The School Health Partnership enhancing inclusion in the school system through provincial collaboration

Photo of Thomas Rolands.
Photo of Thomas Rowlands.

“Without this program, a lot of things would not be possible for Thomas. He would not attend school. For him as an individual, and us as a family, this program is absolutely necessary,” said Laura Billington, mother of Thomas Rowlands, a junior high student who requires care while in school.

The School Health Partnership (SHP) is a provincial partnership between the Department of Education and Early Childhood Development, the Nova Scotia Department of Health and Wellness, Nova Scotia Health, the IWK and public school boards. Currently, there are SHP nurses in all seven regional centres for education across the province and Conseil scolaire acadien provincial (CSAP).

SHP registered nurses support schools, students and families with training, questions, planning, and concerns related to a student’s physical health needs. They are the key contact to ensure a child’s health needs are met and supports are in place while they are attending school. SHP nurses develop plans of care and training to Educational Assistants (EAs) to provide care in the school setting, and work with school staff to ensure they have the education and skills to do the healthcare tasks required. For example, SHP nurses help support students with severe allergies, diabetes, seizure disorder, a cardiac condition, catheterization and more. They also provide guidance on policies, technology, medical equipment, and other necessary elements of care to help the child attend in school.

“The SHP nurses provide peace of mind to students and their families, as well as the education staff. Schools want to be a safe, warm, welcoming place for all students,” explained Sarah MacDonald, Manager, Primary Health at the IWK.

The fundamental philosophy of SHP is that every student deserves the opportunity to attend school, regardless of medical conditions. Without these supports in place, students with complex medical conditions might not be able to attend school.

“Some student’s educational goals might look different, but we will do whatever we can to support students’ health needs to be in school”, said Lisa Garand, Health Services Manager at Nova Scotia Health.

Students like Thomas.

Thomas is a 13-year-old and has a rare genetic disorder which causes epilepsy, and he has been diagnosed with scoliosis. He is fully reliant on personal care for the rest of his life, is non-verbal and mobilizes using a wheelchair. He is also fed through a gastrostomy tube (also called a G-tube) and recently underwent surgery because of his scoliosis.

Thomas’s mother describes him as a calm, sweet, happy and loving child. He loves being at school with all the children, listening to music and gets bored quite quickly. Billington said without the support of the program, school staff would not receive the necessary training to care for Thomas, including bandage care following his surgery, G-tube feeding and seizure rescue protocol.

Formerly from the United Kingdom, conversations with Thomas' SHP nurse, Karen Noiles, began before the family even arrived in Nova Scotia. Noiles connected with his medical team in the UK to discuss his transition to Nova Scotia and develop his care plan for the school year.

“Since then, Karen has been our family’s point of contact and I can connect with her whenever necessary. She’s on top of everything and ensures the school staff can care for him properly,” explained Billington. “Everyone has approached Thomas’s care with as much enthusiasm any parent could hope for. They just care so much about him”.

Angela Arra, Clinical Nurse Specialist, works with complex and medically fragile children at the IWK. Arra said the SHP nurses are a bridge between the health care system and schools, and they are strong advocates for students to safely attend school.

“These are children with multiple diagnoses and often life-limiting medical conditions. They often have a lot of medical equipment with them, such as ventilators or feeding tubes,” said Arra. “They have many medical needs, but this program allows them to have normal childhood experiences, like extracurricular activities and going to daycare or school.”

The nurses meet with teachers, principals, resource teachers and EAs and explain the needs of the child and what is needed from the school to support that student.

“When you are introducing a child with complex medical needs into a classroom, we want to ensure it’s an environment that is good for everyone,” explained Arra.

Arra said planning can start years before a student’s entry to school to ensure they will be able to attend school in a healthy way - not only for the student, but for classmates as well.

“Schools and teachers are very supportive of getting kids into the classroom. They are willing to do just about anything!” said Arra.

The Nova Scotia Department of Education and Early Childhood Development is a key partner of SHP. Annie Baert, Acting Executive Director, Student Services and Equity Branch, and Director, Student Services Division, said SHP is a powerful example of what is possible when systems come together to identify and eliminate barriers that interfere with students’ opportunities to actively attend and engage in learning at their community school.

“Nova Scotia schools are committed to ensuring that all students have access to an inclusive public education system that provides access to a high-quality, culturally, and linguistically responsive and equitable programming that supports their well-being and achievement. This includes students with chronic and complex healthcare needs,” said Baert.

All the SHP nurses recently gathered in Halifax for a day of professional development. It was an opportunity for the nurses to share, learn and discuss cases, scenarios, and policy implementation.

“That was a phenomenal day,” said Garand. “It was an opportunity to stop and learn about everybody's role and how we can put a child in the center of the room and really wrap our arms around them.”

This session was originally scheduled to take place in March 2020 but was cancelled due to COVID-19. The session would have brought together only eight SHP nurses then, but instead 18 SHP nurses were able to attend.

“It just speaks to growth that is occurring in only a short amount of time,” said MacDonald.