Nurse Information/Forms

Missy Walztoni, RN
319.827.1700 option 6
mwalztoni@jesup.k12.ia.us

The School nurse's schedule at Jesup Community Schools will be from 7:30 a.m. to 3:30 p.m. on days school is in session.

Medical information required for school:   

Permanant Health Record      Sports Physical

Immunization Information          Immunization Certificate

Requirements for PS, PK and K

Health Information form     Dental Screening form

Regular attendance is necessary for your child to do well in school.  However, if your child is ill, please help to protect the health of all students by keeping him/her home.                      Guidelines for when to stay home. 

Students who become ill or injured at school should first report to their classroom or playground teacher who will assess the situation to determine whether the child needs additional assistance. If so, the student should be sent to the nurse’s office (or school office if the nurse is not in the building). The nurse (or office personnel) will contact all parents before they are sent home. Parents will be asked to pick up the student. No elementary student will be taken home unless a parent or someone is there to care for him/her. In the event of a serious accident, the nurse (or building principal in her absence) should be summoned.

As soon as the child is under his/her jurisdiction, the nurse will do the following:
  1. Give emergency treatment
  2. Contact the parents and decide with them what to do. Please keep phone numbers current
  3. If the parent cannot be reached, she will contact the person listed on the child’s emergency authorization form and decide with them what to do. 
  4. If these people cannot be contacted, she will consult with the child’s physician. 
  5. If a parent, an authorized person, or the child’s doctor cannot be reached, the decision will be the nurse’s.

It is the responsibility of the parent, NOT the school nurse, to give or obtain medical attention for injuries acquired outside of school. However, students requiring dressing changes, medications, etc., during school hours may report to the nurse for assistance. 

Communicable Disease If your child has a communicable disease, contact the school nurse. In so doing, it will enable us to inform parents that we have the communicable disease in the classroom; thus, alerting parents to watch for symptoms in their own children. No names of students will be given for confidentiality reasons. If we suspect a child has a communicable disease, we will contact the parent and advise the parent to confirm this with a doctor. 

Children are to remain out of school the required number of days as stated by the Iowa State Department of Health. If you have any questions, we advise you to consult your family doctor.

The Communicable Disease Chart lists these MINIMUM number of days exclusion from school for the following diseases:
  1. Chicken Pox – 5 days from onset of pocks or until pocks become dry. 
  2. German Measles (Rubella or 3-day)—7 days from onset of rash. 
  3. Impetigo—Until 24 hours after treatment is begun.
  4. Measles (Rubeola)—4 days after onset of rash.
  5. Mumps—9 days or until swelling disappears.
  6. Ringworm—Until treatment has begun.
  7. Scabies—Until adequately treated by physician.
  8. Conjunctivitis (Pink eye)—During acute state or until treatment begins.
  9. Whooping Cough (Pertussis)—5 days after start of antibiotic treatment.
  10. Pediculosis (Lice)—Adequate treatment to kill lice and nits. Although not a communicable disease, it should be reported to the school nurse so the class can be checked, preventing an outbreak                 

It is important to remember—it is protection to the child who is sick that he/she stays out the required number of days because of complications that might follow as well as protection to the other students. 

Guidelines for medications distributed in schools are as follows:

We recognize some students may need prescription and non-prescription medication at school.  Please see the following guidelines if medications are required to be given at school to ensure the safety and correct administration:

•     Medications may not be administered until the student’s parent or guardian provides a signed and dated medication authorization form.
        o  A new authorization must be completed each school year.  A parent/guardian must notify the school nurse immediately if any changes are made to medication, dosage, and/or administration instructions and a new authorization form must be completed as soon as possible.
            o  Prescriber’s orders must be faxed to the school for any dose changes, unless a new prescription bottle with updated instructions are obtained.
•     Medications must come to school in the original, labeled container as dispensed or the manufacturer’s labeled container.
        o  Prescription Medication: a pharmacy labeled container may serve as the written prescribers order.  Pharmacies will provide, at no cost, a second labeled bottle for school use.
          o  Over the counter/nonprescription medication: must be sent to school in the original medication 
container with the students name attached.
•     To ensure the safety of all children, we request that a parent or responsible adult deliver medications to the nurse’s office when possible.  If your child brings the medication to school, please place the labeled medication bottle in a sealed envelope with the number of tablets/capsules that are enclosed written on the outside of the envelope.
•     The first dosage of any new prescription should be given at home so the child can be more closely observed for possible side effects.
•     Students should not carry medication or keep it in their possession except inhalers for asthma or auto injectors of epinephrine for severe allergies.  An authorization consent signed by the parent and healthcare provider must be on file to self-carry and self-administer medication.
•     Medication may only be given by the school nurse or school personnel who have completed a medication administration course.
•     By law, school nurses are not allowed to administer homeopathic or non-FDA approved medication.
•     Please notify the school nurse how any unused medication at the end of the school year will be picked up.

Required Forms for Asthma:
1.    Asthma Action Plan  An asthma action plan gives personalized instructions on how to manage asthma at school.  This plan is developed and signed by the physician and parent.  It is renewed at the beginning of each school year or as needed if changes are made during the school year.
2.    Medication Consent: Please bring your child’s asthma medications to school with the asthma action plan and a Jesup School medication consent on the first day of school.  This consent must be signed by a parent and renewed yearly for any medication to be stored and given by the school nurse. Medication must be dropped off with prescription information noted on it.  Unlabeled inhalers without prescribing information will not be accepted due to safety reasons.
3.    Self-Administration Consent: Students are able to self-carry and self-administer inhalers. If your child plans to do this, a self-carry inhaler form must be submitted to the school nurse.  This is required to be signed by the doctor and parent yearly.

Required Forms for Food Allergies:
We are committed to providing a safe educational environment for food-allergic students so that exposure to food allergens are minimized for affected students.  Our school is nut aware, not nut free.  Please notify the school nurse and classroom teacher if your child has food allergies so we can make accommodations as necessary.
1.    Diet Modification Request Form:  This form is required before we can provide your student with anything other than the standard meal and also before we can omit/ eliminate items from their meal. It must be signed by a physician or chiropractor.  Please ensure both pages of the form are completed and as detailed as possible.  For example, if your student cannot have milk, we need to know if they cannot have milk to drink or if they cannot have any milk or dairy in their diet.  Or if they cannot have eggs, we need to know if it is just hard boiled eggs, or if eggs cooked in products are allowed. This form is valid for a lifetime or until a physician submits documentation in writing to discontinue the diet.
2.    Food Allergy & Anaphylaxis Emergency Care Plan:  This care plan contains critical information on how to manage your child’s allergies.  It must be signed by a physician and renewed every school year.
3.    Epinephrine Auto-Injector Self Administration Consent Form: If student will self-carry Epinephrine and can self-administer injection, a consent must be signed by a physician and renewed each school year.
4.    Medication Consent:  If your student will keep their Epi pen in the nurse’s office to be given by school nurse or other trained school personal, a medication consent will need to be signed by the parent each school year.

Required Forms for Seizures:
1.    Seizure Action Plan:  Seizure Action Plans are an important tool that help parents and schools partner to keep children safe and healthy during the school day.  It includes information on first aid and medications required specifically for your child in the event of a seizure.  This form must be signed by the parent and the physician.  It will be renewed each school year.
2.    Medication Consent:  For seizure medication that will be kept in the school nurse’s office or near the
student, we need to have a medication consent signed by the parent each school year.

Special Services

Vision screening is provided for all children in grades PK-5, special education, and those referred by a teacher. If you have concerns about your child’s vision, please contact the school nurse and request a vision screening.

Hearing screening is provided for children in grades PK-2 & 8th by AEA267. The screening is usually done in the fall. Audiograms are run on children with known losses regardless of grade. If you have concerns about your child’s hearing, please contact the school nurse and request a hearing screening.

Speech services are provided through the AEA267. If you have questions, contact the principal at school. A school social worker, educational strategist, and school psychologist are employed by the Area Education Agency and are each at the Jesup Community School each week. If you feel your child would benefit from their services, contact the principal.