The role of the school nurse and (rare) doctor

If my child is too ill to go to school what must I do?

You must inform the school that the child will be absent and why, but you do not have to provide a medical certificate. In general, the school has confidence in the parents.

However, there are certain contagious illnesses, such as measles, where a GP must give a certificate showing how long the child should stay at home, and this must be taken in when the child goes back to school to show there is no longer any infection risk. Your GP has a list of illnesses which need a certificate as should the school.

If, however, a child is absent very frequently, the school will try to find out why and if there is a long-term illness, work out what is best to help the child succeed with school work.

If there is truancy, the school will take other appropriate actions.

Is it correct that teachers cannot give any medicines or first aid to children?

Yes, teachers cannot give medicines except in the case of a PAI, Projet d’Accueil Individualisé which is set in place for a child with a long-term illness or condition.

The school nurse, who is present in most collèges and lycées, can only give a limited range of over-the-counter medicines such as paracetamol or Spasfon, unless there is a prescription or a PAI. PAIs are set up to programme the care of a pupil at school who has a chronic illness such as asthma, diabetes or food allergies. It will be set up between the parents and the doctor and will authorise the teacher or nurse to give medication in a precise set of circumstances, for example to use Salbutamol during an asthma crisis, or a procedure for other types of care.

What happens, then, if my child is ill at school, if teachers cannot give medicines in most cases?

In primary school, the teacher will either call the ambulance services if it is an emergency – or the parents if they think the pupil should go home.

In collège or lycée there is nearly always a school nurse who a teacher will send the student to, or the student can go to on their own initiative.

The nurse will either call the emergency services if necessary, or allow the pupil to rest there in one of the beds until they feel able to return to the classroom or call the parents.

When can a parent or a pupil contact the school doctor?

Whenever they feel it is necessary to help the pupil in the context of their schoolwork. It can be varied, to do with conditions like dyslexia, a school phobia or a sudden drop in their marks. It can also be to set up a PAI.

Is it easy to get an appointment with the school doctor and how do you make one?

In a primary school, you can ask a teacher or headmaster; in collège and lycée it is best to ask via the school nurse. It is not easy, because there are too few médecins scolaires. There are around 1,000 of us for 12 million pupils and our numbers are diminishing every year, even though we are in constant demand. Some departments do not have any school doctors. It is a worrying situation.

However, I would always recommend parents to try to make an appointment and at least get in touch with a school nurse if you are worried about your child. Any parent can make an appointment to see the nurse.

What vaccinations are necessary at school?

At present, the only one which is obligatory is the triple vaccination against diphtheria, tetanus and polio (vaccin diphtérique, tétanique et poliomyélitique DTP) which is at two, four and 11 months.

If the child is not vaccinated the parents have three months to get it done, or to give a justification; and, if not, the presence of the child in the school will be put into question.

Vaccinations against tuberculosis used to be obligatory but this is no longer the case, though in some areas it is recommended. New regulations make more vaccinations obligatory but these only concern children born in 2018 and so will not be relevant until those children are three.

(For children born from June 1, 2018 onwards there are 11 obligatory vaccinations. Added to the existing three are whooping cough, measles, hepatitis B, mumps, German measles, and three to prevent meningitis and lung disease. For more information, check solidarites-sante.gouv.fr)

School will soon be obligatory for three year olds, what happens if the child is not potty trained?

There is no law to say a child must be potty trained before they go to school. It is perfectly normal for some children to need a nappy at three.

It is difficult for schools to deal with a child who needs their nappy changing but they must adapt.

It is perfectly feasible that during the siesta, some children will need a nappy, which should not be difficult to deal with as ‘easy to pull-on’ nappies are available nowadays.

You do not have to have a medical certificate if your child is ill, but do you need one if your child cannot attend a sports lesson?

Yes, this is obligatory. One miss may be tolerated but in all situations, whether it be a broken leg or a condition which is not visual, there must be a certificate from the doctor which says how long it is valid for and for what category of sport.

What medical visits are there at school?

There are two. One is when a pupil is six, so in Grande Section at maternelle and one, when a pupil is 12, so in the first year at collège, in Sixième.

The first one will be carried out by a school doctor whose job it is to find out if there is anything which will hamper the child from succeeding at school. The second can be made by a school nurse, with similar objectives.

The aim of the medical staff connected to schools is to help pupils do their best in their education.

In the first visit, the doctor will check hearing, sight, teeth, weight, language skills, psychomotor development, ensure vaccinations are up to date and look at the development of the child as a whole.

Parents can be present and can ask to be present for the second test when the school nurse checks hearing, sight and dental hygiene, vaccinations, weight and the pupil will be asked whether they think there is a health problem.

NB – Parents whose children were not born in France should get a carnet de santé for each child which carries details of vaccinations and other healthcare information. Ask at your mairie or apply to the Service départemental de protection maternelle et infantile.