School health care
School health care is continuation of the work started at the maternity and child health clinic. School health care is preventive in nature. It reinforces the individual resources of each child, young person and family.
The goal of school health care is to ensure the healthy growth and development of children and young people and ensure their study abilities.
Together with the school and other operators and authorities, school health care also makes sure that the school environment is healthy and safe.
The school nurse meets with students annually during scheduled medical check-ups. These check-ups involve interviews, clinical examinations and other methods as required that chart the growth, development and well-being of the child, in accordance with his or her age and individual needs. A school nurse will administer vaccinations in accordance with the general vaccination programme to the children and young people.
Extensive health examinations will be performed during the 1st, 5th and 8th grade, which include, in addition to the check-up by a school nurse
- an examination by a doctor and
- meeting and interview with a parent/the parents.
The purpose of these check-ups is to provide a comprehensive look at the current life situation of the child and his or her family, as well as the factors that affect the health of the child. Feedback about the health examinations will be given to the parents either verbally or in writing.
If a sick child requires an evaluation or treatment from a doctor or a public health nurse, the guardian should take the child to their own health station. The treatment and control of children’s long-term illnesses are the responsibility of a health station.
|School doctor||Health station||Information|
|Psychological (mental) and psycho-social issues||X||X||Contact the location that suits you the best.|
|Learning difficulties that school support measures have not alleviated||X||-|
|Suspected deterioration of learning abilities (e.g. numerous absences)||X||-|
|Suspected scoliosis (spinal curve)||X||-||Scoliosis does not cause pain. Early detection is useful in order to prevent difficult spinal curves.|
|Delayed or early puberty||X||-||Monitoring the progress of puberty is the responsibility of school health care.|
|Weight gain and weight loss||X||-||Primarily the responsibility of school health care.|
|Hormonal contraception||-||X||Pupils at comprehensive school are usually directed to a centralised Family Planning Clinic.|
|Long-term illnesses||-||X||Health station’s responsibility. Periodic examinations by the school doctor ensure that treatment and monitoring are proceeding as planned..|
|Acne, stomach problems, headaches, bed-wetting, allergies, rashes, respiratory and musculoskeletal symptoms||-||X||If the problem is observed during a school doctor’s examination, the doctor may treat the problem or provide a statement. For further treatment, the child is usually referred to a health station (both by the school doctor and school nurse).|
|Cold, cough, diagnosing and control of asthma.||-||X|
|Suspicion of a serious illness||-||X||If it occurs at school, the school nurse will immediately ask the school doctor or the City’s other doctors for advice.|
Frequently asked questions about doctor’s health examination – school doctors’ answers to questions by children and young people
An appointment for a school doctor’s health examination will be made for you in order to ensure that you are growing and developing as you should be. If you have any symptoms or problems, the doctor can comment on them and investigate what the problem could be. You can talk about any issues on your mind with the doctor in full confidence. Sometimes, though very rarely, it is possible that an illness is discovered during the examination that has not been observed before or that has not shown any clear symptoms.
During the doctor’s examination, you will also learn useful things about your own development and health. The doctor will talk with you about what kind of lifestyle supports your health and well-being and, on the other hand, what kind of habits may be detrimental to your health. You will also have the opportunity to ask the doctor any questions that you may have, for example about matters related to your growth, development, sexuality and relationships.
You do not have to attend the appointment. If you wish to refuse, you should first talk to your parents or school nurse.
You should tell the school nurse about your refusal well in advance. It is important to cancel the appointment, because this is the only way the appointment made for you can be given to someone else.
In short, you can refuse the appointment but your guardians cannot stop you from using the services of school health care.
The objective of the school doctor is to form an overall picture of your physical, psychological and social well-being. This means that, in addition to your physical health, the school doctor is interested in how you are doing at school, if you like school, do you have any problems at home or with your friends, and whether there is anything else on your mind.
Usually, the health examination starts with a discussion between you and the doctor about your health and the rest of your life, for example school, leisure time, friendships, family, and hobbies. After this, the doctor will examine you.
Jos huoltajasi on paikalla, lääkäri keskustelee yleensä hänen kanssaan ensin, pyytää huoltajaasi sitten poistumaan ja sitten juttelee kanssasi ja tutkii sinut.
During the advance nurse check-up, the nurse will have examined your vision and hearing and measured your height, weight and blood pressure.
The doctor’s examination includes an interview, and, additionally:
- Looking into the ears, mouth and throat.
- Looking into the eyes: ensuring that you do not squint and that the width of your field of vision is normal.
- Examination of the neck and thyroid gland. The neck area is examined manually in order to check that you do not have enlarged lymph nodes, for example.
- Listening to the heart and lungs. Your heart is listened through your chest and the breathing sounds of lungs usually through your back.
- Inspecting your back and posture. Sometimes, you may have a curve in your spine or your legs maybe different lengths, which may cause changes to your posture. If the curve is pronounced, an x-ray may be necessary in order to examine possible scoliosis.
- Examining your stomach and groin area. The groin area is examined manually in order to check for enlarged lymph nodes, for example. The femoral artery pulse is also examined at the same time.
- The doctor examines boys’ testicles during the examination. In order to examine the testicles, it is usually sufficient to just take a look, but sometimes they may need to be examined more closely. Testicles must have descended into the scrotum in order to maintain their functionality. However, sometimes testicles may leave the scrotum and move towards the stomach area, which is why they must be examined.
- When puberty draws closer, the progression of puberty will be checked and reviewed. This ensures that puberty progresses as normal. For girls, the start of the menstrual cycle signals the progress of puberty, and with the girls, the doctor will talk about menstruation, when it starts and any possible problems related to it. If menstruation has not started yet, other signs of puberty will be noted, such as development of breasts and hair growth. When reviewing the progress of boys’ puberty, the development of genital and hair growth will be noted.
- Usually, a youth health certificate will be provided for young people during the 8th grade doctor’s examination. This is necessary for applying for a driver’s licence, for example.
The school doctor is interested in your comprehensive health and well-being. The doctor’s examination has been arranged for you, which mean that your opinions and experiences really do matter to the doctor. When you are the one to share your experiences, the doctor can form a better overall picture of your situation and is better able to support your well-being.
At the check-up with the school nurse, you will have already talked about your life and health, and the nurse will have noted down the most important points. The doctor can see the notes made by the nurse, which means that you do not have to explain everything again. You can answer the questions you are willing and able answer to. You do not need to answer them all.
The purpose is to talk to you and your family so that everybody can feel safe. You and your family can also ask the doctor questions.
Everyone must have the right to a confidential relationship between a doctor and a patient. Both the doctor and the nurse are bound by professional confidentiality, and they are not allowed to talk about the matters that have occurred during the health examination with anyone without your permission. For example, if you are starting on birth control pills, your parents will not be told. However, you can agree with the doctor that you will tell them about the matter at home.
Only if your health or safety is in danger must the doctor or nurse contact your guardians. Sometimes it may be necessary to contact Child Welfare Services, even against your will. This is only done with your best interests in mind. The doctor will tell about this in advance and will discuss the matter with you.
A doctor cannot allow a child or a minor to be in a situation that may endanger their life or clearly threaten their health and development.
The doctors are aware that children and young people may find it embarrassing to take off their clothes. During the health examination, we aim to ensure that as few clothes have to be taken off as possible. However, the examinations cannot usually be done properly while wearing a shirt and trousers.
For example, your posture and spine cannot be examined or lungs and heart listened through a shirt. This is why you must remove your shirt. Trousers have to be taken off in order to examine the position of your legs and lower back. At the same time, the doctor is able to examine that your skin is healthy and that you have no rashes that require treatment, for example.
Underwear does not usually need to be removed, but boys should lower their underwear so that the doctor can verify that the testicles have developed as normal and that they are in their correct position within the scrotum. If you need to remove your underwear, there will always be a well-founded, health-related reason for it and it will be explained in advance. The examination will not be carried out against your will.
However, no one can force you to take off your clothes. You can tell the doctor directly if taking off your clothes seems very distressing or unpleasant, and the doctor can discuss the matter with you. In this case, the progression of the health examination will be agreed about with you.
Like all doctors, school doctors have completed a six-year long doctors’ training course. All school doctors have sufficient training and the right to practise their profession in Finland. A school doctor is, in particular, interested in the health of children and young people, and they may have some special competence related to children's and youth medicine. The doctor may, for example, be a specialist in general medicine or paediatrics, or they may have special qualifications in child health clinic and school health care work or youth medicine.