Sharon Nelson

Date of Award

11-16-2006

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Teaching & Learning

First Advisor

Kathleen Gershman

Abstract

Approximately ten to thirty percent of school aged children have a chronic physical, developmental, behavioral or emotional condition that requires specialized health care and related services. Providing the needed health care is critical in maintaining students' participation and success in school. The enactment of PL 94-142, in 1975, mandated that public schools give children with disabilities the right to a "free and appropriate public education" in the least restrictive environment possible. School nurses are the logical choice to provide the necessary health care in schools. They have the knowledge, expertise, judgement and critical thinking skills inherent in nursing education and are authorized to provide nursing care through nursing licensure. However in North Dakota there are no state mandates or funding for school nurses. Due to the lack of school nurses, non-medical personnel, particularly paraeducators are delegated by their school administration and authorized by parents to provide the needed health care throughout the school day. In North Dakota, there are no licenses, credentials, state certificates, or endorsements for paraeducators. Paraeducators depend on parents, teachers, other paraeducators and their own ingenuity and judgement to deliver the needed health care. In this phenomenological study, six paraeducators share experiences of their expanding roles as health care providers. Through observations, as well as through interviews and field notes this study helps clarify the way paraeducators make meaning of their roles and responsibilities as health care providers in schools. Paraeducators see their expanding roles as requiring high levels of responsibility. They report feeling, at times, undervalued, fearful and frustrated. School districts offer little to no formal education, training and supervision for paraeducators. Paraeducators are essential members of the educational team, serving students with disabilities and health care needs and contributing significantly to their success. Paraeducators need the support, education and supervision of the entire school community including families, resource teachers, classroom teachers, school nurses, related services personnel and administration. Formalized policies and guidelines developed by health care providers and educators must be in place to ensure the delivery of safe health care and effective learning environments to all students.

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