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Welcome to the School Year 2022-23

Mrs. Melissa Smith, R.N.

School Nurse
School Attended: Auburn University
Degree Earned: B.S. Nursing


School Health Program

Greenbrier Christian Academy recognizes that a student's health is directly related to his or her ability to learn. In order to keep our children healthy, safe and ready to learn, every student has access all day, every day to a school nurse. Our school nurses work closely with students, parents, staff and community resources to help keep students healthy and in the classroom, where learning takes place, and to meet their individual healthcare needs. Our nurse serve as the link between health care and education by addressing the physical, mental, emotional, and social health needs of students to support their educational success.

For minor health care needs, the school provides a clinic with a qualified clinician. Students experiencing illness will be admitted to the clinic for evaluation of their symptoms. Parents will be notified if the student is unable to remain in school and students will remain under the supervision of the clinician until the parent arrives to pick the student up.

Clinic visits must be quick and to the point in order to maintain the Administration’s common goal of keeping all students in class for the best results in their learning experience while here at GCA. While the medical reason the students visits the clinic during the school day will remain confidential, the nurse communicates regularly with each teacher regarding student visits and the amount of time spent in the clinic.


Illness or Injuries

We remind you that our policy states children are to be kept home until 24 hours has passed in the case vomitting, diarrhea or fever over 100.0 without the use of medication to alleviate symptoms. We are not only concerned about spreading illnesses but also what other illness your child could pick up if their immune system has not recovered. It is our prayer that your children are healthy and avoid illness. In the meantime please encourage good nutrition, plenty of rest, and good handwashing.

The following guidelines are expected with regards to attendance at school in conjunction with student illness.

  • Students with a temperature of 100 degrees or more, episodes of vomiting or diarrhea will be required to return home and may not return to school until they are symptom free without medication for 24 hours.
  • Students who are deemed ill by the clinic may not attend or participate in extra-curricular activities until released by the school nurse.
  • Students who leave school due to illness but fail to be dismissed through the clinic will be considered unexcused and will be subject to the academic penalties associated with an unexcused absence.

If a student requires medication during the school day, the parent must submit a Medication Administration Form to the Clinic and provide the medication in the original container to the nurse. Students are not permitted to keep medicine (including over the counter) in their possession while on campus and/or on school-sponsored trips. The only exception to this guideline would be emergency medication accompanied by a doctor's note. Students may not distribute medications of any sort (prescription or over the counter) to other students.

The clinic and school should be notified when students have injuries, illnesses, or surgical procedures that will impair his or her ability to attend classes normally. By communicating directly with the School Nurse, the most timely information about the student's condition is managed consistently and confidentially. This allows for medical accommodations to be devised and communicated to the necessary faculty in a timely manner. In collaboration with the Academic Dean, plans for transition back into normal classroom attendance and participation, as well as the management of makeup work can be created as needed. Contact: - (757) 547-9595 ext 311 and .


The parent/guardian of students that require the use of a mobility assistive device in school; for example, crutches, wheelchair, cane or walker should provide documentation to the school nurse from a hospital or medical practice. This documentation should include the name of the hospital/ medical practice and provider's information (physician, nurse practitioner, physician’s assistant, physical therapist or school athletic trainer). To provide a safe environment this documentation (and other related documentation) should include the following:

  • Reason for use
  • Duration (length) of use (with dates)
  • Ability to use stairs
  • Any activity restrictions
  • Any special instructions

The school nurse will review the documentation and develop and implement a plan to accommodate the student during the school day to include field trips. The parent/guardian must provide the crutches, wheelchair, cane, or walker. 

Cold vs Flu:


COVID Positive

Students or staff  members who test positive (regardless of vaccination status) will isolate themselves at home for 5 days. If they are asymptomatic or symptoms have  resolved and have been fever-free for 24 hours, they may return to school after day 5.  The day symptoms began is counted as day zero.

The student or staff member will wear a mask on day 6-10. 
If unable or unwilling to wear a mask, the student will be out the full 10 days.

Quarantine is no longer required for anyone exposed (within 6 feet for a total of 15 minutes or more over a 24-hour period or having direct contact with respiratory secretions from an infected person) to someone who has tested positive, regardless of vaccination status, so long as the exposed individual is asymptomatic.
Masking is encouraged for those exposed to someone who tested positive for COVID.


Health Screening Program

At the beginning of each school year, our school nurse conduct health screening. The State Code of Virginia mandates some of these screenings and the others are recommended by the Virginia School Health Guidelines.


  • Students in 3rd, 7th, and 10th grade will be screened.
  • The school has volunteer nurses who assist our school nurse with vision screening.
  • If your child does not pass his/her vision screening an email will be sent to the email address provided upon enrollment. If you receive an email, please schedule a follow up appointment for a complete eye exam with a vision health care provider.


  • Upon request, the school nurse can perform basic hearing screening on students. 
  • If your child does not pass his/her hearing screening, an email will be sent to the email address provided upon enrollment. If you receive an email, please schedule a follow up appointment for a complete hearing exam with a health care provider.


  • The Code of Virginia mandates that each school board provide educational information or implement a program of regular screening for scoliosis for students in grades five through ten. (HB # 1834)
  • GCA provides Scoliosis Information to all parents of students in grades 5-10.  See clinic forms for more information on scoliosis. 


CPR Training

Due to a recent change in expectations from the Virginia Department of Education, students graduating in 2020 and beyond must receive instruction in cardiopulmonary resuscitation (CPR) before they graduate from high school. (House Bill 2028, Gwyneth’s Law, § 22.1-253.13:4.)

The CPR class will be incorporated into the 9th grade school year or summertime. This instruction includes basic first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator (AED), including hands-on practice of the skills necessary to perform cardiopulmonary resuscitation as endorsed through the American Red Cross Program.

This is an exciting opportunity for our students. Learning CPR and AED in high school empowers youth to help as first responders in an emergency by becoming the first link in the Chain of Survival. These are tremendous skills to have, an asset to the student’s personal development, and a positive entry on college applications!


Medical Care Plans

The following forms are available for download. Please work with your child's health care provider to complete this plan and return to the school nurse.

If your child has emergency medications prescribed such as inhalers/EpiPens/diabetic supplies, PLEASE make sure that you provide these to the nurse the first day of school or prior. The medication cannot be expired.

If your child's medical care provider allows them to carry their emergency medication with them, PLEASE make sure they have it with them on a daily basis.

Asthma Action Plan


Anaphylaxis Action Plan


Seizure Action Plan


Diabetes Medical Management Plan




Bee Stings/Bug Bites Action Plan


Medication Administration

The administration of medication in the school setting is a service that is provided to promote wellness, decrease absenteeism and to remove a barrier to learning. When there is a need for a student to receive medication in school, safe and proper administration is essential. GCA encourages communication between the parents and healthcare provider to assure maximum safety in the giving of medication to the student who requires medication to be provided during the time the student is in school.

All prescription to be given in school must be ordered by a licensed health care provider authorized to prescribe medication, which includes physicians, dentists, physician assistants or licensed nurse practitioners. This authorization must be updated annually for students in grades K-12. 

Students in preschool and extended care will need authorization by a licensed health care provider authorized to prescribe medication on for any over the counter or prescription medication to be given at school. This authorization needs to be updated every 6 months. All medication needs to be in its original container.

Any changes in the original medication authorization requires a new written authorization and a corresponding change in the prescription label.

Herbal, holistic, homeopathic and/or natural products must be given at home or the parent can administer the medication at school.

Aspirin will only be given with doctor’s order.

Benadryl (except for minor allergic reaction) will not be given at school.

An approved medication authorization form should be used and should contain the following:

  • Date prescription written
  • Student name
  • Diagnosis
  • Name of medication to be administered
  • Dosage Time of administration
  • Route of administration
  • Anticipated length of treatment
  • Possible side effects
  • Provider's signature
  • Parent’s information and signature

The parent will hand deliver over-the-counter medication to the school nurse or staff member. The medication must be in original container.You may discuss with your child’s doctor an alternative schedule for administering medication (e.g., outside of school hours).

The parent will hand deliver prescription medication to the school nurse or staff member. Prescription medication must be dated, labeled with name, name of medication, dosage, doctor’s name, instructions and brought into the school in the original container as dispensed by the pharmacist.

Medications including prescription, over-the-counter, essential oils should be given to the student at home whenever possible. The first dose of any new medication must be given at home.

Students are not allowed to self-administer any medication with the exception of asthma, insulin, or epi pens.

Any self-administration of medication for Asthma, Diabetes, and severe allergic reactions require a completed care plan signed by the health care provider and parent/guardian.

Chap stick/lip balm may be sent to school for your child's use only. It cannot be shared with other students.

It is the responsibility of the parent/guardian to collect any medication from school when the student is no longer taking that medication. If it is not collected, medication will be safely disposed of according to state and federal laws.

School personnel will not administer any medication to students unless they have received a medication form properly completed and signed by the doctor and the medication has been received in an appropriately labeled container. In fairness to those giving the medication and to protect the safety of your child, there will be no exception to this policy.


Medication Consent Form


Prescription Authorization Form


Immunizations and Health Requirements

Virginia state law requires that students be fully immunized against DPT (Diphtheria, Pertussis and Tetanus), Polio, Measles, Mumps, Rubella, Hepatitis B, and Varicella in order to attend school. A certificate from a licensed physician stating that the student has been successfully immunized against communicable diseases as required by state law at the time of registration. Students MUST meet all the immunization requirements before beginning school. The statute does include exemptions from this law for medical and religious reasons. Your school nurse can answer any questions regarding your child’s immunization status. Virginia school entrance laws:

  • TP, DtaP, DT, TD : OR TDAP:
    • Minimum 4 doses with 1 dose on or after 4th birthday.
    • TDAP booster vaccine before entry into 7th grades.
    • Minimum of 4 doses with 1 dose on or after 4th birthday for all new students.
    2 doses of measles
    2 doses of mumps for entry into kindergarten
    1 dose of rubella
    All at 12 months (365 days) or older
    Second dose for entry into kindergarten through 12th grade.
  • HEPATITIS B (HEP B): (Hib is not Hep B)
    • 3 doses all grades.
    • 2 doses of Recombivax for 11-15 years only.
    • HPV
    • 3 doses
    • 6th grade girls only - If no documentation provided, do not exclude.
    • 1 dose at 12 months (365 days) or older
    • 2 doses to enter kindergarten, 1st - 9th grades.
    • 1 dose, grades Pre-K, 10, 11, 12.
    • Documentation from physician indicating your child had chickenpox on immunization form.
    • PRE-K only - 2-4 doses depending on age at first dose.
    • 1st dose before entry into 7th grade.
    • One dose before entry into 12th grade.

All new students AND KINDERGARTENERS are required to provide a report of a comprehensive physical examination, signed by a licensed physician or nurse practitioner, performed within twelve months of the initial enrollment date. Virginia State Form MCH-213-G.


Head Lice

Head lice transmission can occur at home, school or in the community. Communication and proper management are the key components in dealing with an infestation and minimizing transmission to other students. These responsibilities are shared between home and school. We are here as a resource and can provide accurate information and help sift through misinformation.

Pediculosis (head lice) is a prevalent problem in school-aged children. Head lice are one of the most communicable conditions with an estimated 6 to 12 million infestations occurring every year. Head lice are not dangerous, they do not transmit disease and are not a public health issue. Head lice should not disrupt the educational process.

Helpful Information…
  • Check your child’s head regularly as part of your routine hygiene – at least once a week.
  • Watch for signs of head lice such as frequent head scratching especially behind the ears and at the nape of the neck.
  • Remind your children not to share personal items such as hats, helmets, combs, hair accessories, pillows.
  • Hair styles that restrain hair, such as ponytails and braids, prevent spread.
  • Head lice are mostly spread by direct head-to head contact.
What to look for…
  • Find a comfortable area with good light.
  • Look carefully throughout the entire scalp. Wearing magnifying / reading glasses helps.
  • Lice are wingless insects about the size of a sesame seed. They are usually reddish brown in color. They move quickly and shy away from light. (This makes them more difficult to see.)
  • The determination of head lice is more often made by seeing nits (eggs) than by finding crawling head lice.
  • Nits are tiny, oval-shaped, and are usually beige or grayish white in color.
  • Nits are attached to the hair shaft and do not wash or blow away.
If you find head lice…
  • Please call us for advice.
  • Contact your pediatrician for treatment recommendations.
  • Follow directions very carefully and read all the warning labels
  • Be aware that over-the-counter products do not kill 100% of the lice and nits.
  • Combing and manual removal of lice are essential components to successfully removing ALL nits and lice from the head. This may take over several days to accomplish.
  • Check all other members of the household. Only those with live lice or nits close to the scalp should be treated.
  • Do not reapply treatment more frequently than recommended.
  • Be aware that there are many websites that offer advice and products regarding head lice management. Your child’s pediatrician and school nurse are the best resources for information regarding head lice management.
  • Contact us if you have any questions during the process
  • The school nurse must assess your child after treatment. Guidance and further direction by the school nurse will help with successful eradication of the head lice infestation.
Environmental Issues:
  • Machine wash in hot water and regular detergent all clothing and bed lines that have been in contact with the infected person or dry on the hot cycle for at least 20 minutes.
  • Items not washable such as toys, pillows etc. should be stored in a tightly sealed plastic bag for two weeks.
  • Vacuum carpets, floors, upholstered furniture and the car.
  • Soak combs and brushes in hot water for 20 minutes or replace them.
  • Notify anyone with whom your child has been in close contact with so that they can monitor for evidence of head lice.

Heads Up on Lice: 
Head Lice 101: 
Head Lice: 

Please don’t hesitate to contact us if you need additional information or support. Your partnership is appreciated as we navigate through this sometimes difficult and emotional issue.


Contagious or Infectious Diseases (According to Virginia School Health Guidelines)

Re-admission of pupils who have been absent from school because of communicable disease is governed by the following:


  • CHICKEN POX – MUST have doctor’s written permission to re-enter school AND must stay home for at least 5 days after eruptions first appear or until vesicles become dry.
  • CONJUNCTIVITIS (Pink Eye) – Must stay home while any colored drainage present AND until 24 hours of antibiotic treatment has been completed.
  • COLDS, SORE THROAT OR A PERSISTENT COUGH- Fever free for 24 hours without using any fever reducing medication and symptoms do not interfere with routine school activities.
  • *DIPHTHERIA – MUST have doctor’s permit to re-enter school AND documentation that two cultures failed to show presence of the disease.
  • FIFITHS DISEASE- Fever free for 24 hours without using any fever reducing medication and symptoms do not interfere with routine school activities.
  • GROUP A STREPTOCOCCAL INFECTIONS (Strep Throat, Scarlet Fever, Rheumatic Fever)-MUST have doctor’s written permission to return to school, must stay home until 24 hours of antibiotic treatment has been completed, AND without temperature over 100.0 F for 24 hours without the use of ever reducing medications.
  • HAND, FOOT AND MOUTH DISEASE- Fever free for 24 hours without using any fever reducing medication and symptoms do not interfere with routine school activities. The student cannot not have intact or open blister that cannot be covered.
  • *HEPATITIS A – MUST have doctor’s written permission to return school.
  • *HEPATITIS B (acute) – MUST have a doctor’s written permission to return to school.
  • *HEPATITIS E – MUST have doctor’s written permission to return to school.
  • IMPETIGO – MUST have doctor’s written permission to return to school, must stay home until 24 hours of antibiotic treatment has been completed, AND must stay home until lesions are dry. Lesions must be covered until skin is completely clear.
  • INFLUENZA (FLU) – Must stay home until student is without temperature over 100.00 F. For 24 hours without the use of fever reducing medications and symptoms do not interfere with routine school activities.
  • *MEASLES – MUST have doctor’s written permission to return to school, must stay home until at least 4 days after the appearance of the rash, AND without temperature over 100.00 F for 24 hours without the use of fever reducing medications.
    • Unimmunized students may need to be excluded from school. Follow recommendation of your local health department.
  • MENINGITIS – MUST have doctor’s written permission to return to school. Must stay home during acute illness. Non-communicable after 24-48 hours of appropriate drug therapy.
  • MENINGOCOCCAL INFECTION – MUST have doctor’s written permission to return to school.
  • *MUMPS – MUST have doctor’s permission to return to school AND must stay home for 5 days after the onset of gland swelling.
  • NOROVIRUS- MUST have a doctor’s note to return to school. Must stay home until 24 hours after symptoms resolve.
  • OTITIS MEDIA (EAR INFECTION) – Must stay home if uncontrolled drainage from the ear canal is present.
  • PEDICULOSIS (Head Lice) – MUST stay home until the child is free of lice and nits (GCA has no nit policy). Prior to returning to school, the child must be checked by the school nurse.
  • *PERTUSSIS (WHOOPING COUGH) – MUST have doctor’s written permission to return to school AND must stay home for 5 days after the initiation of antibiotics therapy. Discuss with your local health department.
  • PINWORM INFECTION- MUST stay home for 24 hours after treatment is started.
  • *RUBELLA (GERMAN MEASLES) – MUST have doctor’s written permission to return to school AND must stay home for 7 days after onset of rash. Discuss with your local health department.
  • *SALMONELLOSIS – MUST have doctor’s written permission to return to school, must stay home until cessation of diarrhea, AND until stool cultures are negative.
  • SCABIES – MUST have doctor’s written permission to return to school AND must stay home until 24 hours of doctor’s prescribed treatment has been completed.
  • TINEA (RINGWORM) – Must stay home until 24 hours of anti-fungal therapy has been completed AND infected area MUST be covered (Ringworm of the scalp must be treated by a physician).
  • *TUBERCULOSIS – MUST have a doctor’s written permission to return to school.
  • UPPER RESPIRATORY INFECTION – Must stay home until student is without temperature over 100.0 F for 24 hours without the use of fever reducing medications.
  • VOMITING/DIARRHEANo vomiting or diarrhea for 24 hours to return to school. Please notify school nurse if your student has been diagnosed with a medical condition that may cause vomiting such as reflux or if student is having side effects from antibiotic treatment.

*These are communicable/reportable diseased to the Virginia Department of Health.


General Resources

If you would like to set up an appt to discuss any medical issues regarding your child, please email me with dates/times which are convenient for you. I will be available the week prior to the first day of school.Thank you in advance as you help me to prepare for a healthy, safe, and comfortable school year. Please don't hesitate to contact me throughout the school year to update me on any changes with your child or if I can be of any assistance with your child's health needs.