problem on the lists*
File the lists in the workbook until the following semester
when one will be given the school nurse as her new A9 work
sheet.
Friday
All A9 pupils who will not receive the diploma
because of poor scholarship and who will not be retained
t
because of age, will be excused from attendance for the 1
remainder of the semester. They will circulate the clear
ance card which will be signed by the health coordinator
when all cards and records are pulled and delivered to the
guidance director. 1
1. Ke-order health cards and temporary health cards j
if the supply is under five hundred. 1
i
2. Since B7 routine examinations have practically i
i
been completed, prepare a complete list of B7 pupils with j
! health problems for the B7 grade counselor. She may find
that pupil performance and behavior have health implica
tions and that the list will serve as a guide for future
counseling.
VII. TWENTIETH WEEK
Monday
Use the list of A9 graduates to pull all A9 records
from the files this week. !
89
1* Pull all A9 programs from the program file.
These are retained for the rest of the semester as a filial
check that all records have been pulled.
2. Direct office monitors to pull, clip together,
and alphabetize the health office visit card and the
emergency card for A9 pupils, using the A9 program cards as
a guide. Health coordinator will clip the health office
visit card and the emergency card to the corresponding A9
health card for each pupil.
3. Prepare summons slips for the last visit of the
boysf doctor.
Tuesday
The boys 1 doctor will examine B7 pupils for the
routine B7 examination. Those BJ pupils, if any, who have
not received the routine examination by the end of the day j
will be examined as A7 pupils with the new B7 routine |
examinations during the following semester.
1. Using the list of graduating A9 pupils, sort the
health cards by the high schools to which the pupils will
be transferred.
2. Under the direction of the health coordinator,
monitors will place a white clip on the health cards of all
incoming B7 pupils whose cards have already arrived.
3* Process the health cards of pupils examined by
the school doctor•
Wednesday
Report cards are circulated by all pupils below the
A9 grade and are returned to the homeroom. Homeroom
teachers will record all failures and submit the list to
the guidance office at the close of the day*
1* With the assistance of a monitor, the health
coordinator will correlate the program cards with the
i
emergency cards to discover if there are emergency cards
missing from the file*
2. Type a list of the missing emergency cards. The
monitor will enter the homeroom number obtained from the
program card before each name* Place the list in the work- |
book for checking their return. I
i |
3* Monitors will sort the new emergency cards by
homeroom number in preparation for their distribution by
the homeroom teacher on the opening day of the semester.
If. Prepare an item for opening day bulletin explain
ing that the emergency card is to be taken home for
signature and should be returned on the following morning
to the homeroom teacher.
Thursday
1. Retype all lists in the health coordinator’s
workbook from which names have been deleted during the
semester* ;
2# Correlate the program file of pupils lafoo have I
i
transferred with a similar file in the guidance office. I
Correct any errors by pulling all cards and delivering them
to the guidance office.
Friday
Graduation exercises are held in the auditorium and
school will be in session for the rest of the student body 1
until 12:20 p.m.
1. All pupils who know that they will be trans
ferring to another school for the coming semester will
t
circulate a clearance card for office signatures during I
the morning. After pulling and sending all cards to the I
guidance director, delete the names from all lists. j
2. Strip the two cots of linen and mattress cover |
i
for laundering. Place covering of plaster sheeting over
the mattress (if in June). Prepare the beds with fresh
linen if the end of the semester falls in January.
VIII. ROUTINE PROCEDURES COMMON TO
THE ENTIRE SEMESTER
Of necessity, some of these procedures have already
been described in earlier sections of this chapter. Repe
tition here is to facilitate ready reference to a procedure.
Preparation for the doctors’ visits. The monitor
dusts the desk and chair with a damp paper towel. The
health coordinator arranges on the desk top a jar of tongue
!blades, a jar of cotton pledgets, a small bottle of alcohol,'
and a.small glass tumbler. At the right side of the desk
arrange a pad of home notices, a pad of Physical Education
excuse forms with carbon, blank health cards, and blank
supplementary health cards. At the back of the desk blot
ter, place the metal file box of health cards from which
the doctor will pull the health card as the pupil comes in
for examination. In the center of the blotter lay the
health cards of any pupils who have transferred to the
school which may have arrived since his last visit. He may
t
wish to inspect these cards before they are filed into the |
i
regular health card file. Open the window, adjust blinds,
i
and light the Snellen eye chart.
Procedure for admitting the pupil to the doctorsf
office. Prom previously prepared summons slips for whom
the school nurse has screened the vision and recorded the
height and weight, three pupils are summoned. The first
pupil presents his summons slip to the doctor who will use
the name to find the health card in the file box. When a
pupil leaves the doctor’s office, the next pupil is sent in
and another pupil is summoned. When the master absence
93
sheet arrives, summons slips of absentees are pulled and a 1
notation of the absence is made on the summons slip. The I
unused summons slips for the day form the nucleus for
compiling the group for the doctorfs next visit.
Procedure following the doctors * visits. Unless a
doctor will be examining the following day, remove bottles
and jars from his desk to a table nearby and cover. Place
blank forms in the desk drawer. Screen the health cards of
the pupils who were examined. Post significant health
information in the workbook. Remove the white clips from
the health cards to indicate that the doctor has completed
the examination of the pupil. Notify the Physical Education’
i
teachers of the doctor!s recommendations concerning a I
modified type of activity. Post the information in the
workbook under the heading, "Modified Physical Education."
Notify classroom teachers concerned with the pupils of
significant findings so that preferential seating may be
arranged. If lip reading or speech correction have been
recommended, inform the appropriate specialist. Prepare
envelopes to enclose any home notices which the doctor may
have initiated, noting the information on the health card.
Place the health cards of examined pupils on the nursefs
desk for her processing, recording, copying of the health
history, and follow-up procedures. When finished with them,
I she will place them in the appropriate spot for filing by
the health coordinator.
Filing of health cards. Only the health coordinator ;
files health cards into the health card file since she is
responsible for locating them when the occasion arises.
The nurse places the health card she has used into the
designated section behind the first tier of cards in the
health card file. Before replacing a card, the health
coordinator screens it for notations made by the nurse. If i
a clinic appointment has been scheduled, a tfclinic reminder1 *
form is prepared and Is placed within the leaves of the j
desk calendar two days ahead of the scheduled date. When a \
clinic report has been noted, recommendations involving
i
preferential seating or modification of Physical Education <
activities is advised, they are followed through by notify
ing teachers concerned and by recording the information in j
the proper section of the health coordinator’s workbook.
If the nurse has recorded the examination of vision, and
any impairment is noted a health information card is
prepared for pupil circulation to his teachers and the
information is recorded in the health coordinator’s work
book.
Health cards for pupils transferred to the school.
As the requested health cards for new students arrive with
95
the cumulative records in the guidance office, they are
recorded there and placed in a metal basket above the healthj
card file in the health office• The health coordinator I
I
checks the doctors1 metal file box marked, ”New Pupils,” j
pulls the temporary health card with its accompanying health!
history form and clips it to the health card. She screens
the card for guidance and/or behavior problems, notifying
the guidance director and/or the vice principal concerned#
If a health problem is noted, the information is recorded
in the workbook. The speech correction teacher and/or lip
reading teacher are advised if a hearing or a speech defect
are noted. The Physical Education teacher is advised if
there has been found the recommendation for restricted 1
t , I
activity. The health card and attached temporary health j
card with health history form is placed on the doctors’
desk for inspection on their next visits, unless the health
problem noted is one which requires the nurse’s immediate
attention. Otherwise, it will reach her af4 ter the doctors’
inspection of it and will be placed in the prescribed
section of the health card file for filing by the health
coordinator.
Temporary health cards, emergency cards, health
history forms and program cards received from the guidance
office. When a new pupil is programmed in the guidance
i
i
|office, he fills out a temporary card there# He is given a
I health history form and an emergency card to take home for
signature by the parent to be returned the following day.
These three forms and the program card are clipped together
and placed in the wire basket above the health card file in
the health office. The health coordinator notes if the
pupil is transferred from a school outside of the Los
Angeles City School District# If not, she attaches a blank
i
health card, with a white clip attached, to the temporary
health card. She fills out a summons slip, writes ! l for
screening” in the lower left hand corner and places it with
the other summons slips prepared for the doctor’s next
visit. If, after screening the temporary health card and j
the health history form for significant health problems one ,
i *
is found, the health coordinator places a red flag on the
card beside the white one. The card is placed with the
cards of other pupils who will be examined on the doctor’s
next visit. Monitors will file the emergency card in the
emergency card file and the program card into the program
card file.
Pupils transferring out of the school. The attend
ance office initiates a clearance card for pupils trans
ferring from the school. This card is circulated by the
pupil to the several offices, including the health office,
for signature. The nurse or the health coordinator signs
the card after removing from the files five cards, namely:
the health card, the emergency card, the health office
visit card, the "Confidential’ 1 health information card, and
the program card. The program card is placed in the
"transfers" file behind the regular program file and the
other four cards clipped together are sent to the guidance
office. The health coordinator deletes the name from all
records in the workbook. !
Tickler file. The tickler file is located at the
back of the boys f program file. It is maintained for the
purpose of reminding the health office personnel of coming !
events and routines for which preparation must be made in |
advance. A 3”x5” slip is dropped behind the appropriate !
jmonth whenever the re-examination of a pupil is due at a j
clinic, when one of the special services such as the audio
meter testing program will be conducted at the school, when
the school doctor has expressed the wish to re-examine a
pupil a month or more hence, or when the health office
personnel must meet specific responsibilities which are not
of a routine nature.
Health Club meetings. The Health Club meets In the
auditorium every other Wednesday morning from 8:00 a.m.
until 8:20 a.m. It is composed of a representative from i
each homeroom. Preparations for the meeting are made during
I
t
the week preceding the meeting. Prom suggestions mad© by
the members and from known needs of the group, a committee
i
meets with the health coordinator to decide on and assist
with the composition of a health bulletin. The bulletin is
written by the health coordinator and is mimeographed by a
clerk in the principal’s office in time to be distributed at
the following meeting and read to the homeroom members
during the homeroom period that day. Leaflets, pamphlets,
and posters relating to the special services programs are
also distributed to homeroom members in this manner. At the^
beginning of the meeting, attendance is taken on 3"x5T T slips
which are distributed as pupils enter the meeting and are ;
collected at the close of the meeting. Monitors will check
the attendance on a Health Club roster and place a health
bulletin or other literature which was distributed at the
meeting into the box of the homerooms which had no repre
sentative at the meeting.
Maintenance of the health information card file. The
health information card file is located behind the health
cards in the third or last tier of the health card file. A
card is made when it is discovered that a pupil has a
health problem of which the teachers should be concerned.
It provides for preferential seating for poor vision,
99
hearing, and epilepsy and it alerts the teacher to special
I
handling necessary for an orthopedic, heart or chest condi
tion, or for a pupil with a history of diabetes or hernia.
i
When the problem concerns hearing or vision the card is
circulated and returned to the health office by the pupil
concerned. All other problems are handled confidentially
by means of the teachers1. mail boxes or by counseling the
teachers individually. These cards are circulated each
semester until the problem is "solved” and they are trans
ferred with the pupil*s other health office records. A
running list is maintained by the health coordinator. As a
card is circulated the name is added, to be deleted when
the card is returned.
Health office summons slips. Summons slips for
examination by the school doctor are initiated for all |
i
pupils whose health cards are in the doctors* boxes. |
Monitors supply the program of room numbers from the pro
gram file. They are clipped to the health card. After the
initial two weeks* screening program by the doctors, and
for convenience in handling, the health cards of twenty-four
to thirty pupils to be examined earliest are removed from
the r i B7” box, the ”Hew" pupils* box or the health card
file (when a re-evaluation has been requested by school
personnel) and are placed in a smaller box for the day of
100
th© examination. Summons slips are removed and sorted for
distribution after this selection of health cards for
examination has been made.
i
Emergency care in case of accident or sudden
illness. After presenting a note from the teacher and being
seated (or taken to a cot if the emergency warrants this),
the nurse or the health coordinator renders the necessary
first aid. The pupil is questioned regarding the injury
r
or illness to determine the nature and origin of the
complaint. If a minor injury or accident, the pupil is
advised to see his family physician if symptoms have not I
been relieved in the next few days and to determine the S
t
need for further care. If the complaint appears to be due |
to the fact that the pupil has not eaten breakfast (or j
lunch) or if the pupil did not have sufficient rest, he is j
t
counseled regarding their importance. The temperature is
taken to determine if it deviates from the normal. The
pupil is given permission to rest on a cot for the period
if he wishes. If first aid is rendered, the form "Notice
of First Aid" is filled out in duplicate, the tear-off to
be signed by the parent and to be returned the following
day. The disposition and time the pupil left are entered
on the note. The pupil may be advised to modify his
activities, be given a Physical Education excuse for the
I 101
i
day and returned to his class. The health office visit |
i
card is charted and returned to the file for filing by th©
monitor#
If it appears that the injury or illness Is of a
serious nature, the parent is contacted and the condition
reported# He is requested to state his wishes as to the
manner in which the pupil is to be returned to the home#
The parent may wish to call for the pupil or send a taxi
for him# If the emergency requires it, the parent may ask !
to have the Central Beceiving Hospital send ah ambulance
for him in which case the administrator is consulted* He
I
will possibly agree that the pupil should be accompanied j
by the nurse or health coordinator where he will be met at
I
the hospital by the parent. If the illness seems of such
i
a nature that medical care is necessary and the parent I
indicates that there Is no family physician, it is suggested
that she call one of the hospitals or the County Medical
Association for the name of several physicians in her area#
If the parent cannot be reached, the emergency card
is consulted for alternate phone numbers which have been
authorized by the parent. If no one can be reached, the
pupil is made comfortable on a cot while repeated efforts
are made to make a contact. After consulting the adminis
trator, and if the condition warrants it, an ambulance is
called and the pupil is accompanied to the hospital by the
102
nurs© or health coordinator. An accident report is made
out in duplicate, one copy to be filed with the principal’s |
office for follow-up and one to be retained in the health
office.
Exclusions and re-admissions. Whenever a pupil is
' - ■ ' - i .. - !
excluded from school, he! must report to the attendance
office before leaving. If he has been excluded by the
health office personnel, has been absent because of an
accident, or has been absent three days or longer because
of illness, he will be routed through the health office
when he returns to school. When the monitor has completed
i
preparing his health office visit card, he is seated until 1
he receives the attention of the health office personnel. I
Depending upon the nature of the illness and appearance of j
the pupil, the temperature is taken. If the temperature is j
normal and the pupil claims to feel well he is readmitted, !
I
is given a temporary Physical Education excuse and Is j
advised to modify his noon activities for a while. If he
has been absent with a respiratory infection for five days
or longer, he is given a five-day Physical Education excuse.
If a pupil returns with a request from his physician that
he be excused from participation in Physical Education
activities for more than five days, a temporary five-day
excuse is written and the pupil is scheduled for the next
103
visit by the school physician for confirmation of the
longer recommendation. When the pupil returns after having
had a serious accident, he too is scheduled for the next
visit by the school physician.
If the pupil does hot appear completely recovered
from an illness or injury or if he is found to have a fever,
the parent is advised that the pupil is not ready for
admission. Arrangements are made for his return to the
home and the attendance office is advised that he has not
been readmitted.
Pertinent information concerning pupil health needs
| to school personnel. As soon as a health problem comes to
J the attention of the health office personnel, it is brought j
j to the attention of all sehool personnel who have any rela- !
i
I
tions with the pupil. This is done either by counseling
j
the teachers concerned individually, by circulating a ;
"Confidential” health information card through teachers’
boxes or by circulating the health information card by
means of the pupil. During the fourth week of the semester
the same information with the addition of the pupils who
should be wearing glasses is sent to all school personnel
as a mimeographed bulletin entitled, "Health Office Over
view of Pupils With Health Problems."
Bulletin board displays. Relate bulletin board
loll
displays to th© current Health Club bulletin or to a
special school-wide health service program. Enlist the
assistance of interested Health Club members who may also
volunteer to write for new posters and literature from
authorized sources.
Clinic appointment reminders. The desk calendar is
cleared each day of the clinic reminder forms which had
i
been inserted at the time the appointment was made. Moni- |
tors deliver these forms during the homeroom period. When
the pupil is absent it is sent the following day. If still
absent, the health coordinator calls the home to remind the
parent and incidentally inquires the reason for the pupil’s I
|absence. 1
i
! In this school, the health coordinator calls the !
j
parents of pupils absent that day from a list previously i
i
prepared by the vice principal and the registrar. The |
reason for absence is noted. If for illness, the nurse is
informed. The vice principal is notified of suspected
truancy. These calls often reveal social history helpful
in the future guidance of the pupil.
Emergency card file. An emergency card file is
maintained in the health office. Emergency cards distrib
uted by the guidance director are returned by him to the
health office. Addresses are kept current with the
10$
attendance office* At the close of each semester, emergency
cards are correlated with the program cards* Missing
emergency cards are replaced with new ones which are
distributed and collected through the pupil’s homeroom. A
similar file for adult personnel is maintained by the
principal. The card indicates whom to call and where to
take the pupil if the parent cannot be reached*
i
Program card file. Each office maintains a program
..
card file. Permanent program cards are made out by all
pupils during the third week of the semester. A "Transfers”
file is maintained behind the boys* program file. A check
!
is made with a similar file in the guidance office several '
times a semester to assure that the file is current. j
i
IX. PROCEDURES RELATED TO THE SPECIAL HEALTH
SERVICES TESTING PROGRAMS AND SURVEYS
i
l
Organization details are somewhat similar for each
of the four or five services available to the school. The
time arranged for the service must be such that It does not
interfere with the school’s routine calendar of events.
The place must be large enough for the operation of the
program but not so large as to inconvenience school person
nel unreasonably* A plan for summoning pupils must be made
well in advance if the time of a whole classroom period is
jto b© used* When the school personnel become involved in
the planning and realize the educational possibilities the
service affords, it is likely that classroom time is more
willingly relinquished. During each survey, the plan and
approach is on the basis of health education with home
participation*
Tuberculosis case-finding program* This service is
i
conducted at the school by the Los Angeles County Tuber
culosis and Health Association approximately every third
year* A tentative date is submitted for the approval of
the administrator a semester previous to the operation of
the program. Three weeks before the program is commenced a >
representative meets with the school personnel concerned 1
for assistance in organizing the details and suggestions
I
for 1 1 selling1 * the program to the student body. The
Physical Education department is usually in the best j
i
position to facilitate the smooth and steady flow of pupils
to the physician, nurse, and technician. It also affords
the best manner in which to assemble for an educational
program of films and a lecture and demonstration. The
homeroom seems to be th© logical place in which to distrib
ute and collect the parent consent form and to conduct an
educational program from literature distributed to the
homeroom pupils. The Science department may integrate the
program with its unit on disease prevention and on family
participation in community health. The fact finding and
thoughtful planning of a theme which are attendant to the
i
making of posters in the Art department serve as another
means of bringing the importance of the program to the
attention of the pupils# Emphasis is based fundamentally
on the importance of personal health habits, cleanliness,
adequate rest, and a balanced diet.
After the Mantoux skin test itself has been given
the Physical Education department is again called upon to
assist with organizing the movement of students through the
t
process of "reading” the test for positive reactors. j
i
Following this the plan is made for the X-ray Mobile unit
to be moved to a convenient but traffic-free area on the !
i
school grounds. Summons slips are prepared for the pupils |
! I
who showed a positive reaction to the test to be used as .
requested by the services personnel. Appointments are |
made by the nurse for counseling parents of positive
reactors as the follow-up program is commenced. Clerical
personnel who accompany the testing service chart the
results on the health cards in the health office.
The audiometer testing program. The audiometer
testing program is conducted at the school by the Hard of
Hearing section of the local Board of Education every third
108
semester* It is planned primarily for the A7 class and for
the known hard of hearing* However, those pupils who have
never had a hearing test and pupils recommended by the
school personnel are also included. For the group tests a
reasonably quiet room with adequate facilities for setting
up earphones on a desk or chair arm for each pupil is
necessary. In this school, the library annex seems most
convenient. The school is notified of the program well in
advance, affording time for the health coordinator to
screen all health cards for pupils who have no record of a
hearing test and to make arrangements with the English-
Social Studies department to conduct the testing of A7
pupils through their classes. From a list of A7 pupils
procured from the guidance office, the health cards for
these pupils are partially lifted from the health card file.
Since the record of the test is found on the back of the
I
I card, the file is screened from the rear. It is not
necessary to screen the partially lifted cards of the A7
pupils and they may be replaced in the original position as
they are reached. Summons slips are initiated for all
pupils on the list for whom a test is needed. Monitors add
the room schedule for each pupil by consulting the program
file. The summons slips are arranged into groups of forty
per period for the periods in which no A7 English-Social
Studies class is scheduled. Summons slips are placed in
109
the homeroom teachers* boxes for distribution* A bulletin
is prepared to be read the day the tests are begun* It
notifies the pupil that he will be given a summons slip for
the period in which he is to report for his hearing test
and that he must show it to his classroom teacher before-^
hand* Summons slips for those pupils with a known hearing
loss as a result of previous hearing tests are prepared for
the individual test by the audiometrist. With a health
monitor assigned to her, she will summon pupils at her
convenience. When the testing has been completed, an
otologist uses the doctors* office to examine all pupils
with hearing loss and to make recommendations to parents by
means of a home notice* The nurse follows up the recommend
ations for parent conference and/or clinic appointments.
I
The health coordinator notifies the teachers concerned if I
preferential seating arrangements are recommended by ;
circulating a health information card with the pupil* The
audiometrist charts the results on the health cards in the
health office*
nSmile-of-the-Year" program* This dental health
program is conducted annually through the B9-A8 Science
classes under the sponsorship of the Los Angeles Dental
Society. It is primarily an educational program of
preventive dentistry and of case finding* The school is
110
notified of the program well in advance and is sent appro
priate dental health literature and teaching material in
preparation for the period of the program itself. An
assembly featuring a speaker and two dental films is
conducted through the Physical Education classes as an
introduction to the program. Facilities for the dental
examination of the students are a room with running water,
a desk, and four chairs. The office of the girls1
Corrective room with its plinths bordering the sides serves ■
as a waiting room for the Science class to be examined
that period. The health coordinator with the assistance of
i
the chairman of th© Science department prepare the schedule j
and notify the Science teachers of their part in the pro- |
gram. Bach Science teacher is requested to submit a roll
i
of the students in her class to be used by the health
(
coordinator in pulling the health cards for charting by the j
unit’s dental hygienist and for the use of the dentist in
recording the findings of the examination.
When the examinations have been completed, an
elimination contest is conducted for the six winners in
each grade and for the winning boy and winning girl.
Summons slips are prepared and the pupils are summoned by
monitor at the disposal of the examining dentist. Though
examination is limited to the A8 and B9 grades, the entire
student body participates in the dental education phase of
Ill
the program— the films and lecture through the Physical
i
I Education department, the instruction in the homeroom by
means of the dental literature, and a study of the dental
unit in the Science classes.
As the examination is completed, each pupil needing
dental care is given a card, "Report of Dental Examination,"
indicating the dentistfs findings. He is asked to return
the card to the health office when the family dentist has
signed the card indicating that corrections, which in his
opinion were necessary, have been completed. When it is
returned, the correction is recorded on the health card by
i
the nurse, a "Certificate of Dental Health” is issued and j
i
the card is returned to th© Dental Section of the Health
!
Education and Health Services Branch of the Board of Educa-
i
tion. (These cards have been stamped with the "John Muir |
Junior High School" and the "Health Office” stamps by the
!
health office monitors.
Poliomyelitis vaccination program. This program of
iimmunization was conducted for the first time at this school
i
during the spring of 1957 in cooperation with the City and
County Health Departments. The Physical Education depart
ment conducted the flow of pupils to the doctors through
their individual classes. The girls1 Corrective room was
set up for the program by the unit itself with the assist
ance of volunteers from the local P.T.A. Parent consent
112
slips and educational literature were stamped with the
"Health Office” stamp and assembled in the health office by
the monitors— then distributed through the teachers* mail
boxes, 'The health coordinator prepared a directional
bulletin which was read in the homeroom. It requested
pupils to fill in the homeroom number and the Physical
Education period and return the signed slip to the homeroom
teacher for delivery to the health office. Here the
i
monitors sorted the slips by boys* and girls* Physical
Education periods, then alphabetized them. By consulting
the program cards, the monitors were able to assemble the
slips for each Physical Education teacher. An educational j
assembly with a speaker and two films was conducted through i
I
the Physical Education classes before the program was begun.
The homeroom period featured the educational literature.
All who participated were urged to follow up this initial
procedure by "booster shots” from the family physician or
by the Southwest Health clinic in the area.
CHAPTER VI
HEALTH SERVICES ACTIVITIES FOB
FUTURE CONSIDERATION
For future planning the following fields of activity
seem to merit consideration:
The case study conference* Initiate the use of the
case study conference with students who are failing, who
are not adjusting, and who are frequently absent.
Faculty health committee. If the time were to be
arranged and an interested representative from even three
or four departments were able to meet once a month, this
nucleus for a faculty health committee might be valuable as
an advisory group to this school where health problems are
so complicated.
Adult clerical time. The allotment of an adult
clerk to the health office for an hour a day would free the
health coordinator to spend more time to coordinate the
health education activities within the school and between
the school and the community in a more thorough manner.
Screening of pupils for extra-curricular activity.
Because of the possibility of an embarrassing accident and
of danger to the pupil’s health, students who plan to elect
H i) .
student service as an elective or who plan to run for a
student body office should be required to clear with the j
i
health office personnel regarding such health defects as j
heart murmur, epilepsy, diabetes, hernia, malnutrition, and
emotional disturbance*
Health films* More time should be allotted to the
use of the many health education films available* The
health coordinator should list available films with a brief
description of content and recommendation for use of
specific departments* This should be posted with other
faculty news in the faculty mail room.
School-sponsored trips with the Health Club* A trip 1
! to the P*T.A* Health Center may prove a valuable educational
I i
experience to the sixty-seven members concerned. The |
>
experience may be profitably shared with the homeroom if !
only one classmate is encouraged to follow up recommenda
tions made by the school physician.
Health requirements and health awards for graduating
pupils * It should be required that correctible health
defects such as dental caries and poor vision should be
cared for or should be in the process of having attention
by the time of graduation.
Health awards. When all correctible health defects
115
jhave had attention, A9 pupils should receive some sort of
i
token of recognition for their health behavior#
List of dental defects to homeroom teacher# The
homeroom teacher to receive a list of dental defects with
eight or ten dental cards for those pupils who can be
encouraged to have dental care# A list of the dental
clinics in the area are posted on a bulletin board in the
homeroom. Prom this pupils may select several phone num
bers to make the appointment#
Health appraisal information to homeroom teacher.
Inform each homeroom teacher when a pupil in his homeroom
has had a medical appraisal. List the defects found and
recommendations made, if any.
\
t
CHAPTER VII
SUMMARY AND CONCLUSIONS
Summary* It has been the purpose of the writer to
present in detailed fashion the policies and procedures in
the area of health services as they stem from the health
office at John Muir Junior High School. The setting of the
community and the school were described to indicate to show
their relationship to the health problems found in the j
school. Since most of the major policies of the school
stem from a higher source, namely, the state, county and
city departments of health and the state, county and city
boards of education, these policies were outlined. Local |
policies were delineated in detail. Duties and responsibil-’
!
i
ities of the health services personnel were enumerated in j
order that there be a better understanding of the inter- !
i
relationship between the responsibilities as they relate to
a common goal. For the same reason the interrelationship
of health services with the various departments and offices
of the school was elaborated. Finally, a running account
of the day-by-day and week-by-week activities were set
down revealing the continuity of purpose and organization
of detail necessary to achieve a continuing effort to meet
the challenging needs of the pupils.
_____ Conclusion._The project will be of assistance to
117
the health coordinator at the school in planning the
services for the coming semesters* Because detailed
processes have been outlined and an overview of coming
events may be seen at a glance, valuable time and effort
may now be expended on another role of the health coordina
tor, namely, that of attempting to improve the coordination
of health instruction with the health education efforts of
the school.
The project should be of assistance also to a sub
stitute teacher or to a successor to the position of health
coordinator at the school.
BIBLIOGRAPHY
BIBLIOGRAPHY"
National Committee on School Health Policies.
Suggested School Health Policies. Second edition.
New York: Health Education Council, l$4-5» P* 7*
The Joint Committee on Health Problems in Education of
the National Education Association and the American
Medical Association. Health Education. Washing
ton: National Education Association of the United
States, 19i).8. Pp. 86-88, p. 135, p. 9 l | - .
Committee on Health Education of the California
Community Health Education Project. Teachers Guide
in Health Education for Secondary Schools. Sacra
mento: California State £>epartment of Education,
1952. Pp. 1-ij..
Gilkey, John J. MThe Organization and Administration
of a Health Services Program for a Secondary
School.” Unpublished Master’s project, The Uni
versity of Southern California, Los Angeles, 1947 •
P. 12.
State Legal Provisions Relating to Health Education,
Physical Education and Recreation. Sacramento:
California State Department of Hducation, 195& *
P * * 9 9 P • 13 *
Aschenbrenner, Albert J. ”The Organization and Admin
istration of Health and Health Education in
Secondary Schools.” Unpublished Master’s project,
Th© University of Southern California, Los Angeles,
1947. P. 29.
Committee on the School Child, White House Conference
on Child Health and Protection. The School Health
Program. New York: The Century Company, 1932.
P. 85.
Teachers Guide in Health Sducation for Secondary
Schools. Sacramento: dalifomia State Department
of Education, 1952. P. I 4 . .
120
9-
10.
11.
12.
13.
lif-.
15.
16.
17.
18.
The Joint Committee on Health Problems in Education of
the National Education Association and the American1
Medical Association. School Health Services.
Washingtons National Education Association of the
United States, 1953. 2£2, p. 300, p. p. 186.
California State Joint Committee on School Health,
representing the State Department of Education and
State Department of Public Health. Suggested
Responsibilities of the Administrator. the Teacher,
the Medical Adviser, the Nurse for the Health of
School Children. Sacramento: California State
Department of Education, 1953* Pp. 3-19*
Oberteuffer, D. School Health Education. New York:
Harper and Brothers, i95>4* 1^19, P* 38l>
p. 285. !
Brownell, C. L. Principles of Health Education
Applied. New York: McGraw-Hill Book Company,
Inc., 19lf9. P. 168.
f
The Joint Committee on Administrative Problems of the |
American Association for Health, Physical Educa- i
tion and Recreation. Administrative Problems in
Health Education, Physical1 Education and Recrea- |
tion. Washington: American Association for
Health, Physical Education and Recreation, 1953. i
P. 10, p. 5. 1
*
I
Daillard, R. and C. T. Byrne. "General Administrative i
and School Health Services,1 1 Teachers College I
Record, LDC (January, 1958). P. 232.
Turner, C.E., C. M. Cellery, and S. L. Smith. School
Health and Health Education. St. Louis: The C. V.
Mosby Company, 1957* P. 77.
Committee on the School Child, White House Conference
on Child Health and Protection. The Administration
of the School of the School Health Program. New
York: The Century Company, 1932. P. 11.
Sharmon, J. R. Intro due tion to Health Education. New
York: A. S. Barnes and Company, 19^8.' P. ifb.
"Outline Course of Study." Health Publication No. ij.08.
Los Angeles City Schools, Office of the Superin
tendent, I9I 4 . 5. P. 7.
121
19. Daniels, A. ”The Organization and Administration of
Health Education for Secondary Schools.” Unpub
lished Masterfs project, The University of
Southern California, Los Angeles, 19S2*
Om vsrsity oT Southern Caiiforsicii

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Asset Metadata

Creator Hollberg, Elsa W. (author)

Core Title Health services and procedures employed by the health office personnel at John Muir Junior High School.

School School of Education

Degree Master of Science

Degree Program Education

Degree Conferral Date 1958-08

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag education, health,OAI-PMH Harvest

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Wagner, Elmer E. (committee chair)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c24-194151

Unique identifier UC11276913

Identifier EP49558.pdf (filename),usctheses-c24-194151 (legacy record id)

Legacy Identifier EP49558.pdf

Dmrecord 194151

Document Type Thesis

Rights Hollberg, Elsa W.

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA