Childhood Cancer

Your Child in the Hospital

Returning to school

The sooner a child can return to school, the better. Preparation and communication are key to a successful return. If your child has only missed a week or two, work with the teacher to find ways for your child to catch up. If, however, your child has been gone for an extended period, ask the physician or primary nurse to prepare a letter for the school staff containing the following information:

• Your child’s health status and its probable effect on attendance.

• Whether he can attend regular physical education classes, physical education with restrictions (no running, for example), or adaptive physical education.

My high-school gym teacher gave me a B after I tore the ligament in my knee and had surgery. Even though I was able to lift weights during class, I couldn’t participate in regular class activities. In hindsight, I should have fought this or negotiated to drop the class and take it again later.

• Whether adjustments in your child’s schedule are needed. For example, a child with a cast on her arm will be unable to complete a typing class and may benefit from changing classes, even if this isn’t standard school procedure.

My 16-year-old son was allowed to leave each textbook in his various classrooms. This prevented him from having to carry a heavy backpack all day. They also let him out of class a few minutes early, because he was slower moving from room to room.

• A description of any changes in physical appearance, perhaps with suggestions on how to discuss this with classmates.

• The possible effect of medications on academic performance.

• Whether school personnel must administer medications or other services as directed by a doctor.

• Any special considerations such as extra snacks, rest periods, or extra time to get from class to class.

When Brent returned to kindergarten after a long stay in the hospital, he was exhausted. There was a beanbag chair in the back of his classroom, and he just curled up in it and went to sleep when he needed to.

• A list of signs and symptoms requiring parent notification, such as fever, nausea, pain, or swelling.

Stress that the teacher’s job is to teach, and the parent and school nurse will take care of all medical issues.

I’m a school nurse. I like parents and their children to come and talk with me when it’s time for the child to reenter school. We talk about how the child is feeling, how many hours a day he should be in school, and whether he needs to come rest in my office. I remind parents that I need doctor’s orders to give meds or provide nursing services. I love it when parents share information through conversation, journal articles, or brochures. I also prepare the child’s class for reentry. I give talks and show videos. I find children to be wonderfully receptive and helpful when they are given truthful information.

Once teachers have had a chance to read the letter, request a meeting that includes the teacher, principal, school nurse, and school counselor or psychologist. At this meeting, answer any questions about the information contained in the letter, distribute any useful information you have, and do your best to establish a rapport with the entire staff. Take this opportunity to express appreciation for the school’s help and your hopes for a close collaboration in the future to create a supportive climate for your child.

The following are additional parent suggestions on how to prevent problems through preparation and communication:

• Keep the school informed and involved from the beginning. This fosters a spirit that “we’re all in this together.”

• If your child has a long-term illness, bring the nurse into the class whenever necessary to talk about your child’s illness or injury and answer questions.

• Ask the school to bend some rules and policies if you think it will help your youngster.

• Find ways to check your child’s progress after she returns to school. Some children, especially teens, are reluctant to talk about school with parents, but they may need a parent’s help negotiating changes in school schedules or rules.

• Volunteer at school if you feel it is important to be nearby in case of problems.

• Realize that teachers and other school staff can be frightened, overwhelmed, and discouraged when they have a child with a serious illness in their classroom. Accurate information and words of appreciation can help immensely.