Diverse roles

First aid in schools

Not a bandaid solution

Schools are complex places. They are dynamic learning and play environments for active children and young people, and they are the worksites for a wide range of occupational groups of employees. First Aid is one of those key areas of responsibility where care and legal responsibility meet. IEU VicTas Assistant Secretary Cathy Hickey takes a look at the work of three First Aid School Officers.

Long gone are the days when bone fractures, sprains and gashed limbs were just part of the rough and tumble of one’s school days, a badge of honour featured in many an author’s (albeit male) biography.

Schools, like any workplace, must adhere to the relevant Health and Safety legislation, must follow the compliance codes or guidelines on First Aid, and are required to provide adequate facilities for the welfare of those at the workplace.

School systems in all states overlay this legislative framework with school specific policy and guidelines. Schools at the local level will have their own ways of clarifying policy and practice – drawing up protocols, staff training, website information, parent information and the like. But for all schools, risk management and trained staff are the key.

First Aid Officers – central to effective management of first aid

IE spoke with First Aid Officers in three Victorian schools to take the pulse on the complexity and skill required in this important role. Carmel works in a Catholic primary school and Margaret and Heather work in Catholic secondary schools.

Student health issues can vary from complex to relatively minor. What type of student health needs do you come across?

Carmel Over the years I have dealt with a range of complex student health needs, all with the support of various organisations such as The Royal Children’s Hospital, Asthma Foundation, Diabetes Australia etc. I have had students with haemophilia, diabetes, anaphylaxis, severe asthma and students in remission from leukaemia.

Heather We have students in our school who have diabetes. Several of them are very serious and need to test at regular intervals during the day. Management of these students requires them to come to the first aid area and test. This is recorded every time they test.

Margaret Our students encompass complex health needs such as the management of anaphylaxis, Type 1 diabetes, cardiac and renal disorders, students recovering from operations, students on crutches and in wheel chairs, students who have emotional disorders, students who come to school from challenging family backgrounds. Injury issues include broken bones, dislocations, rolled and twisted ankles and knees, and soft tissue problems, ‘white out” splashed into eyes, sewing machine needles through finger tips and cuts, abrasions from using equipment. Head injuries can result from falls and sporting impact.

What are the other kinds of health/injury issues?

Carmel The most common injury, which I see every day, is head injuries, either from balls, falling off play equipment or just running around and tripping over. Another common injury which I would deal with is fractured or broken bones in children who have fallen off the monkey bars, if they were banned in schools sick bay wouldn’t be so busy!

Heather Working in a boys school there are always injuries. These range from falls to sports injuries. We deal with concussions, breaks, dislocations, anxiety related issues and general illness.

What are some of the most difficult or challenging health management issues you have had to deal with?

Heather The most difficult and challenging health management issues are head injuries. We have a lot of these.

Margaret The most challenging issues for me include an unconscious head injury student resulting from a fall, a partial finger amputation, tending to an attempted medication overdose, caring for a suspected stroke (staff) and a possible spinal injury. Ongoing student issues include eating disorders and post surgery mobility, chronic fatigue and glandular fever.

In your experience, what are the key skills/knowledge/personal attributes First Aid Officers need to manage the diverse health issues in schools?

Carmel One of the key skills a person needs to have in First Aid is to have the knowledge and confidence in your abilities to administer first aid properly and effectively. Having a lot of patience and compassion helps in every situation.

Heather First you need to have attended a first aid course. Secondly you need to be very calm and patient. Thirdly you need to be able to work in a team environment.

Margaret Always have an open, listening ear that is not judgemental. Many students have the need to establish trust before sharing information. Always have the issue at hand as the point of discussion, not prior difficulties, infringements or behaviour. Maintain professional development to progress with upcoming trends in care. Liaise with others in the field to share methodology and ideas that function well in a school environment. Have a referral list of health professionals and medical centres available for parents and staff. Keep contact with teaching staff and particularly home room staff regarding the needs of students. Little things to adults may be huge to a student. Use humour, laugh and always expect respect to be returned. Always have an open door!

Do you think schools in general are equipped/staffed to really manage the First Aid/health needs of students?

Carmel I think schools that only have a first aider (not a nurse) in sick bay are quite capable of managing the ‘general’ first aid/health needs of students. However, if a school was presented with a student who has very complex health issues then I would have to say no, as our training does include managing/assisting children with long term illness/health issues.

Heather Overall no I do not think that schools are well equipped to manage first aid health issues. We have over 900 students at our college and it is the prime responsibility of the receptionist and student receptionist to deal with all first aid issues as well as our normal role/day to day duties.

Some situations can be very stressful and school life is busy, so we just have to get back to work. All our staff are level one first aid trained, however, most do not deal with any incident or injury, everything is referred to the front office. This can be very frustrating when an injury happens on our oval which is quite a distance from the front office. Valuable time is wasted getting to the student. We have no problem calling an ambulance if we think it is necessary.

Margaret My sense is that school communities are dealing with an increase in pre-existing health conditions that can and do impact on learning. My sense is that in schools where there is not a specific staff member available for health, accidents and injuries, they would perhaps need to rely more heavily on parents and/or ambulance.