School health care
School health care is intended for primary school pupils and their families. It is a statutory preventive service in primary health care and is free of charge. It is mainly available during school days in the school or in its immediate vicinity.
The school health care cooperates with parents, teachers and other student welfare personnel. The work is confidential.
School health care includes:
- promoting the pupil’s growth and development and health and wellbeing
- supporting the work that parents and guardians do to raise a child
- early identification of a pupil’s needs of special support or examinations, support for the pupil, support for self-care of a child with a chronic illness in cooperation with other student welfare personnel and, if necessary, referral to further examinations and treatment.
- promoting and monitoring the health and safety of the school environment and the wellbeing of the school community
- oral and dental care
- special examinations necessary to find out what a pupil’s state of health is
School health care includes annual health examinations, of which 1st, 5th and 8th grade health examinations are extensive. Extensive health examinations are used to assess the wellbeing of a child/adolescent and the whole family. The hope is that parents/guardians participate in extensive health examinations.
Digital appointment booking for school health care
The digital appointment booking in DigiSoite’s My Healthcare service is used in school health care. An appointment can be booked via the internet for the health examination in/before 1st grade and for the extensive examination in 5th grade.
Identification in the My Healthcare service is done via the online service Suomi.fi. For identification, you need online banking codes or a mobile certificate.
Please note!
You can make an appointment for an examination once the child’s own school nurse has informed you.
The appointment can also be moved and cancelled via the My Healthcare service. Moving and cancelling an appointment must be done 24 hours before the appointment.
An appointment for the health examination in/before the first grade can still also be booked by phone.
Digital form on medical history
School health care uses a digital form for medical history, which can be filled in via DigiSoite’s My Health care service.
We ask parents to fill out the digital form for medical history about their child’s health before coming to the examination.
Oral and dental care for school children
The oral and dental care services are part of the pupil’s health care. Oral and dental care complies with the decree by the Finnish Government on child health clinics, school and student health care, and preventive oral and dental care for children and adolescents. Pupils in 1st, 3rd, 5th and 8th grades are asked to come to an examination and, if necessary, pupils from other age groups are also asked to come to an examination depending on their individual needs.
The need for orthodontic care is assessed through examinations and a screening by an orthodontist. 3rd graders are invited to be screened by an orthodontist if a need for orthodontic treatment has not been found before. Screening appointments are sent to the client’s home.
Client fees in social and health care services
Persons aged 15 years and older are charged a fee for a doctor’s appointment or an appointment to oral and dental care if the appointment is not used and is not cancelled, if there are no grounds for not coming to the appointment. A cancellation must be made 2 days before the appointment.
In school and student health care, client visits to the school nurse are still free of charge.
School health examinations
School health care includes annual health examinations, of which 1st, 5th and 8th grade health examinations are extensive. Extensive health examinations are used to assess the wellbeing of a child/adolescent and of the whole family. The hope is that parents/guardians participate in extensive health examinations.
The examinations are based on the national decree (338/2011) from 2011. Health examinations include individual health advice in accordance with the pupil’s stage of development.
The child will be transferred to school health care in the autumn when the child starts school.
The aim of the school health examination in/before 1st grade is to start the best possible cooperation between the parents and school health care and to support the child and the family when starting school.
The health examination for a first-grader is carried out in the summer before the school starts, or at the latest in the autumn in first grade. An invitation to a health examination is sent to the guardian by letter in the spring. At the same time, the parents’ form and substance abuse questionnaire are also sent. They are given to the school nurse when coming to the examination.
The guardian makes an appointment with the school nurse. Before the health examination, the school nurse familiarizes him/herself with the information obtained from the child health clinic on the child’s previous health, wellbeing and illnesses.
The main tool of the health examination is a health discussion, in which the child and the family play the main role. The discussion is based on the form on medical history that has been filled out by the parents/guardians. All issues related to the health and wellbeing of the pupil who is starting school are discussed with the parents and the child. Examples are:
- issues that occupy the child’s or the parents’ mind
- the family’s health habits
- the child’s emotional life and social skills
- in addition to this, information on school health care services is provided
The core ideas are to build a foundation for cooperation between the home and school, to motivate parents when it comes to school, and to support parenthood.
An assessment of a child’s state of health includes:
- height
- weight
- monitoring growth
- posture
- distance vision and near vision
- hearing
- blood pressure
- giving vaccinations that have not been given before
Areas of focus in the health discussion
Ways the parents can support their child when s/he is starting school and ways they can help their child to feel well in school are discussed with the parents. These may include:
- Adequate rest and sleep
- Regular and varied meals
- Support/help when doing homework
The school nurse and the parents jointly draw up a health care plan for the pupil.
A medical examination is part of an extensive health examination, and it is carried out by a doctor and a school nurse together or in cooperation. It also includes an interview with the parents and a comprehensive assessment of the family’s health and wellbeing.
With the permission of the parents, an assessment of how the pupil is doing in and of their wellbeing in day care, preschool or school may also be requested from other professionals.
The health examination includes an examination by a school nurse, an interview with the teacher, and a meeting and interview with the parents in connection with the medical examination. The examination is accompanied by written questionnaires for the pupil and the guardians. The aim is to survey the child’s wellbeing, potential health risks and school wellbeing as comprehensively as possible.
Interviews with the teacher
A school nurse interviews the teacher before beginning the health examinations and records the information about school that the teacher brings up about the pupils in the patient records.
Meeting with the school nurse
The subjects that are discussed at the meeting with the school nurse are related to the pupil’s health and school wellbeing. The discussion is based on a health questionnaire (The Finnish Institute for Health and Welfare THL) that the pupil has filled out and a THL questionnaire filled out by the guardians. Guardians and schoolchildren have the opportunity to discuss matters that concern them. The meeting is interactive in such a way that everyone gets to express their point of view.
The meeting will address matters such as:
- Family and the child’s home environment
- How the child does in school
- Circle of friends and social relationships both in school and at home
- Hobbies
- Health habits; smoking, hygiene, exercise, screen time, nutrition, rest
- State of health
- The schoolchild’s view of themselves and the interaction of the family community
Examinations
- length, weight
- posture and scoliosis examination
- measuring blood pressure
Areas of focus in the health discussion
- how the child is doing in school and how the child likes school, bullying in school
- puberty
- smoking, intoxicants
- pupils at risk of marginalization
- home, spare time
Medical examination
The parents are invited to the medical examination and sufficient time is set aside for discussion with the parents. A physical examination is performed like in the first grade, with special attention paid to pubertal development.
A health care plan is drawn up and recorded as in the 1st grade examination.
The health examination is done in the summer before the seventh grade before school starts, or at the latest during the seventh grade. An invitation to the health examination is sent to the guardian by mail in the spring. At the same time, the parents’ form and substance abuse questionnaire are also sent. These are returned to the school nurse in connection with the examination. The guardian makes an appointment with the school nurse.
The seventh-grade examination is part of the eighth-grade extensive health examination to which parents are invited. The school nurse also meets the pupil in eighth grade. At the medical examination in the eighth grade, the youth health certificate is also drawn up.
In the extensive health examination in the eighth grade, an assessment is done of the pupil’s potential limitations and particular needs in terms of career choice and further studies. To this end, the necessary examinations and support measures are planned and started in cooperation with other student welfare services and, in particular, with the school’s study and careers adviser.
Extensive health examinations
In the extensive health examination, a school nurse and a doctor assess together not only the health and wellbeing of the pupil but always also the wellbeing of the whole family, and the parents are invited to the examination. The examination includes an interview with the parents as well as the teacher’s assessment of how the pupil is doing in school. If necessary, cooperation with other student welfare services is organized.
Sometimes the pupil’s health issues require more detailed examinations and investigations. In such a situation, the school nurse or doctor refers the pupil to further examinations by other experts. These include physiotherapy, occupational therapy, nutritional therapy, oral and dental care, laboratory services and specialised medical care.
Health examinations can also be carried out at other times and for other groups, depending on individual needs. When it comes to those who do not come to the examination, their need of support is investigated, because it is known that the risk of marginalization among those who do not participate in examinations is higher than among those who do participate. The need of support can be determined, for example, by contacting the family or by arranging a home visit.
School nurse’s appointments
Pupils can come to open receptions without booking an appointment in order to discuss their symptoms and matters that are on their mind. Parents can also contact the school nurse. The parents book an appointment for their child for extensive health examinations. If necessary, the examination can take place after 4 PM.
Temporary care leave
If a pupil is under 12 years of age, the parents have the right to stay at home and take care of the child for a maximum of 4 days. Through a school nurse, you receive a certificate on care leave for your employer when taking care of a sick child. A certificate is not written retrospectively.
Vaccinations and permission for vaccination
School health care takes care of the pupil’s vaccination protection and continues with the voluntary and free vaccination programme that was started at the child health clinic. The parent/guardian of the pupil must have a given a written permission for vaccination.
Cooperation with other student welfare and teaching personnel
School health care is part of the schools’ multi-professional student welfare. It cooperates closely with teachers, school social workers, and school psychologists both when it comes to promoting the welfare of the community, prevention, health examinations, and organizing individual support. The transfer of data takes place in accordance with confidentiality regulations.
Promoting the health, safety and wellbeing of the school community and environment
School health care audits the health and safety of the school community and the environment every three years in cooperation with many other parties. Corrections to shortcomings that have been identified in the audit are monitored annually.