Nursing Support Services

Nursing Support Services (NSS) assists parents and caregivers of children and youth (0-19) with medical complexities to lead active, healthy lives in their communities.

Our services

Who are we?

We are community-based registered nurses throughout BC who assist children and youth with medical complexities to live in their homes and in their communities.

What we do

Provide supplemental scheduled intermittent periods of nursing respite so that families can have a break from the day-to-day medical/nursing care needs of their medically complex child or youth
Teach and support school staff to assist children and youth with their diabetes care and tube feeds
Train school staff to provide seizure rescue interventions prescribed by a physician or Nurse Practitioner
Complete eligibility assessments for the At Home Program which is administered through the Ministry of Children & Family Development (MCFD)

Who we partner with

families
physicians and primary health providers
hospital teams
community agencies
nursing agencies
schools
Ministry of Children & Family Development

Who we provide care for

We provide care for children and youth living with chronic complex medical conditions whose care needs require the scope of practice of a registered nurse for some aspects of their care.

Please read the FAQs to see if your child/youth is eligible.

We provide in-home respite care for children who may:

have a tracheostomy
require supported ventilation (ventilator, BiPAP, CPAP)
have a life-limiting/palliative diagnosis where the scope of nursing is required for symptom management
have other conditions that require the nursing scope of practice in the absence of parents

We provide scheduled/routine support in the school setting for select activities under the act of delegation for children living with:

diabetes
- Health Canada approved diabetes technology supported by NSS
tube feeds
in and out catheterisation

How do you apply?

Referrals to Nursing Support Services are made by a physician or nurse practitioner who is licensed to practice in British Columbia.

Please refer to our "Resources" page for additional information.

*Please note: NSS is not contracted for and is not in a position to provide emergency, on-call nursing services or palliative care plans. NSS offers respite care for medical care needs; nurses can only provide care that a family is also trained and capable of providing related to their child’s medical complexity. For families that use NSS, the family members are primary-care providers. Family members can and do administer medication. NSS respite hours are put in place to allow a family to sleep/have time away from the continued medical surveillance and nursing care of their child. NSS Coordinators work with the parents/guardians, child and other care providers to develop a respite plan to provide the appropriate nursing support specific to a patient’s needs.

For more information, please see the NSS Principles and Philosophy of Care for In-Home Respite Care Services .

Resources

Referral for services

Referrals for Nursing Support Services require a physician/nurse practitioner who is licensed to practice in British Columbia.

Referral forms need to be completed in their entirety along with supporting documentation.

Referral process:

download the correct referral form
complete the form in its entirety and include any supporting documentation
fax the form to: ‎604-708-2127

Referrals for care in the home/community setting

Referrals for care in the home/community setting are intended to provide planned, intermittent periods of direct care nursing respite in a child's home whose care needs require the scope of practice of a registered nurse for some aspects of their care due to the child/youth's medically complex and fragile health needs.

Referrals must be initiated by a physician/nurse practitioner licensed to practice in British Columbia. Completed referral forms and supporting documentation can be faxed to 604-708-2127

Referral form

Referrals for care in the school setting

Delegated care in the school is intended to support children who require support and assistance with specific tasks related to their care. Delegation of these tasks is determined by the registered nurse on an individual basis for children/youth whose care needs and response to treatment is stable and predictable and can be safely managed by NSS provincial standardized care plans.

Referral form

Referrals for delegated care support in the school are initiated by the child/youth's physician/health care provider and can be faxed with supporting documentation to 604-708-2127

Learn about diabetes in the school setting

Read FAQ's on Diabetes Management in the School Setting (PDF)

Provincial Standards: Supporting Students with Type 1 Diabetes in the School Setting (PDF)

Diabetes Support Plan (Fillable PDF - Includes Med Admin Form) (Rev Jun 17 2024)

Read the NSS Practice Standards for Managing Diabetes in the School Setting (PDF)

Download the NSS Diabetes Medication Administration Form (PDF) (Rev Jun 2024)

Read the independent Child Health BC report: Diabetes Care in the School Setting: Evidence-Informed Key Components, Care Elements and Competencies, September 2013 (PDF)

Download the Nursing Support Services Referral Form for Children with Diabetes (PDF) (Rev June 2024)

Create your own Bolus Calculator Sheet using the Bolus Calculators for school lunches (expand the "Basal-bolus insulin with MDI" tab to download)

Insulin Scale for School Lunches (expand the "Basal-bolus insulin with MDI" tab to download)

NSS Principles and Philosophy of Care for Type 1 Diabetes Delegated Care Plan in the School Setting (PDF)

Family Role in Transition Planning for Student on a NSS T1D Delegated Care Plan (PDF) (Aug 17, 2022)

FAQs for Consent: Establishing a Delegated Care Plan for Diabetes Care in the School Setting (PDF)

Evaluation of a Province-Wide Type 1 Diabetes Care Plan for Children in the School Setting (PDF)

Technology information

NSS Support of Health Canada Approved Technology within the School Setting in BC (PDF) (including technology supported under NSS Delegated Care Plan)(updated Nov 17 2023)

Continuous Glucose Monitoring (CGM) and Flash Glucose Monitoring (FGM) Principles of Care (PDF)

Continuous Glucose Monitoring (CGM) Q&A‎ (PDF)

Flash Glucose Monitoring (FGM) Q&A (PDF)

Statement on Do-It-Yourself ‘Looping’ for Type-1 Diabetes Care in Schools (Link to Ministry of Health Website) (PDF) (Aug 2023)

For further family resources produced by BC Children's Hospital go to:

http://www.bcchildrens.ca/health-info/coping-support/diabetes

In-home respite services information and resources

NSS Principles and Philosophy of Care for In-Home Respite Care Services (PDF)

Child Health BC - Youth Transitions to Adult Services

Questions and concerns

Providing services to meet the needs of children and their families is important for Nursing Support Services. To improve our services we would like your feedback to tell us how we are doing.

If you have questions or concerns about your child care or care plan the best place to start is with your Nursing Support Services (NSS) Coordinator and local NSS team. Issues are best resolved at the time they occur and with the health care team members who are involved.

NSS Coordinators work together with students and parents to develop individual care plans (ICPs). The ICPs are designed to be flexible to address the needs of each student within the Provincial Standards.

ICPs are reviewed at the start of each school year to ensure that they meet with each student’s current needs. ICPs are updated during the school year when ever there is a change in a student’s condition and treatment.

Delegation information (incl. tube meals and order forms)

FAQ document for Tube Feeding in the School Setting (September 2023) - PDF
Delegation Order Form (September 2023) - PDF
Delegation Care School Referral Form (September 2023) - PDF

Learn about seizure care in the school setting

Please see the following resources for your child's seizure care at school:

Forms and checklists for training

Seizure Action Plan (fillable PDF) (revised Jun 17, 2024)
Family Checklist - Optional Support Tool (PDF)
Request for Seizure Rescue Intervention Training (fillable PDF) (rev June 2024)

School checklist (fillable PDF) (June 2024)
Learning Hub Module - Seizure Rescue Intervention for Non-Medical School Staff (note that an account must be created in order to register for the module).

Learning Hub Sign Up Instructions (PDF) (rev Aug 28, 2024)
If you receive an error message stating "This course is not open to your account type" when you try to enrol for the Learning Hub course, follow the instructions here - Changing Account Type to Affiliate Instructions (PDF) (rev Sep 9, 2024)

Seizure rescue intervention instruction sheets

Lorazepam (Ativan) Instruction Sheet (PDF) (rev Aug 28, 2024)
Midazolam (Intranasal) Instruction Sheet (PDF) (rev Aug 28, 2024)
Midazolam (Buccal) Instruction Sheet (PDF) (rev Aug 28, 2024)
VNS Instruction Sheet (PDF) (rev Aug 28, 2024)

Infographics

Cleaning and Storing the Nasal Atomizer (PDF) (Oct 14, 2022)

BC Children's Hospital neurology resource

How to give Midazolam for Seizures Video

FAQs

What is Nursing Support Services?

Nursing Support Services assists parents and caregivers of children and youth with medical complexities to lead active, healthy lives in their communities through facilitating safe, consistent and appropriate health supports.

Nursing Support Services is available to eligible children in BC aged 0 to 19 years whose care requires the scope of practice of a registered nurse for some aspects of their care due to the child/youth's medically complex and fragile health needs. NSS is delivered by the regional health authorities across the province.

How does this service work?

Upon receipt of a child/youth's referral from their most responsible prescriber (MRP), the referral will be triaged for eligibility of a nursing assessment. Once determined, the referral is forwarded to the local NSS Coordinator who will contact the parents/guardians to book the nursing assessment. The information from the nursing assessment informs a child/youth’s eligibility for NSS. Once admitted, the NSS Coordinator will work with the parents/guardians, child and other care providers to develop a plan.

Where are these services provided?

NSS in-home respite services are provided in the family home setting. School based care is provided in the K-12 school setting.

Who pays for these services?

There is no cost to families for Nursing Support Services.

Who may be eligible for Nursing Support Services?

Child/youth who is a resident of BC as defined by the BC Medical Services Plan (MSP)
Child/youth who is enrolled with BC's MSP
Child/youth who is under the age of 19 (up to the day of their 19th birthday)
Child/youth who requires regional and/or provincial subspecialty health services
Child/youth who requires in home care within the scope of practice of a registered nurse due to their high complexity health needs (direct care)
Child/youth who cannot independently and safely perform tasks related to their diagnosis in the school setting (delegated care)
Child/youth/family who is not in receipt of a settlement or court award related to their disability (direct care nursing respite)

How are referrals made?

Referral from a physician licensed to practice in British Columbia or a nurse practitioner registered by the College of Registered Nurses of British Columbia and who confirms the following:

the child/youth can be safely discharged to and cared for in the specified community setting
the child/youth has a local physician to provide required medical care, consultation and written physician orders
the parent or guardian has overall responsibility of their child/youth's care and is fully competent and prepared to provide care in the absence of a nurse or school staff (delegated care)

Who do I contact for more information?

Please contact the NSS Provincial office at 236-427-9250 or nssgeneralinfo@cw.bc.ca for assistance.

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