Elizabeth Stoffers MHSc BSN CSN-NJ RN

estoffers@nutleyschools.org

973-661-8873

 

 

Learn how you can shop for a health plan through Get Covered New Jersey:

https://nj.gov/getcoverednj/?utm_campaign=20210226_nwsltr&utm_medium=email&utm_source=govdelivery 

 

Nutley Public Schools Physical Form - https://www.nj.gov/health/forms/ch-14.pdf

OR

https://www.nutleyschools.org/news/2019-08-22/nursemedical-forms-available - has area for immunizations

 

IMMUNIZATIONS NEEDED FOR MIDDLE SCHOOL

DTP (3 doses) including Tdap after 10th birthday

Polio (3 doses)

Measles (2 dose) Mumps (1 dose) Rubella (1 dose) OR MMR (2 doses)

Varicella (1 dose)

Hepatitis B (3 child doses OR 2 adult doses - age 11-15)

Meningococcal (1 dose) upon entering Grade 6 and 11 years old (must be after 10 years of age) - NJDOH requires that children in grade 6 or higher be immunized against the four serogroups (A, C, W, Y) that are present in the meningococcal containing vaccines (MCV4) licensed for use in the United States.

Mantoux or QuantiFERON-TB Gold is ONLY required for new students entering from outside the country from certain countries that have a high incidence of tuberculosis.

 

 

I have been a nurse for over 40 years! I am looking more like the above caricature every day. I graduated from Nutley High School and attended Rutgers University, graduating with a Bachelor of Science degree in Nursing. I worked as an OB/GYN Nurse at  Saint Barnabas Medical Center in Livingston since graduation until January 2020. I have had the greatest pleasure of meeting some of my “special deliveries” 12 years after their actual “birth”day as students in the middle school.

 

I was “recruited” into School Nursing by John Walker when my three children attended Yantacaw School and he was their principal. Mr. Walker convinced me to obtain my School Nurse certification and arranged for me to do my student teaching in the Nutley School District. I was mentored by the best: Mrs. Flannery the School Nurse at Yantacaw School (now retired) and Mr. Chern while teaching Health at the Middle School. I have since completed my graduate degree in Health Science along with post-graduate studies in Supervision and Special Services.

 

I have been the School Nurse here at JHWMS for over 20 years. I do yearly screening on all the students for Height, Weight, and Blood Pressure and screen all the 7th graders for Hearing and Scoliosis and the 8th graders for Vision. If parents do not want their child screened they can send a letter to the school and just ask their child to remind me on the day of screening. I keep and update physical forms on all students including their immunizations so that the district is compliant with state mandates. I also see the students on a daily basis caring for anything from paper cuts to the occasional trauma. If your child has medical concerns give me a call and I will make sure they have the accommodations they need.

 

 

General guidelines for illnesses:

• Call the Main Office if your child is going to be absent 973-661-8871.

• Send in copies of medical/dental notes.

Many parents ask, “When is my child sick enough to stay home from school?” This is not always an easy question to answer! I hope that these tips can help! A child who is sick will not be able to perform well in school and is likely to spread the illness to other children and staff. We suggest making a plan for childcare ahead of time so you will not be caught without a comforting place for your child to stay if he/she is ill.

 

Most school policies state that you should not send your child to school if they have::

o Fever in the past 24 hours and/or Vomiting in the past 24 hours

o Diarrhea in the past 24 hours

o Chills and/or Sore throat

o Strep Throat (must have been taking an antibiotic for at least 24 hours before returning to school)

o Bad cold, with a very runny nose or bad cough, especially if it has kept the child awake at night

o Head lice – until your child has been treated according to the nurse or doctor’s instructions.

If your child becomes ill at school and the school nurse feels the child is too sick to benefit from school or is contagious to other children, you will be called to come and take them home from school. It is essential that the school have a phone number where you can be contacted during the day and an emergency number in the event you cannot be reached. Please be sure that arrangements can be made to transport your child home from school and that childcare is available in case of illness. If your daytime or emergency phone number changes during the year, please notify the school immediately.

Please call the school’s Nurse's Office if you have any questions or concerns 973-661-8873 or email me at estoffers@nutleyschools.org during regular school hours.

 

Respiratory Virus Guidance

Exclusion and Preventing Transmission:

Students and staff with symptoms* of a respiratory virus (including COVID-19) should stay home and away from others until:
• The individual is fever free for 24 hours without fever reducing medication AND
• Symptoms are improving, which means the individual is no longer feeling ill and able to participate comfortably in educational and other activities as they did before they were ill. Any remaining symptoms, such as cough or runny nose are mild or infrequent.

Individuals can then return to normal activities, but they should take additional precautions for the next five days when they are around other people indoors. These precautions include:
• Wearing a well-fitting mask
• Taking steps for cleaner air
• Practicing good hand hygiene and respiratory etiquette
• Physical distancing when around others
• Testing for respiratory viruses to determine next steps such as treatment.
               Using at-home COVID-19 tests for screening before being around persons at risk for severe disease.

*Symptoms can include fever, chills, fatigue, cough, runny nose, and headache, chest discomfort, chills, cough, decrease in appetite, diarrhea, fatigue (tiredness), fever or feeling feverish, headache, muscle or body aches, new loss of taste or smell, runny or stuffy nose, sneezing, sore throat, vomiting, weakness, wheezing.

Please contact your health care provider for medical guidance. 

 

Norovirus Information

Do you think you have the stomach flu or a stomach bug?

It is probably norovirus, a common virus that is not related to the flu. Norovirus is the most common cause of vomiting and diarrhea, and foodborne illness.

Symptoms - 

The most common symptoms of norovirus are:

• diarrhea
• vomiting
• nausea
• stomach pain

Other symptoms include:

• fever
• headache
• body aches

 

Prevention -  Practice proper hand hygiene

Wash your hands thoroughly with soap and water

• After using the toilet or changing diapers.
• Before eating, preparing, or handling food.
• Before giving yourself or someone else medicine.

Norovirus can be found in your vomit or feces (poop) even before you start feeling sick. The virus can also stay in your feces for two weeks or more after you feel better. It is important to continue washing your hands often during this time.

Hand sanitizer does not work well against norovirus. Handwashing is always best. Wash your hands with soap and water for at least 20 seconds. You can use hand sanitizers in addition to hand washing, but hand sanitizer is not a substitute for washing your hands with warm water and soap.

Norovirus causes inflammation of the stomach or intestines. This is called acute gastroenteritis.

A person usually develops symptoms 12 to 48 hours after being exposed to norovirus. Most people with norovirus illness get better within 1 to 3 days.

If you have norovirus illness, you can feel extremely ill, and vomit or have diarrhea many times a day. This can lead to dehydration, especially in young children, older adults, and people with other illnesses.

Symptoms of dehydration include:

• decrease in urination
• dry mouth and throat
• feeling dizzy when standing up

Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.

 

Treatment -

There is no specific medicine to treat people with norovirus illness.

If you have norovirus illness, you should drink plenty of liquids to replace fluid lost from vomiting and diarrhea. This will help prevent dehydration.

Dehydration can lead to serious problems. Severe dehydration may require hospitalization for treatment with fluids given through your vein (intravenous or IV fluids).

Watch for signs of dehydration in children who have norovirus illness. Children who are dehydrated may cry with few or no tears and be unusually sleepy or fussy.

**If you think you or someone you are caring for is severely dehydrated, call your healthcare provider.**

https://www.cdc.gov/norovirus/about/index.html

 

 

Dental Clinic Information

 

The 2022 New Jersey Dental Clinic Directory provides a central source of information on public dental clinics and services in New Jersey. These clinic services are primarily provided by local health departments, hospitals and Federally Qualified Health Centers (FQHCs). Please note that clinic information is subject to change.

https://www.nj.gov/health/fhs/oral/documents/dental_directory.pdf

 

 

 

 

HPV Vaccine 

More than 9 of every 10 cases of cervical cancer are caused by HPV. Cervical cancer can be largely prevented by HPV vaccination.

Every year in the United States:

• Nearly 200,000 women are estimated to be diagnosed with a cervical precancer, or abnormal cells on the cervix that can lead to cancer.
• 11,000 cases of cervical cancer are caused by HPV.
• Over 4,000 women die from the disease.

Cervical cancer was once the leading cause of cancer deaths among women in the United States. HPV vaccine and cervical cancer screening have made it one of the most preventable cancers. Even women who have received HPV vaccine should still get regular cervical cancer screening starting at age 21 years. (https://www.cdc.gov/hpv/parents/cancer.html

The HPV vaccine is most effective when given to girls who are not yet sexually active; therefore, it is important to get vaccinated at the recommended age, ideally 11-12 years old. However, it is sometimes given to girls as young as 9 and women through age 26.
People receiving the HPV vaccine get a series of three shots over several months. For full protection, all three injections must be received.

https://www.nj.gov/health/cd/topics/hpv.shtml

https://www.cdc.gov/hpv/

 

FOOD ALLERGIES in SCHOOL

 

We have “peanut-free” tables in the cafeteria. The food tables are wiped down after every lunch period.

Our school district utilizes an electronic Student Information System (S.I.S.). Once we receive medical documentation of a life threatening allergy from your child’s doctor the information is added to the S.I.S. All of your child’s teachers then have access to this as well as to a Health Care Plan document. The Health Care Plan document has information on the student’s allergy, the signs and symptoms of exposure to the allergen, what to do if symptoms develop, and the names of delegates who have been trained in the administration of an epinephrine auto-injector. A copy of the Health Care Plan document is available to administrators, cafeteria and office staff, as well as substitute teachers and nurses.

We encourage students to carry their own epinephrine auto-injector but it can also be kept in the Nurse’s Office. If in the Nurse’s Office, it is kept in a locked cabinet; the building administrator has a key. There is also an epinephrine auto-injector located in the Main Office that is readily accessible.

All school-sponsored functions that your child will attend, will have an epinephrine auto-injector trained delegate in attendance. The student must have up-to-date medical documentation that must be submitted every academic year. Please make sure emergency contact information is correct in the portal and accurate information is included on permission forms when your child is attending field trips and/or after school functions.

Please include your child in the management of their food/environmental allergy.

Some specific topics to discuss are:

• avoidance strategies - not sharing food, not eating food prepared by persons who may not be familiar with cross-contamination

• symptoms of allergic reactions – mouth/throat, respiratory, stomach/intestinal cramping, rashes

• actions – the importance of when and how to tell others you are having an allergic reaction or think you may have been exposed to an allergen

• reading food labels

 

Food Allergy Emergency Care Plan form can be found at:

https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan

 

 

Asthma / Reactive Airway Disease

 

Asthma is a leading chronic illness among children and adolescents in the United States. It is also one of the leading causes of school absenteeism. On average, in a classroom of 30 children, about 3 are likely to have asthma

Effective asthma management can lead to the following positive results:

• A supportive learning environment for students with asthma.

• Reduced absences—students have fewer episodes and symptoms are treated earlier.

• Reduced disruption in the classroom— students have fewer symptoms when they adhere to their asthma treatment plan.

• Appropriate emergency care—school staff members know how to respond to emergencies.

• Full student participation in physical activities— physical education (PE) instructors and coaches know how to prevent exercise induced asthma.

Asthma Action Plan (to be completed by parent and healthcare provider and turned into school):

 

https://www.lung.org/getmedia/aa8ce6f5-667e-4726-b4ab-8ac8d5d448e4/fy20-ala-asthma-action-plan_home_school.pdf

 

 

Resources from the State of NJ

https://nj.gov/health/fhs/chronic/asthma/resources/

CDC informative videos on how children should use their inhalers

https://www.cdc.gov/asthma/inhaler_video/

CDC guide to asthma - https://www.cdc.gov/asthma/pdfs/asthma_brochure.pdf

 

 

Diabetes Management in School

For a student using insulin, diabetes must be managed 24/7, including the many hours spent at school, on field trips and in extra-curricular activities.

I have had many students with diabetes, some with pumps, some doing injections. Most need some assistance with calculations in 7th grade but by December they are pretty independent. I try to make them look at the whole picture and not just the numbers on their glucometers/sensors and in their calculations/pumps. If they are running high or low - what could the reason(s) be and how should it be treated taking into account how long from or until their next meal, how long from or until physical activity, or even how old the Insulin is that they are using or the battery in their pump.

I will send a copy of an individualized health plan to all of your child’s teachers explaining to them that your child has diabetes, your child will be able to check their blood sugar in class and treat with insulin or a snack as needed, that they get unlimited access to the bathroom and the water fountain. I also include a list of symptoms of hypo- and hyper- glycemia and the actions a teacher should take if they see any symptoms. A copy of the health care plan is kept on file with the class roster in case the teacher is absent and there is a substitute teacher. A copy also goes to guidance, administration, and the cafeteria. Most students come to me at lunch time to check their glucose and calculate. Whatever your child, you, and your doctor decide is best for them will be fine. I will need doctor's orders (as I am sure you are aware), just make sure they state "independent". I will be here as a resource and will call a parent if I have any concerns, just supply the phone number of the person easily accessible.

We have a Student Information System (S.I.S) that generates a red + when I input a student’s medical concern into the system and will print out on the teacher's class rosters as well as be seen by teachers (password protected) on the computer screen. The teacher clicks on the + and the medical concern is there along with the health plan document. This information will also be available through guidance in the 504 that all teachers must sign off on. In summary, all of your child’s teachers will get a health care plan document, there will be a notation red + in our password-protected S.I.S., and teachers will sign off on the 504 from Guidance (504 also appears in the S.I.S.).

Many students come in 7th grade and want to leave their glucometers, insulin pens, and snacks in my office. I strongly encourage students to carry their glucometers and Insulin pens (if applicable) and a snack with them at all times. I do this to encourage independence but also in the event we have an emergency that necessitates an evacuation, lockdown, or secure in place. I welcome extra supplies (batteries, pump tubing/site changes, ketone sticks, snacks, bottled water, insulin pen, spare glucometer) and will keep them secure in my office.

I am sure you have many more questions, please feel free to call or email. I try to get the students with diabetes an earlier lunch but many (most) times it does not work out with their schedule. Guidance may be able to help you with their lunch schedule. Your child can always snack in the morning if a late lunch will disrupt their routine.

 

 

 

Medications in School

 

The administration of prescription and over-the-counter medications during school hours is a complex issue. However, in order for many students with chronic health conditions and disabilities to remain in school, medication may have to be administered during school hours.

Herbal remedies and nutritional supplements are not considered medications and should not be administered in school.

Parents/guardians should be encouraged to administer medications at home whenever possible. Medications should be administered in school only when necessary for the health and safety of students.

Before any medication may be administered, the Board policy requires written permission from the parent/guardian and a written order from the prescribing physician.

The written order from the prescribing physician must include:

a) the purpose of the medication
b) the dosage
c) the time to administer or special circumstances under which medication should be administered
d) the length of time medication is prescribed
e) possible side effects of the medication

 

Authorization for medication in school - https://www.nutleyschools.org/news/2019-08-22/nursemedical-forms-available

 

Seizures

 

When a seizure occurs, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects.

 

When to contact medical personnel:

Call 911 if:

• This is the first time the person has had a seizure.

• A seizure lasts more than 2 to 5 minutes.

• The person does not awaken or have normal behavior after a seizure.

• Another seizure starts soon after a seizure ends

• The person had a seizure in water.

• The person is pregnant, injured, or has diabetes.

• The person does not have a medical ID bracelet (instructions explaining what to do).

• There is anything different about this seizure compared to the person's usual seizures.

Report all seizures to the person's health care provider. The doctor may need to adjust or change the person's medications.

 

reference - National Institutes of Health -  http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm

https://epilepsyservicesnj.org/kids-epilepsy/

Seizure Action Plan form - .https://www.epilepsy.com/sites/default/files/2023-08/SeizureActionPlan2023ACCE.pdf

 

 

WORKING  PAPERS

 

The way teens obtain working papers in New Jersey will be changing on June 1, 2023!

Thanks to a new law, the working papers process will be online and streamlined. Rather than going through local schools, younger workers will simply visit this site and be walked through a few easy steps.

MORE INFORMATION FOR YOUNG WORKERS: https://nj.gov/labor/youngworkers

 

https://nj.gov/labor/youngworkers/find-a-job/working-papers/getstarted.shtml?utm_campaign=20230505_nwsltr&utm_medium=email&utm_source=govdelivery

 

Working Paper forms and instructions:  https://www.nj.gov/labor/wageandhour/assets/PDFs/A300.pdf

 

 

Hand Washing

EVERYONE should make a point of washing their hands regularly to prevent the spread of disease. The Centers for Disease Control and Prevention (CDC) recommends that hand washing should be done:

Before, during, and after food preparation

Before eating

Before and after looking after someone who is ill

Before and after treating a cut or a wound

After using the washroom

After changing diapers or cleaning up a child who has used the bathroom

After coughing, sneezing or blowing one's nose

After petting, playing with or touching an animal

After handling pet food or treats

After touching garbage

If soap and water is not available, an alcohol-based hand sanitizer may be used to clean the hands. Recommended hand sanitizers should contain at least 60 percent alcohol to be effective

 

 

______________________________________________________________________________

 

BBP -  https://docs.google.com/presentation/d/14durJ0eUyD345swBLZW9AQnjdxSLdqFMFk0LZK1xoNw/edit?usp=sharing

 

Asthma - https://www.cdc.gov/asthma/pdfs/asthma_brochure.pdf

https://www.lung.org/getmedia/aa8ce6f5-667e-4726-b4ab-8ac8d5d448e4/fy20-ala-asthma-action-plan_home_school.pdf

 

Diabetes - 

https://diabetes.org/sites/default/files/2019-06/tipstohelpteacherskeepkidssafeatschool0807%20(3)-compressed.pdf

https://www.omnipod.com/what-is-omnipod/omnipod-5

https://www.baqsimi.com/when-to-use-baqsimi

 

AED - 

 Philips HEARTSTART -  https://www.youtube.com/watch?v=cjLp3fbekXE

                                        Child/Infant Key -   https://www.youtube.com/watch?v=jhnOE0Hk3MU

 "AED in Action" video - https://www.youtube.com/watch?v=bMDLU5ma3f0

   

Concussion -  https://www.cdc.gov/headsup/pdfs/schools/TBI_Returning_to_School-a.pdf

                         https://www.cdc.gov/headsup/pdfs/schools/TBI_Classroom_Tips_for_Teachers-a.pdf

 

Seizure -  https://www.youtube.com/watch?v=fbFxZ5Aml4g

                https://www.youtube.com/watch?v=8zPn6aOQ7AY

 

Allergies - 

https://docs.google.com/presentation/d/1W9cOEkugLjBrI9za7ZMoZ0LwxG1Gv8Hyh8yIAuSxjYw/edit#slide=id.p

Epinephrine Auto Injector Training - 

Generic - https://epinephrineautoinject.com/what-is-the-epinephrine-injector/how-to-use-the-epinephrine-injector/

EpiPen - https://www.epipen.com/en/hcp/about-epipen-and-generic

Auvi-Q - poster - https://www.auvi-q.com/pdf/ifu-poster.pdf

Auvi-Q video - https://www.auvi-q.com/hcp/about-auvi-q

 

Air Cast use for ankle sprains - Wear with sneakers (NOT Crocs)  https://www.youtube.com/watch?v=JzPlIBuS9YQ