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Gap in epilepsy training for school nurses 'putting children at risk'

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School nurses are failing to receive sufficient training to ensure children with epilepsy and other long term conditions are cared for properly when they are in education, it has been warned.

Registrants are coming under increasing pressure from schools to produce care plans for these children and to advise teachers about long term condition management, despite not having received updated training themselves.

This could be putting children - particular those with epilepsy - at great risk, a specialist nurse has claimed.

Following new legislation introduced in September, it is now a legal requirement for teachers to be taught how to help children manage medical conditions.

“We are always asking for training, but it is very difficult to access, there are no funds and no epilepsy specialist nurse”

School nurse

The government’s guidance document – called Supporting pupils at school with medical conditions –suggests a relevant healthcare professional, such as a school nurse, should help to identify the type and level of training teachers require.

It does not state school nurses must deliver the training, but at a Royal College of Nursing conference in London yesterday school nurses said they are often the first port of call.

One school nurse said she had been asked to devise care plans and the school’s policies for supporting epilepsy management despite having only been on one training session on the condition in the past decade.

“In the south of the county they have a specialist nurse who school nurses write the care plan with but in the north we don’t have one and have to write the care plans and protocols,” she said.

“We are always asking for training, but it is very difficult to access, there are no funds and no epilepsy specialist nurse. It’s really challenging,” she added.

“One nurse today said she only had 30 minutes to deliver epilepsy training while another has a three-hour session…Where’s the quality standard?”

Ann Brown

Another school nurse from Dorset said she and colleagues were coming under increasing pressure to provide epilepsy training because schools in the area were not prepared to accept students until their staff had been through the coaching.

“I have spoken with a specialist nurse but she does not have the resources to come into school herself and deliver training so it is down to us to do it….It puts a lot of pressure on us because parents are very anxious the children start school,” she said.

Another school nurse said she had experienced similar problems when trying to access updated training on supporting children with diabetes.

Royal College of Nursing

Fiona Smith

“The issue is specialist nurses are often not allowed to come out into the community – they are not covered or paid to do it. So we are stuck without them. If we go to them [specialist nurses for training], the schools say ‘You can’t keep going to the hospital, you are paid to be at the school,” she said.

Fiona Smith, professional lead for children and young people at the RCN, warned delegates they would be breaching regulatory requirements if they delivered training without having the competency to do so.

Ann Brown, epilepsy nurse specialist at Nottingham Children’s Hospital, spoke at the RCN conference about her concerns around the variation of training being provided to both nurses and teachers.

“One nurse today said she only had 30 minutes to deliver epilepsy training while another has a three-hour session.  If you get the voluntary sector in to do it they might provide half a day. Where’s the quality standard?” she said.

She told Nursing Times this variation posed a great risk to children with epilepsy because, as had happened in the past, teachers could fail to spot epileptic seizures.

Ms Brown highlighted that on average every school would have at least one child with epilepsy and said this was set to increase as more children survive premature birth, which is associated with the condition.

She urged school nurses to raise training concerns with their managers and approach specialist practitioners for help.

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Readers' comments (1)

  • As a paediatric epilepsy nurse specialist (and previous school nurse), I agree that many school nurses are inadequately trained and up-to-date enough to deliver training in schools and in writing care plans, not just for epilepsy but for other long-term concerns.
    The service delivery has changed so much over the last the few years, with the emphasis shifting to safeguarding, mental health/ behaviour support, and obesity, that this along with staff cuts means there is little time for other training needs to be met.
    However, I find it interesting that comments were made in the article about specialist nurses not being able to leave the hospital to provide training as personally, I have found that my local school nursing teams (and I have worked in two different areas in the past 8 years) choose not to access me for training/ care plan advice despite it being offered on a regular basis, and instead use one of their own team who has an interest in epilepsy. There continues to be an overall lack of joint working between acute and community sectors, which is both sad and detrimental to the children in my care.

    I also find that many schools themselves do not prioritise epilepsy training for staff and only allowing 15-30 minutes to train staff in epilepsy management is sadly growing increasingly common.
    There are training standards suggested by JEC guidelines (2012) for emergency medications, but these are just guidelines and each LEA has their own policies regarding training.
    Schools are also writing their own health and education plans without consulting a health professional, which is even more worrying.
    Ideally what is needed to better support children in epilepsy in schools is that the guidance document (Supporting pupils at school with medical conditions) should go further about stipulating for schools that training is not an 'optional extra for 15 minutes', but a necessity that is needed to be taken seriously.
    I would encourage school nurses to approach the paediatric nurse specialist where there is one, most of us are happy to help support and advise as we recognise that the school nursing team is a valuable bridge between school and hospital which is in the best interests of the children in our care, but we also recognise that there is a long way to go with getting schools, commissioners and NHS managers to recognise and raise the training and support of non-medical staff caring for children with long-term health conditions as a higher priority.

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