Role of the Health Clerk

As a non-certified paraprofessional, the Health Clerk * provides support services for the nurse in the schools to which she is assigned.

As a result of this support, the Health Clerk allows the nurse more time to better focus on functions requiring professional skill and judgement, and to resolve those health problems that interfere with learning. However, the School Nurse should be responsible for supervising no more than three health clerks.

In this way the Health Clerk makes a valuable contribution toward achieving, maintaining and restoring the health of students, an integral goal of every school's program of education.

ROLES AND RELATIONSHIPS

The Health Clerk and the School Nurse

Upon delegation from the school's Registered Professional Nurse (RN), the Health Clerk

-- performs clerical tasks,

-- implements health office procedures, and

-- is responsible for diverse, non-professional health program duties. * Some school districts refer to this clerical support position as a School Health Services Assistant, School Health Aide, etc.

Adapted from The School Health Clerk (1990) with permission from California School Nurses Association (CSNO). This non-certified paraprofessional Health Clerk may also perform various other technical health care functions but only if those functions are specifically delegated by the School Nurse. Delegation by Registered Professional Nurses (RNs) to unlicensed personnel means:

THE RN TRANSFERS to a competent individual the authority to perform a selected task on a specific individual.

THE RN REMAINS ACCOUNTABLE for the application of:

  • the nursing process (assessment of the student's nursing care needs, plan of nursing actions, implementation of the plan, and evaluation of the outcomes), and
  • the nursing theory when making the decision to delegate.

DELEGATION CRITERIA:

  1. It is student specific and caregiver specific.
  2. The competency of the caregiver is assessed and documented.
  3. A recording method is established.
  4. The method and schedule for contact is defined.
  5. Problem interventions are identified.
  6. The entire procedure is periodically reviewed.
  7. Student outcomes are evaluated.

School Nurses should review the statutes and regulations relating to nursing. Pertinent regulations are Title 172, Chapters 99, 100 and 101, promulgated by the Board of Nursing and the Nebraska Health and Human Services.

However, certain other activities are completely outside the role of the Health Clerk because there are some functions which the School Nurse may not delegate.

Therefore, because the School Nurse cannot delegate certain functions,

--the Health Clerk may not diagnose physical, mental, or behavioral conditions

--the Health Clerk may not counsel students

--the Health Clerk may not suggest specific treatments to students, parents, or staff

--the Health Clerk may not manage mandated health screening procedures

--the Health Clerk may not supervise the health and physical development of students

--the Health Clerk may not consult with, or refer clients to, professional health care

practitioners or agencies

--the Health Clerk may not deal with complex nursing care procedures requiring prior nursing or medical assessment of the student

The Health Clerk and the School Principal

The school principal is responsible for all personnel and programs at the school site. This remains the case at sites which utilize the services of a Health Clark.

Therefore, although the health clerk is accountable to the school nurse for all health services duties and responsibilities, the Health Clerk is also equally accountable to the site administrator for adhering to school policies. The principal retains overall jurisdictional responsibilities for the school and its policies.

Consequently the full support of the school principal is invaluable in enhancing the effectiveness of the Nurse-Health Clerk team in providing a quality school health services program to the principal's school.

Qualifications for the HEALTH CLERK Position

Requirements for the position of Health Clerk should, at minimum, include the following:

High school diploma or equivalent

Acceptable clerical skills of filing, typing, computer literacy and general office management

Ability to function within the legal and ethical constraints of the health clerk position

Ability to establish rapport with children and to relate positively to them

Trustworthiness regarding confidentiality of health records and other student and family information

Completion of the American Red Cross Standard First Aid Course of Training and current certification for cardiopulmonary resuscitation (CPR)

Completion of pre-service training by school nursing personnel which includes health services policies and procedures

Possession of a valid Nebraska Driver's License

Bilingual skills as appropriate for the community served

Willingness to work as a team member

In addition, personal qualifications should be congruent with those for all school staff.