Working with Your School Nurse

The school nurse plays a pivotal role in seizure management. Many children with epilepsy control their seizures with antiseizure medications that must be taken from one to four times a day. In many states, the school nurse has the primary responsibility for administering these medications during school hours.

School nurses also work with the parents to develop a seizure action plan, a tool that organizes and communicates the student’s health care and educational needs. A seizure action plan helps ensure a safe environment for the student, while maximizing opportunities for learning
and development.

The plan should be specific for each student and should include instructions for both basic first aid as well as appropriate emergency responses to ensure the child’s safety in the event of an acute seizure emergency. Many action plans include the following guidelines:

For all seizures:
• Keep calm
• Remain with the student until he or she is fully alert
• Do not offer food or drink
• Reassure the student after the seizure is over

For absence seizures:
• Make sure the student has not missed key parts of the lesson

For simple partial seizures:
• Ensure the student is fully oriented to person, place and time before resuming activities
• Comfort and reassure the student if he /she seems confused or frightened

For complex partial seizures:
• Speak to the student softly and calmly
• Reassure the student that he /she is safe
• Move harmful obstacles to ensure safety
• Allow a wandering student to walk in a contained area
• Stay with the student until complete awareness of environment is regained
• Help reorient the student if he /she seems confused afterward

For generalized tonic-clonic seizures
• Stay calm and reassure the student that he /she is safe
• Reassure the other children that the student will be fine shortly
• Ease the student gently to the floor and clear the area around him /her
• Cushion the student's head
• Turn the student gently on one side
• Do NOT put anything in the student,s mouth
• Do NOT hold the student down
• Let the student rest until full consciousness returns

Of course, each child is unique and parents should work with the school to create an individualized seizure action plan that outlines the specific needs of their particular child. Here are just some of the accommodations
that parents have included in their children’s seizure action plans, depending on the child’s unique needs:

• The child should be seated at the front of the classroom so the teacher can be more aware of his or her seizures and to diminish distractions
• The child should be escorted to the restroom and lunchroom
• When the child participates in activities on risers (e.g. choir), the child should stand on the lowest riser
• The child should have extra test time or untimed tests
• The child should be closely monitored during PE activities
• The child should stay indoors during recess on hot days
• The child should be allowed to wear a hat if needed to dim classroom lights

School nurses also play a key role in helping train teachers and staff to respond appropriately to seizures and in creating a positive environment among teachers, staff and fellow students with respect to a child with
epilepsy. This helps to minimize stigmatizing beliefs, reinforce the need for compassion and support the student’s positive self-image.