| Learning Objective #1: Discuss competing priorities faced by parents, nurses, and educators when children who are technology dependent and developmentally delayed attend school | |||
| Learning Objective #2: Analyze implications for nurses who educate teachers to care for children with complex needs at school |
Background: All children are legally entitled to an appropriate public education regardless of health and developmental status; yet, providing a nurturing, safe environment that facilitates development is challenging when children are fragile and dependent on skilled care. Nurse case managers work with families and schools to facilitate enrollment, and educators and school nurses must provide services that maintain children's health and allow academic progress while maximizing parental trust.
Design and Methods: Two field studies were conducted, including parent interviews in family homes, and multiple site visits at 5 elementary schools and 1 high school in an urban school district in the Western U.S. Formal interviews included 26 mothers, 5 fathers, 8 nurse case managers, 7 school nurses, and 14 teachers. Eleven children were observed over the course of one school day. Thematic analysis was applied to interview and field note data
Results: The overarching themes of care at school were balancing complex needs and advocacy for specific requirements of individual children. Balancing occurred as parents sought social and skill building opportunities, yet feared for childrens' safety. Educators balanced the need to provide total care with the desire for academic progress. Parents, nurses, and teachers advocated for programs based on the health and skills of individual children.
Implications: Parents, nurses, and educators need skills in juggling complex negotiations that affect the health of children with multifaceted needs. Policy at every level must be directed to facilitating positive health and educational outcomes.