In every school district in the US, just like in any other part of the world, there are students who are unable to go to school for short or long spells because of physical or emotional illness, yet their education must go on. What’s it like to be a teacher for such kids, what are the skills it takes? Jamie Murphy lays out the task and its many rewards.
I live and work in an affluent county on the East Coast of the United States, not far from the country’s capital. Based on multiple surveys over the years, our school district, which serves approximately ~ 60,000 children, is considered one of the finest, and people flock to this area to provide their children a top notch education. Although this microcosm I write about is one of the wealthiest counties in our state, we too have many vulnerable children in our school system. Like in any other part of the world, physical and emotional illness do not discriminate based on socioeconomic status, race, gender or age; terrible things happen suddenly and lives are turned upside down overnight. Yet, families must pick up the debris and inch forward, with the resources at their command and this is where the ecosystem kicks in. We routinely serve families who have never heard of our services before extreme illness or tragedy struck. And, after they come into the fold, the word of mouth advocacy for our system is phenomenal. This is not about our county alone, it is the nature of the rewards for serving the most vulnerable population which has almost no other viable option left.
Although our caseload of students is ever changing, we service approximately 300 children a year. The program is intended to provide short-term service to students in an effort to help them remain current with their peers while they are absent from school. The goal is to transition them back to school as seamlessly as possible. The best case scenario is when the homebound child is able to show up at school, take a test or complete classwork and feel that the subject matter is familiar and the difficulty level similar to what he/ she covered at home. This isn’t easy but it is within reach as long as all stakeholders have a steady stream of ongoing communications. It’s never perfect, and the process is not always a triumph but the journey itself and the trust it instills among families can be incredibly rewarding.
The school year usually begins with just a handful of children, but by mid year, we have a much larger caseload. This pattern holds true for several reasons. It takes some time to navigate the application process; both parents and doctors must complete detailed paperwork before students are accepted into our program and then matched with the right resources among the teaching staff. In addition, when possible, parents will often schedule surgeries later in the school year to give children an opportunity to get a feel of the syllabus and course work prior to their impending absence. Quite often, children who are experiencing emotional challenges begin to struggle as the school year progresses. If these children are not able to function in school, they will often apply to our program until they are stable enough to return to school. Many of our homebound students also divide time between home study and school if their health permits. Parents, naturally, are keen for some semblance of social interaction in typical settings and opt for this variant if their child’s health permits. Doctors too need some time to consider multiple aspects - including toxicity tolerance - before they recommend full time homebound study, and this should be a last resort and chosen when there are no other viable options.
As for the teaching staff, there is no “typical” Home and Hospital teacher. Just as the group of students we serve is so diverse, so is the population of educators. In our county, over 100 teachers work with the homebound population. Some of my colleagues are retired teachers, while others have left the classroom and chosen this path instead. There are those who are raising their children and want to stay involved in education and some that have just graduated from college. In addition, there are current classroom teachers who work with homebound students outside of the school day. Each teacher’s caseload is unique. Some choose to work only a few hours a week, while others work with several students every day. Many teach different age groups and a variety of curriculum, while others take a more specialized approach; they may only teach a foreign language or advanced levels in specific subjects. As a job, it gives us immense flex; as a career option for those who may be exploring this area, it insulates many of us from the inevitable automation that is taking over so many traditional career paths.
While every Home and Hospital teacher is so diverse in their background and caseload, there are certain qualities that are necessary for all. This position requires generous doses of flexibility and creativity as every day and every student is so different. Classes may get cancelled at last minute because the child is suddenly unwell or has to be rushed to hospital, there are days when you are teaching and the child is simply unable to absorb much because of physical discomfort or a fever that is spiking. Since many of our students are experiencing emotional or physical challenges, learning is not always their first priority.
While the primary caregivers deal with the child, it’s also for us to stay cool and re-organize our teaching goals. For children in elementary school, the catch-up is fairly easy; but this is not always the case. For example, math skills build upon one another, so if a child has been absent for an extended period, it is often a challenge to keep them current with their peers. the challenges for the middle and high school child are immense. In addition to staying abreast with the academics, there are definite social implications. For homebound students, it is a challenge to maintain that connection to peers and the school community. Our organizational skills are paramount as we travel from student to student and bring the classroom with us. There are many individuals vested in our students’ lives such as counselors, nurses, teachers and parents. We are often the connection between our students and all others, so having excellent communication skills is critical. While it is sometimes easy to slip into a position of sympathy with our students, that does not serve them well. It’s often a balancing act to express empathy while maintaining high expectations. We don’t do our students any favors by lowering our expectations because they are ill. We need to understand that they have challenges that might require modifications in their instruction and their performance, but they can still learn and express their understanding and knowledge.
I spend my days with young children who are faced with medical and emotional challenges that no child should have to imagine. I became a Home and Hospital teacher almost by accident. I studied healthcare administration as an undergraduate student and began working in the field right out of college. I quickly realized that I wanted something different in my life. I returned to school for a master's degree in elementary education and taught in an urban elementary school. I taught in a primary classroom for several years until my first child was born. I took leave to raise her, and began working a few hours a week with homebound students so that I could remain involved in education. I planned to return to the classroom when the time was right, but felt this would be an excellent short term position. Twenty three years later I am still working with homebound students and I look forward to work every single day.
In the few hours I share with my students each week, I witness such a mosaic of human will, perseverance, strength, positive attitude, humility, appreciation and living in the moment because that is the only option in most cases. So many of these children deal with issues that most adults would struggle with, yet they crave normalcy. As homebound students, they can focus on something other than their illness for two hours a day. They learn to read, write, communicate and do math. They conduct science experiments and learn about social issues in our world. For a short part of the day, they can feel just like any other kid. They look forward to my arrival and often don't want the time to end. There are days when getting out of bed is a challenge and nausea and exhaustion are overwhelming, there are days of a waning appetite, hair loss, anger, sadness and incredible mood swings because of medication. But in between, the doorbell rings and there is a teacher standing at the door with a giant tote stuffed with school supplies, a powerful visual symbol for every student and family that a bridge exists between the difficult place they are in today and a healthier future. We always reinforce the sense of our work being a placeholder until the time our students feel well enough to go back to school. Although I am not a special educator, I am an educator of special students and I have found a place in their world for more than two decades now. Many of my students hail from places that I have never travelled to and I have learnt from anecdotal inputs that homebound instruction doesn’t exist in many of these countries as a formal academic intervention. Governments and policy makers in education must make this a priority; its benefits to society are immense; the blessings for all of us involved are countless.
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