Clinic Guidelines & Nurse Responsibilities

• General Caretaking: Includes noninvasive actions for minor issues, such as cleaning spills, providing a change of clothing, feeling a student’s forehead for warmth, or applying a basic adhesive bandage (band-aid).
• Emergency Care: In the event of a serious medical emergency, the District will always seek appropriate emergency medical care and contact the parent or guardian immediately.

• First aid, injury evaluation, and care to protect the immediate health and safety of the student
• Evaluation of illness or physical symptoms at school, including checks of temperature, pulse and blood pressure and nursing assessment (e.g. listening to breath or heart sounds, otoscope examination of ears or throat, examination of eyes and pupil responsiveness)
• Communicable disease or condition symptom evaluation, exclusion and readmission (e.g. fever ≥ 100.0°F, diarrhea, viral or bacterial pink eye, rash)  
• Hygiene and basic health education, including handwashing, illness prevention, general wellness, providing clean clothing or menstrual supplies
• Administration of parent-provided over-the-counter and prescription medications, with written parent permission, and physician order in accordance with law
• Special procedures (e.g. gastrostomy tube feeding), with written parent permission, and physician order in accordance with law
• Care of chronic health conditions (e.g. asthma, seizures, diabetes), with written parent permission, and physician order/management plan in accordance with law
• Topical nonprescription medications and cough drops for use when administering first aid and with parent consent provided on the annual Student Health History form (caladryl clear, non-lidocaine burn gel, preservative-free lubricating eye drops)
• Consent DOES NOT AUTHORIZE invasive screenings or procedures, laboratory tests, or collection or sharing of biometric identifiers.

• First Aid: Immediate treatment for minor injuries or conditions to protect the student's health and safety.
• Health Screenings: State-required screenings for vision, hearing, and spinal health to identify potential barriers to learning.
• Wellness & Comfort Care: Basic nursing assessments (e.g., checking temperature or pulse) and providing comfort for minor symptoms like a headache or stomachache (e.g., rest, ice packs).
• Health Education: Guidance on hygiene, illness prevention, and symptom management.
• Consent does not authorize invasive screenings or procedures, laboratory tests, or collection or sharing of biometric identifiers. 

Texas law requires students to be screened for vision and hearing disorders, screening for abnormal spinal curvature, and Risk Assessment for Type 2 Diabetes. For more information about screening requirements, see policy FFAA(LEGAL), TDSHS Vision, Hearing, Spinal Screening, Texas Health & Safety Code Chapter 36 and Chapter 37, and TRAT2DC websites. 

• Vision screening is a non-invasive and non-diagnositic test to determine if a student’s vision falls within the normal range. Screening is conducted using approved eye charts. Midlothian ISD also uses a photoscreener, which is a special-purpose camera that is an alternative to eye chart screening. Parents are notified by the school nurse if a student’s screening results are not in the normal range. 
• Hearing screening is a non-invasive and non-diagnostic test to determine if a student’s hearing falls within the normal range. Screening is conducted using a pure tone audiometer. Parents are notified by the school nurse if a student’s screening results are not in the normal range. 
• Spinal screening is a non-invasive and non-diagnostic test to observe for signs of a spine deformity, such as scoliosis. Girls will be screened two times, once in the fall semester of grade 5 and again in the fall semester of grade 7. Boys will be screened one time in the fall semester of grade 8. The school nurse will look at your child’s back while he/she stands and then bends forward. Boys and girls will be screened separately. Students should remove their shirt for the exam, and may wear a sports bra, halter top, tube top, or snug-fitted camisole. Parents are notified by the school nurse if a student’s screening results are not in the normal range. 
• Risk Assessment for Type 2 Diabetes is a non-invasive and non-diagnostic test. Health Services staff look at the back of students' necks for acanthosis nigricans, which is a skin marker associated with high insulin levels and insulin resistance. Students who have acanthosis nigricans will have their blood pressure, weight and height measured by the school nurse and will notify parents of the student’s screening results and blood pressure, weight and height measurements.

Parents may claim an exemption from any or all of these screenings to the school nurse following TDSHS requirements outlined in the Texas Administrative Code. Vision & Hearing: TAC §37.23, §37.25; Spinal: §37.143 and §37.144. 

• The student is actively under medical care for a vision or hearing problem; your child has already been diagnosed with a spine deformity, such as scoliosis; or has been diagnosed with type 2 diabetes or evaluated for acanthosis nigricans. Notify the school nurse before the screening date and provide documentation from your child’s healthcare provider. 

Please be aware that if state-mandated screenings are declined, you must either provide a signed, written objection or submit screening results from a licensed healthcare professional.

Texas law requires students to be fully immunized against certain diseases as required by TDSHS, or present a valid medical exemption or exemption for reasons of conscience. Midlothian ISD staff may check the Texas immunization registry, ImmTrac2, for student immunization records. Midlothian ISD is NOT an immunization provider and DOES NOT administer any vaccines. See policy FFAB(LEGAL) and TDSHS School Immunization website for additional information. 

Additional information relating to student welfare, wellness, and health services can be found in the following board policies and the Student Handbook:

• FFA — Student Welfare: Wellness and Health Services
• FFAA — Wellness and Health Services: Physical Examinations
• FFAB — Wellness and Health Services: Immunizations
• FFAC — Wellness and Health Services: Medical Treatment
• FFAD — Wellness and Health Services: Communicable Diseases
• FFAF — Wellness and Health Services: Care Plans

A parent has the right to withhold consent for or decline any health-related service. Consent may be revoked by the parent/guardian at any time in writing. If you DO NOT consent to routine health-related services, the parent will be contacted when a health concern arises with their child, and it is the parent’s responsibility to provide care in a timely manner if their child has a non-emergency health need during the school day. 

The District shall seek appropriate emergency care for a student as required or deemed necessary. The parent/guardian will be contacted in emergencies. Please contact the school nurse if your child will need medication or health care at school, and visit the Health Services Department website for forms. 

If you wish to decline certain health-related services, please complete the Opt-Out Form (PDF) and return it to the campus nurse. Opt-Out forms are effective until the end of the school year in which obtained. You may update your preferences at any time by contacting the campus nurse or school office to request a new Opt-Out form or revoke your previous opt-out selections in writing. Once received, your child will be eligible to receive the updated service selection moving forward.

• Medication Administration: Giving prescription or over-the-counter medications (requires a physician's order).
• Clinical Procedures: Specialized treatments such as tube feedings or nebulizer treatments (requires a physician's order).
• Chronic Condition Management: Ongoing care plans for asthma, diabetes, or seizures (requires a physician’s order).