Teachers found themselves having to juggle many aspects of their children’s lives including their educational, social, medical and welfare needs. For many teachers this proved a significant challenge and one that arose frequently within the
interview transcripts.
Sometimes it’s just difficult to fit everything in (P1).
When faced with a class of children with life-limiting conditions many teachers began with collating a timetable of all of the different daily care routines needed. These involved positioning, personal care, physiotherapy, tube feeding, medication, amongst others. Many teachers found that once these needs had been timetabled, the time left for educational input was minimal:
When I’ve got the students I kind of looked at what I needed to fit in in terms of meds, medical stuff and with physio and all of that as well I kind of started with there’s my timetable what do I need to fit in kind of when I need to do the meds and enteral feeding and things erm in terms of the routine stuff and then added in the physio and then added in the whatever and kind of looked at what time I had left for teaching [laughs] (P12).
For some teachers, especially if they began teaching this group of learners as NQTs, the amount of medical, physical and educational needs these children had was overwhelming, suggesting that teachers new to the role require some support in terms of managing their time effectively.
When I first started teaching...I was how are we meant to do anything with all this medical stuff going on all we’ll ever do is feed them [laughs] (P2).
This was also found to be the case of experienced teachers new to special schools who, in contrast to mainstream, struggled with the fact that they could not spend the whole day teaching because of the demands that medical and positioning needs had on their time. At first, for one teacher new to special education, this was a shock and something they took time to get used to:
I felt a real pull when I first started between the care needs and the teaching [...] at the end of my first day I remember like meeting up with people and they said oh how did your first day go and I said oh god I only taught about an hour and a half for the whole day and they said well-done that’s amazing! [laughs] and I was like woah this is a slightly different world (P8).
This difficulty in managing time and fitting in all of the daily needs of students was not something found to be an issue just for NQTs or those new to special education however. Many established teachers found managing time difficult and often described this as a ‘juggling act’ or something that needed to be balanced throughout the day.
I suppose as a teacher it’s difficult to get the balance of...medical needs erm education, physio and all of that sort of thing that I really, I find has an effect on your classroom practice, how you organise and structure your day (P11).
One teacher described the impact of the National Curriculum as contributing to time pressures experienced. As previously discussed (see section 5.4.1), many teachers felt the National Curriculum was inappropriate for their students, due in part to abstract subject content. The teacher quoted here found that having to teach French every week exacerbated the time pressures experienced within their weekly timetable. It is clear that this teacher felt that that time could be used more
effectively by meeting other perhaps more therapeutic needs whilst still meeting the demands of the National Curriculum more flexibly.
The time pressures can be built in around the curriculum model [...] I think we try and fit a lot of work in er to meet the needs of the National Curriculum [...] in reality...you don’t have there aren’t enough hours in the day to meet all of those
needs...and for example yep it’s important that the children are exposed to different cultures like we do French er but to me it’s not important that they do it every week (P1).
A further compounding factor in juggling daily needs was the access to facilities and staffing levels. Teachers found that children could not all go to the bathroom at convenient or appropriate times such as lunch time due to staffing levels and space. This is particularly pertinent given that the majority of children with life-limiting conditions discussed in this study are wheelchair bound and doubly incontinent, therefore requiring at least two members of staff to hoist and change them. In
addition, gastrostomy feeds can be notoriously slow and where pumps are not used, a simple feed can take a member of staff in excess of forty minutes. Often, these feeds are required at specific times throughout the day and not necessarily at lunch time. All of these issues mean that fitting in the daily needs of multiple children within one classroom can be a significant challenge.
I suppose you have to work the students’ day around so many needs that’s the difficulty is balancing what facilities you’ve got so they can’t all just go to the bathroom at the best time (P1).
Personal care especially for the older children erm some of the children that I’ve worked with have brittle bones or erm have to be really careful when you’re handling them so then that can take two of your teaching assistants out for twenty minutes to half an hour [...] then you have to think about ok well what I am going to do with my eight other children who all need support as well (P11).
It is clear that the sheer quantity of daily needs children with life-limiting conditions have, poses a significant challenge for teachers. The impact of such needs on
teaching time within the classroom is also problematic as identified by teachers in this study.