Nurses' Corner
Our school nurses, Ms. Melissa Doyle, RN, and Mrs. Anne Fiorentino, RN, are on campus to tend to our students' medical needs!
Contact Information:
e-mail: nurse@rosaryacademy.org
phone: 714.879-6302 x 1113
- NURSING & HEALTH SERVICES
- MEDICATIONS
- EARLY DISMISSAL DUE TO ILLNESS
- REPORTING INJURIES
- IMMUNIZATION REQUIREMENTS
- CHANGES IN HEALTH
NURSING & HEALTH SERVICES
NURSING and HEALTH SERVICES
Two registered nurses staff the Health Room full-time, Monday – Friday from 7:00 am - 3:30 pm. The Health Room is located down the hallway between classrooms 5 and 6. The nurses are on campus to support our students' mental and physical health needs, focusing on “wellness” and personal responsibility. Our nurses provide first aid, health counseling, and educational programs. If it is not an emergency, students should come to the Health Room during passing periods, breaks, or lunch to avoid missed class time. We ask that the nurse evaluate students before contacting her parent or guardian if she is not feeling well. In addition, Rosary Academy has three CPR/First Aid certified American Red Cross instructors on campus.
MEDICATIONS
MEDICATIONS
- Tylenol, Advil, Claritin, Sudafed PE, Midol, and Tums are available in the Health Room and can only be given to students with parental consent obtained through online registration by completing the “Rosary Academy Student Health History Form.” This form needs to be completed annually. All prescription and over-the-counter medications must be taken in the Health Room.
- If your student needs to take a prescription medicine at school, it must be in a pharmacy-labeled medication container (labeled with the student's name, medication name, dosage, and frequency). In addition, a DIOCESE OF ORANGE PARENT/HEALTHCARE PROVIDER REQUEST FOR MEDICINE FORM needs to be completed by the student's parent and physician and returned to the Health Room by the parent when bringing in the medication.
- Over-the-counter medicines must be in their sealed original labeled container along with a DIOCESE OF ORANGE PARENT/HEALTHCARE PROVIDER REQUEST FOR MEDICINE FORM signed by the parent (a physician's signature is not required).
- All medications must be kept in the Health Room at all times. Students are not allowed to carry medications on themselves, in their backpacks, lockers, or cars.
- Students with asthma/allergies (provided proper documentation is completed in the Health Room) may carry an inhaler or Epipen with them. Still, it is also highly recommended to keep an extra Inhaler/Epipen in the Health Room in case of an emergency.
EARLY DISMISSAL DUE TO ILLNESS
EARLY DISMISSAL DUE to ILLNESS
- When a student becomes ill or injured during class, the student must obtain a pass to the Health Room from the current teacher. If a student is too ill to remain in school, the nurse will notify the parents or guardian. Students are not allowed to make arrangements to go home on their own. If the parent is unavailable, the persons designated on the student's emergency card will be called. It is important that all phone numbers be kept current for the protection of the student. A student may drive herself home with parental permission if feeling well enough to do so.
- Students are advised to stay home if suffering from active illness, temperature > or = to 99.9 degrees, vomiting or diarrhea, to protect other students and staff from possible disease transmission. Students should remain at home until their illness has resolved (fever-free for 24 hours without the use of fever-reducing medication such as Tylenol or Advil; no vomiting or diarrhea for 24 hours), even if examinations will be missed as a result of illness. Students should not come to school to complete an examination with the intention of leaving early because of illness. If a student is absent for three consecutive days, it is mandatory that she presents a physician's note indicating that the student has been seen and is safe to return to school. This will allow the student to take the absences as excused and, more importantly, reassure the school community that we are making every effort to minimize the transmission of treatable, contagious diseases.
- Parents may report an absence to the Attendance Office at 714-879-6302 x 4 or attendance@rosaryacademy.org. Parents are requested to report all confirmed or suspected contagious diseases to the school nurse.
REPORTING INJURIES
IMMUNIZATION REQUIREMENTS
IMMUNIZATION REQUIREMENTS
To enter into Rosary Academy, incoming freshmen and transfer students must have immunizations that meet the California School Immunization Law, Health and Safety Code Sections 120325-120380. Your student’s immunization record (yellow CA immunization card, MD immunization record, or previous school immunization record) may be mailed, faxed, or e-mailed. Incomplete or missing records will delay the admission process.
Under a 2011 California law, all California high school students must be vaccinated against pertussis (whooping cough). Incoming Freshmen and students transferring from out of the “Tdap” booster shot before starting school. Parents should be aware that the protection from childhood immunization to pertussis wears off, and adolescents may be at risk of the highly contagious disease without a booster.
The Shots For School website provides useful information about the new Tdap requirements, a new state law, requiring students to be vaccinated to protect against whooping cough. Visit ShotsForSchool.org for more information.
Immunization Exemptions
Under Senate Bills (SB) 276 and SB 714 (Pan, 2019), all new medical exemptions for school and child care entry must be issued through CAIR-ME beginning January 1, 2021. Medical exemptions can only be issued by MDs or DOs licensed in California and must meet applicable Centers for Disease Control and Prevention (CDC), Advisory Committee on Immunization Practices (ACIP), and American Academy of Pediatrics (AAP) criteria.
CHANGES IN HEALTH
Concussion Protocol
- Start Here
- Concussion! Now What?
- Concussion Management Program
- Points of Emphasis
- Special Considerations
- Concussion Management Team
- Return to Learn
- Return to Play
- FORMS
- Recommended Providers
- Definitions
Start Here
Rosary Academy understands the seriousness of concussion both in and out of sport. That is why we've created a comprehensive Concussion Management Program that begins the moment a concussion is suspected. Based on medical best practices set forth by professionals in the study of concussion management, this program is designed to transition your daughter back to the classroom and playing field in the safest way possible.
If you suspect your daughter has suffered a concussion, please contact Rosary’s nurses at nurse@rosaryacademy.org and review these tabs for additional information.
If you believe your daughter is having a medical emergency, please call 911.
Concussion! Now What?
First and foremost, Do Not Panic. A vast majority of individuals that suffer a concussion resolve back to normal function over time. Expressing panic may exacerbate the student's symptomology as they may feed off of a parent's emotions. Concussions are to be taken seriously but are generally not cause for panic.
If you feel your student is having a medical emergency, call 911.
If your child has been diagnosed with a concussion or you feel she may have suffered a concussion, it is imperative the Concussion Management Program be implemented as soon as possible. The first step in this process is both physical AND cognitive rest. Please see the definitions page for more information.
If your child has not yet been diagnosed with a concussion and you feel she may have suffered one, please contact Rosary’s nurses and arrange a physician visit to one of our approved concussion management providers by contacting one of them directly.
Concussion Management Program
The purpose of this program is to underscore the importance of specifically addressing the topic of head injuries sustained by Rosary students and provide a consistent, comprehensive approach for the management and safe Return to Activity of the student. A student’s best chance of full recovery from a concussion involves two critical components: cognitive and physical rest followed by a stepwise Return to Learn (RTL) progression then a stepwise Return to Play (RTP) progression.
It is important to note that the recovery from a concussion is a very individualized process. Caution must be taken not to compare students with concussions as they progress through the recovery process.
In any circumstance where a concussion is suspected, the first priority is to remove the student/athlete from further participation for the remainder of the day. This initiates the Concussion Management Program. For the academic (RTL) protocol to be initiated the student must be evaluated by an approved health care professional within 2 days and documentation must be provided to the school’s nursing office.
The recommendations in this document for the management of concussion are based on a review of the current best practices in concussion management from a wide variety of resources from across the country.
Points of Emphasis
It is important that once the student has returned to school that they report to the nurse on a daily basis in order to monitor symptoms as well as to determine progression to the next stage within the return to academics guidelines.
If a student remains in stages 0-3 for more than 2 weeks, it MAY be necessary to schedule a conference with the assistant principal of academics, counselor, and the student’s parents in order to discuss a plan of action for the rest of the semester.
Special Considerations
Medications are usually not needed but in some cases may be needed when considering sleep and headaches. Please follow your physician’s orders when taking any medications during concussion recovery.
Any physician authorized or restricted medication use (especially Ibuprofen or Acetaminophen for pain management) must be reported to the nursing staff.
NOTE: The student/athlete should not be using medication when assessing symptoms and RTP.
Concussion Management Team
Successful recovery from a concussion is a multi-faceted process. Following a concussion, your student will work closely with the Concussion Management Team (CMT). The Rosary CMT is a team of individuals within the school and in the community to assist the student through the recovery from concussion. Members of the concussion management team include physicians, administrators, counselors, school nurses, and athletic trainers. In more complex cases, it may be necessary to add more team members such as: neurologists, psychologists, neuropsychologist, additional physicians, etc.
The nurse acts as the point person for all members of the CMT. The nurse collects and disseminates information from and to all appropriate CMT members throughout the recovery process. Please submit all correspondence through the nurse regarding your student's recovery process.
Return to Learn
It is important that once the student has returned to school they report to the nurse as indicated in order to monitor symptoms as well as to determine progression to the next stage within the RTL guidelines.
Much like the Return to Play (RTP) progression, Rosary employs a RTL progression as well.
Stages for Returning to Learn
Overall Protocol and Notes
Return to Learn Stages
Stage 0
*Stay Home per Doctor directives and/or parent preference
Stage 1
*Gradual return to school as tolerated
o Sit and watch/listen while in class
o Handwritten notes in a note book (no screens)
o Pre-printed slides from teacher (if requested by the student and available)
Stage 2
*In class activities
o Work on/complete in-class assignments that are essential for learning (Allow to take home if extra time is needed)
o Active listening and note taking
o Work on/complete essential homework
- Extended deadlines
- Allow and provide hard copies
Stage 3
*Begin administering tests & quizzes in the testing center
o Allow extra time
o No more than 1 test per day
*Complete all homework and assigned classwork
Stage 4
*Full return to academics with clearance from a medical doctor (MD, DO)
o Schedule makeup work allowing 1.5 of time to do so (i.e., if out for 1 week with a concussion, allow 1.5 weeks to make up missed work)
NOTE:
*If diagnosed with a concussion, students are not permitted to participate in ANY Rosary sponsored extra-curricular activities including, but not limited to:
o Rosary sports
o Dances
o Red & Gold
o Trinitas
o Rallies
o And any other activities that may increase concussion symptoms (such as certain class retreats)
*Return to the activities mentioned above can occur once the student is medically cleared to return to full academics.
Return to Play
The Return to Play (RTP) process following a concussion follows a step-wise progression. The student must be symptom free for a minimum of 24-48 hours and completed the entirety of the Return to Learn (RTL) protocol before beginning this progression. The student will complete each level and progress to the next only if they remain asymptomatic both at rest and with provocative exercise. There will be roughly 24 hours between each step of the RTP progression and this process will take no less than 8 days. Should the student become symptomatic during the progression, they will drop back to the previous asymptomatic level and try to progress after a 24-hour period of rest has passed. Each phase of the RTP will be administered and assessed by an ATC (certified athletic trainer) at Rosary. Parents/Guardians must, in writing, approve of their student to progress back to full contact activities. Final return to play clearance is at the sole discretion of the athletic training staff in accordance with state education codes.
Stages for Return to Play
- Stage 1: Light Aerobic Activity
- Stage 2: Moderate Aerobic Activity/Light Resistance Training
- Stage 3: Strenuous Aerobic Activity/Moderate Resistance Training
- Stage 4
- Stage 5: Return to Competition
Stage 1: Light Aerobic Activity
Stage 2: Moderate Aerobic Activity/Light Resistance Training
Stage 3: Strenuous Aerobic Activity/Moderate Resistance Training
Stage 4
Stage 5: Return to Competition
FORMS
Your student will complete a number of forms during their recovery process. Some of these forms will need to be picked up in person from the school nurse. Other forms the student may need are listed below.
When visiting your physician, please have the MD or DO complete the Physician Recommended School Accommodations Following Concussion form below. Return this form to the school nurses.
The following "return-to-learn" documents are to assist the concussed student to “return to the classroom and learning environment” in a scientific manner regarding brain activity.
Physician Recommended School Accomodations Following Concussion
Medical science and concussion care experts have found that a concussed athlete must take a gradual and progressive, stage by stage, step by step return to practice under medical supervision to minimize risks and allow the brain to properly recover.
A.B. 2127 and CIF Bylaws mandated a MINIMUM timeline, but medical experts recognize that many adolescent concussion patients may take much longer to recover. Always be cautious as returning to practice and play too quickly may have catastrophic consequences.
Concussion Return to Play Protocol
Forms that are filled out by the Concussion Management Team
Suspected Head Injury Home Information - This form alerts you to the fact that your student may have suffered a concussion while at a school related event. It also outlines certain instances when a trip to the Emergency Department is warranted and how to initiate the Concussion Management Program for your student.
Graded Symptom Checklist (GSC) - This checklist helps the Concussion Management Team document the recovery process following a concussion. Vital accurate information is necessary and documented on the GSC to ensure the safety of the injured student-athlete and to make return-to-play decisions.
Recommended Providers
In an effort to provide your student with the best possible care, Rosary encourages students to use licensed health care providers we know are trained in the management of concussions. This is backed up by an Assembly Bill passed in 2011. If you choose to use another provider for any reason and the Sports Medicine department does not feel your child has received the standard of care they deserve, we may ask that you get a second opinion with one of our recommended providers.
RECOMMENDED PROVIDERS
Dr. Ashika Sharma
601 Yorba Linda Blvd, #5
Placentia, CA 92870
(714) 274-6733
Dr. Chris Koutures
500 S. Anaheim Hills Road, #140
Anaheim Hills, CA 92807
(714) 974-2220
Definitions
Concussion - A complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include:
Concussion may be caused either by a direct blow to the head, face, neck or elsewhere on the body with a great enough force which can be transmitted to the head.
Concussion typically results in the rapid onset of short-lived impairment of neurologic function that resolves spontaneously.
Concussion may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury.
Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course; however, it is important to note that in a small percentage of cases, post-concussive symptoms may be prolonged.
No abnormality on standard structural neuroimaging studies (i.e. x-ray, ct-scan) is seen in concussion.
Mild Traumatic Brain Injury (mTBI) – All concussions are a form of mTBI, however not all mTBI's are concussions. The terms mTBI and concussion should NOT be used interchangeably.
Post-Concussion Syndrome – A set of symptoms which may last for weeks, months, or years following a concussion.
Second Impact Syndrome – Rare condition when an athlete sustains a second head injury before symptoms from the first have resolved, often fatal.
Cognitive Rest – Avoiding such behaviors and activities as: driving, video games, computers, text messaging, cell phone use, loud and/or bright environments, television, and reading and studying; these must be limited, and in most cases, completely avoided.
Physical Rest – Avoiding such activities and behaviors as: physical education, sports activities, and strength or cardiovascular conditioning must be regulated or avoided while recovering from a concussion.
Return to Activity – A two part process involving BOTH Return to Learn (RTL) and Return to Play (RTP) components to assist Rosary students in returning to both full academic and extra-curricular activities in a safe manner.
Return to Learn (RTL) – A stepwise process re-integrating the student back into the classroom and a full academic load.
Return to Play (RTP) – A stepwise process re-integrating the student back into their extracurricular activities.
Concussion Management Team (CMT) – A team of individuals within the school and in the community to assist the student through the recovery from concussion. Members of the concussion management team include physicians, administrators, counselors, school nurses, and athletic trainers. In more complex cases, it may be necessary to add more team members such as: neurologists, psychologists, neuropsychologist, additional physicians, etc.