Does your child's school have a school nurse? - Page 3

[eepster]

I voted other since DS is still in a private preschool. All the public schools in our town do have full time school nurses as far as I know.

I would not be comfortable with a nonmedical staff member administering insulin if my child had diabetes. My father's cat has diabetes, and DH is primarily responsible for his insulin and we are having a very hard time getting the cat's bloodsugar under control since the dosage has been off several times. The cat got so sick he had to spend 4 days at the vet with an IV.

[Kristine233]

Our public school has one that my kids just adore! I think my son makes up excuses to go visit with her. She's been awesome with him over the past couple years he's been there... everything from his "fake vomiting" to his "irratated eyes". I think he has a crush on her, lol.

I think having her there does help the teachers and other staff a lot. But I don't think a school is any less equiped without one. Heck, I'm a pre-k teacher at a local college and we don't have a nurse on site and manage to get by fine. We teachers give the medication, fix up scraped knees and do whatever else is needed to ensure the health of the kids.

[Kirsten]

Originally Posted by ecoteat

Last year we almost got a new student who was diabetic and needed shots and a nurse on duty every day. The family ended up moving to a different town, but our school panicked--no one had any idea how on earth we were going to afford a full-time nurse.

Originally Posted by eepster

I would not be comfortable with a nonmedical staff member administering insulin if my child had diabetes.

I am the nonmedical staff member who has administered insulin for the last three years to a little girl in our private elementary (first grade when she started with us; third grade now). I have clocked many hours learning about how to properly care for her while she is in our care. The parents of a newly diagnosed child with diabetes have no medical degrees in most cases. They are taught. I was taught.

Originally Posted by Kristine233

I think having her there does help the teachers and other staff a lot. But I don't think a school is any less equiped without one.

I agree. I think it is VERY nice to have a full time nurse on staff. It allows the teachers to teach and the admins to do the office work. But the amount of time in my day that I spend on nurse duties ranges from ten minutes to maybe 45 in an extreme case (which has only happened twice in three years). I can see where a tight school budget couldn't afford to pay a nurse a fair salary to be there all day when he/she is actually needed just a tiny portion of that time.

Having two of my three kids in public schools, I am much more concerned about losing art and music in the budget. I feel confident that the school staff can take care of minor injuries for my kids, and will call 911 for anything more serious.

[lightheart]

2 different elementary schools here where my children go to school one in 1st grade and the other in the special ed. preschool program, both schools have a nurse on staff.

We moved in Dec. from a school that had a school based health center adjacent to the school, separate building and funded through a University outreach program. They had a FNP (family nurse practitioner), RN, LPN, and others on staff and on site and was setting up computer stuff so that they could do imaging (pictures, not x-ray) and work with specialists like ENT's and other medical professionals to make a better diagnosis and plan of action. It is a really great thing for the community that is rural. Siblings of school aged children could also be seen even if they were not in school yet. The school health clinic was free although insurance would be billed but no co-pays were required, a grant paid for everything but basically no out of pocket for anyone to be seen there. Medical records were kept through them separate from school records, they had access to the school records, but the school did not have access to the medical unless permission was granted. You had to enroll your child in the health based program for them to be seen by the folks in the clinic so if you wanted to opt out of their services it was okay. There were others at the school, the secretary, teachers... who I saw handling Band-Aid type of scrapes and injuries.

The clinic provided vision screens (contract work through the school) and the speech teacher in the school was in charge of the hearing screens.

Lions Club came in yearly also and did vision screens that you could elect to participate in where they took pictures of the child's eyes and had a ??more qualified?? ??doctor?? look at them with a report that came home later that said "okay" or "follow-up"

There was a service/program also offered through the school that parents could give permission and a bus/van would take groups of children to be seen and treated by the dentist at the county Health dept. The dentist came into the school and did a screening of kids each year.

[lightheart]

To shed some light to the question what about the child with XYor Z condition that would need actual medical care on a day to day basis at school, there are 2 different laws to protect and help the child the IDEA, which is more an education law and 504 which is a civil rights law.

IDEA, Individuals with Disabilities Education Improvement Act, the US Federal Law (originally written in 1975, then known as P.L. 94-142) that is written to insure that all children with disabilities receive a free and appropriate education (FAPE) that emphasizes special education and related services designed to meet their unique needs and prepares then for further education, employment, and independent living......

section 300.34 Related Services
basically defines what related services are

"300.34(a) ....Related services also include school health services and school nurse services,...."

exceptions are in 300.34(b) and all it's subparts ... (I'm ad-libbing here, not quoting the law) Basically the school is not responsible for medical devices that are surgically implanted specifically saying the school is not responsible for mapping cochlear implants, maintaining or replacing any surgically implanted devices.

It does say that the public agency is responsible to appropriately monitor and maintain medical devices that are needed to maintain the health and safety of the child, including breathing, nutrition, or operation of other bodily functions, while the child is transported to and from school or is at school;

The last part of that section defines what school health and nurse services are...

"300.34(c)(13) School health services and school nurse services
means health services that are designed to enable a child with a disability to receive FAPE as described in he child’s IEP. School nurse services are services
provided by a qualified school nurse. School health services are services that may be provided by either a qualified school nurse or other qualified person.

(A parent, (term generically used to mean the person making the decisions and acting on behalf of the child) would have a bunch to say in who they felt was a "qualified person" while they were writing an IEP for their child.)

Section 504 of the Rehabilitation Act Rules Regulation who's purpose is to eliminate discrimination on the basis of handicap in any program or activity receiving Federal financial assistance

Under subpart E, Section 104.37 Nonacademic services

"(a) General.
(1) A recipient to which this subpart applies shall provide non-academic and extracurricular services and activities in such manner as is necessary to afford handicapped students an equal opportunity for participation in such services and activities.
(2) Nonacademic and extracurricular services and activities may include counseling services, physical recreational athletics, transportation, health services, recreational activities, special interest groups or clubs sponsored by the recipients, referrals to agencies which provide assistance to handicapped persons, and employment of students, including both employment by the recipient and assistance in making available outside employment."

http://www.tnstep.org/ near the bottom of the page is a link [Read our 2009 Parent Manual and the Implementing Regulations] you can find a copy of IDEA and 504 that you can download in a pdf format, note that there is a section in it that deals directly with the state of TN and their laws so if your searching around the manual be sure what section you are reading from if you aren't from TN because it wouldn't apply to you.

[4Blessings]

Originally Posted by Kirsten

Having two of my three kids in public schools, I am much more concerned about losing art and music in the budget. I feel confident that the school staff can take care of minor injuries for my kids, and will call 911 for anything more serious.

Having two children with life-threatening conditions, I am concerned about losing *my child* without a school nurse in the budget.

911 is great, if they get there in time.


This story about the death of a 5th grader, at school, is a good example of why I don't trust teachers, the janitor or the secretary to take care of my child's medical needs during the school day.

[SunshineJ]

My DS's school has a full time nurse. Honestly I wouldn't consider sending him to a school without one. Administrative staff is there to perform the multitude of administrative duties assigned to them, not to fill in as an on the spot nurse. Does that mean that they are incapable of doing so for most things? Of course not. However they really don't have the more advanced training of an actual RN or even LPN, and I'm not personally comfortable with that. Our state requires vision screenings, etc. and that's part of what the nurse handles. While I agree that most incidents are minor, that's not always the case and with over 500 students in the school it can get overwhelming. I can't imagine the regular staff getting anything done during flu season! We live in a very diverse community and the nurse is also a good point of contact for many of the lower income parents who simply don't have the resources or knowledge where to turn for different issues as well.

[CarrieMF]

Originally Posted by Proud2BeAnAmerican

Having two children with life-threatening conditions, I am concerned about losing *my child* without a school nurse in the budget.

911 is great, if they get there in time.


This story about the death of a 5th grader, at school, is a good example of why I don't trust teachers, the janitor or the secretary to take care of my child's medical needs during the school day.

The school followed the health plan they had for that child. Yes she had an epi pen prescribed but it was not to be used for an asthma attack. They called 911. They can speculate that if they used the epi pen she'd be alive, but there is no way to say that is what would have happened.

My dd has a life threatening condition too, that has progressed in the last week. We do not have nurses on staff.

If I did not feel I could trust the staff at the school, my kids would not be in that school.

[blizzard_babe]

Heck, our VILLAGE doesn't have a nurse, never mind our school.

[eepster]

Originally Posted by CarrieMF

The school followed the health plan they had for that child. Yes she had an epi pen prescribed but it was not to be used for an asthma attack. They called 911. They can speculate that if they used the epi pen she'd be alive, but there is no way to say that is what would have happened.

bold mine

That's the difference between a nurse and a layperson. A layperson can follow a well written plan, but a nurse can see when it's time to stop following the plan and do something else.

[weliveintheforest]

When I was growing up I went to a few different schools. The elementary school in the city had a nurse, at least part time. My high school in a small town did not have a nurse. If someone was injured a teacher or TA would help them, or they just went to the doctor's.

[NikonMama]

Our son's school gets a visit from a Visiting Nurse for things like vision and hearing screenings, but otherwise the secretary or the "health specialist" (no clue if she is an RN or anything) do everything.

If it goes to prove anything that the schools need a nurse on hand, last Thursday I picked my son up from school and he seemed upset. I asked what was wrong and he said he was hit in the head with a ping pong paddle during PE at 2:45 (it was about 3:40 when he got into the car) and he had a cut next to his eye. It had a bandaid on it so I asked him to take it off so I could look at it. It actually wasn't a cut, it was split open, really deep, and about 1/4" long. I immediately drove to the doctor's office and just walked in. By the time we got there, were called into a room, and the doctor got in to see us after all the other patients (the ER would not have been any faster) it was 5:00 and he said that he probably would have needed stitches if he had seen him right after it happened, I'm talking at 3:30ish) he would have gotten stitches, but by that point it had closed up and was beyond repair. He said that most likely it was split all the way to the bone. DS got quite the black eye from that. Boy was I mad at the school for not calling me about it. I had to find out about it from my son after school. All the secretary did was slap a bandaid on it and send him back to class. He said she didn't even really look at it.

[CarrieMF]

Originally Posted by eepster

bold mine

That's the difference between a nurse and a layperson. A layperson can follow a well written plan, but a nurse can see when it's time to stop following the plan and do something else.

and if the nurse had given the epipen & the child still died the parents would most likely still be suing. you can almost guarantee that if the layperson had given the epipen the parents would be suing that person too, not just the school.

Bad things like that happen, on rare occassions. I wouldn't base my decision on whether a school was good/bad on something that is unlikely to happen to my own child.

If it goes to prove anything that the schools need a nurse on hand, last Thursday I picked my son up from school and he seemed upset. I asked what was wrong and he said he was hit in the head with a ping pong paddle during PE at 2:45 (it was about 3:40 when he got into the car) and he had a cut next to his eye. It had a bandaid on it so I asked him to take it off so I could look at it. It actually wasn't a cut, it was split open, really deep, and about 1/4" long. I immediately drove to the doctor's office and just walked in. By the time we got there, were called into a room, and the doctor got in to see us after all the other patients (the ER would not have been any faster) it was 5:00 and he said that he probably would have needed stitches if he had seen him right after it happened, I'm talking at 3:30ish) he would have gotten stitches, but by that point it had closed up and was beyond repair. He said that most likely it was split all the way to the bone. DS got quite the black eye from that. Boy was I mad at the school for not calling me about it. I had to find out about it from my son after school. All the secretary did was slap a bandaid on it and send him back to class. He said she didn't even really look at it.

This has nothing to do with a nurse being at the school though, it has to do with school policies. at our school if a cut was that bad I would have called your child's teacher to the office & she would have called you in. If the teacher was gone for lunch then the principal/vp would have been called to the office. I do not have the authority to call myself, but you would have been called within 10-15 minutes. A nurse wouldn't have done anything differently.

[NikonMama]

Originally Posted by CarrieMF

This has nothing to do with a nurse being at the school though, it has to do with school policies. at our school if a cut was that bad I would have called your child's teacher to the office & she would have called you in. If the teacher was gone for lunch then the principal/vp would have been called to the office. I do not have the authority to call myself, but you would have been called within 10-15 minutes. A nurse wouldn't have done anything differently.

I think a nurse would have been able to recognize that it needed more than a bandaid and would have done something about it. That was my point. Personally I think a nurse would definitely had done it differently. At our school the secretary is the one that calls home for things like this.

[eepster]

Originally Posted by CarrieMF

and if the nurse had given the epipen & the child still died the parents would most likely still be suing. you can almost guarantee that if the layperson had given the epipen the parents would be suing that person too, not just the school.

While it is still possible that the girl would have died even with an RN treating her, I think it is a lot less likely. Not only would the nurse have administered the epi-pen when she saw that the abuterol inhaler wasn't working, but she also wouldn't have waited till the ambulance showed up to start CPR. She also might have been able to do other things that niether of us would think of, b/c we aren't nurses and weren't there.

If the nurse gave the epipen, administered CPR, etc, etc, and the child still died, then at least her mom would know that someone did everything possible.

[CarrieMF]

Originally Posted by NikonMama

I think a nurse would have been able to recognize that it needed more than a bandaid and would have done something about it. That was my point. Personally I think a nurse would definitely had done it differently. At our school the secretary is the one that calls home for things like this.

I understand that, but my point is that a different layperson most likely would have recognized that too. Not being a nurse does not mean a person is incompetent in dealing with emergent & non-emergent situations.

We had an incident at the school today where we needed to call 911. I was the first adult to arrive. I am not a nurse, nor do I even have a first aid certificate/cpr(have an appt to take them now). As soon as I saw the situation I sent a runner into the school, I would have called 911 myself but I didn't have my cel on me. The principal came out we sent another runner to get the phone to call 911. The ambulance was there within 10 minutes of me arriving at the scene & they even had to wait for a train.

[eepster]

Originally Posted by CarrieMF

I understand that, but my point is that a different layperson most likely would have recognized that too. Not being a nurse does not mean a person is incompetent in dealing with emergent & non-emergent situations.

This is true, some laypeople will be more competent than other laypeople. I'm more compotent at giving the cat his insulin than my DH is.

However, a nurse had the pass nursing school, where s/he study anatomy, physiology, chemistry, psychology, etc. S/he has had hands on training in a clinical setting. Finally s/he is licensed and certified, and required to do various things to stay up todate to stay licensed.

With a layperson there is a chance that they might just happen to be competent to handle whatever situation comes up, and things might go well. With a nurse, while nothing is 100% in life, you can almost gaurantee that the nurse will be competant.

[texmati]

I went to an extreamly large public highschool, 3000+ kids, and we had a nurse. I don't think that she was ever idle.

[lightheart]

I just thought of this... our son's school (as well as the last one) has a police office on duty at school, I would think he has some sort of emergency medical training.

(don't equate have an officer on duty at school being a bad school, it's actually a good school and having the officer there will hopefully help keep it that way)