medical services in the school - Page 2

[columbusmomma]

I am a school nurse in a public school system. We have over 100 schools in our district and over 100 school nurses. Cases like these are why we as school nurses here,are advocating for more hiring of nurses so that schools can be staffed with RN's at all times. It is a shame that due to finances we are spread so thin! Most schools do not have fulltime nurses. With job cuts(we are basically "teachers" per se, when it comes to pay, contracts,layoffs,etc.)we are always trying to advocate our importance.We have to delegate our nursing responsibilities to other staff and train them. This is a shame. There have been so many times that a school nurse has saved a life. We need more of us!!! Ok, a little off topic but just wanted to throw my 2 cents in! Oh, our district employes only RN's with BSN's. We also have our school nurse licensures. Each district is different though.

[ecoteat]

Originally Posted by LiamnEmma

Boy, I hope they're suing the last school since a school is legally required to provide accommodations under Section 504.

Obviously you are not familiar with small communities and rural schools. We just don't handle things like that here.

Originally Posted by annethcz

This is one of those subjects on which I have mixed feelings. I do believe that every child should have an appropriate education. But at times I do struggle with the amount of resources that are made available to children with special needs. It's not that I think kids with special needs shouldn't have those needs met, but when such a large percentage of resources is spent on such a small percentage of the population, it seems unfair. Especially in the case of a small school, where the addition of one extra staff person who is hired to care for only one child takes away from the resources available for the other 65 children who may not benefit from that extra staff person. In a small school, hiring a nurse or an extra paraprofessional may mean that there isn't money for an art class or for field trips.

I don't think this really has anything to do with whether or not there is adequate funding for schools, but rather how we as a society have chosen to prioritize school spending. As a society, we have decided that all kids should have their special needs accomidated, even if it means that the majority of students lose resources because of this. Again, I'm not against special education or against making accomidations for kids with special needs. But the reality is that special services do take funding away from mainstream funding, and this is especially true in small schools.

I feel the same way, which is I guess why I started this thread. I just don't know how to respond. I can't imagine how hiring another 80% of a staff member is even feasible with such a tight, small budget. I also know the town will have a VERY hard time approving a change to the budget, which they try to streamline too much already, after next year's budget has been approved. It's not that I don't think there should be a full time nurse, I just know the politics of this little town.

This is an interesting discussion. I'm so glad to hear from a school nurse and someone else from a tiny rural school!

[alegna]

Originally Posted by annethcz

I'm not suggesting anything else. I am saying that because we expect our schools to meet the special needs of students during school hours, it does take money and resources away from the kids who don't need special services.

I can see both sides of the argument.

ETA: Because of hearing about my mom's experiences as a special education teacher, I do have some ideas about reducing special education costs. But my thoughts probably wouldn't be well received, so I won't post them here

eh, that's life. And sick people and old people use more health-care resources. Part of being part of a community.

some kids are more expensive to educate. No way around it. As long as we have a system of FREE and appropriate education for all, that's just the way the cookie crumbles.

It's expensive to build wheelchair ramps too...

-Angela

[alegna]

Originally Posted by ecoteat

Obviously you are not familiar with small communities and rural schools. We just don't handle things like that here.

It may not be how things have been handled, but legally it's how things MUST be handled.

There are a few other options that rural and small school districts have tried- things like paying for the child to go to another school district or private school, but they must provide transportation and such. But LEGALLY the child has a protected right to a free and appropriate public education. That includes medications (or modifications or technology) needed to function.

-Angela

[mommy68]

I thought in cases such as this a parent is responsible for going by the school to help the child out during the day if needed. I couldn't imagine them putting a nurse on staff just for one child but if they *are* doing it then good for them! That's wonderful.

Diabetics are not the only children who may need medical care during a 6+ hour school day. I am surprised to hear of a school of that size that does not have a medical professional on hand to deliver medication.

this makes sense. Even if a nurse isn't needed each and every day, it should be law to have one there on site every single day for at least a few hours. If children get hurt who helps them? They could hire a nurse that could do office work as well or something so they aren't just sitting around doing nothing all day.

[CarrieMF]

Originally Posted by alegna

If she's not on insulin, then she's type 2, not type 1- a whole different ball game.

-Angela

Yes I am aware of that.

I wonder if there is a parent who currently stays at home but is a RN or similar profession would who have the capability of doing the job but not necessarily be a full time nurse at the school.

If children get hurt who helps them?

Teachers, TA's, Librarian, Janitor.

Today at noon I had 4 hurt kids. There are 250ish kids at the school. normally there are no hurt kids.

1(grade 4) was playing soccer & she tripped, when she landed another kid landed on her head. I had her lay down in the infirmiry(which is basically a closet). When the bell rang she did get up & go to class, though I told her teachers what had happened & they were going to let her lay down again or lay her head on her desk if she didn't want to lay down.

I had another one(grade 6) come in becuase she somehow landed with her face on the sand. I have no clue what she did. I got an ice pack for her & she sat in the office.

Then when the bell rang 2 more came in. 1(grade 3) was limping & she had hurt her ankle a bit, got her an ice pack. The other one(grade 1) got hit in the mouth/throat with a soccer ball. I didn't have any more icepacks becuase they seem to grow legs. She didn't look real hurt as if she needed an ice pack so I just sent her off to her class & told her to let her teacher know.

Most of the time if there is an injury all that is required is a bandaid. Before I started supervision, I heard through the grapevine that there were 2 instances where they had to call the ambulance in. However my kids don't know anything about these so either it is true & they were put into lockdown or it wasn't true.

The last school may have had a nurse on staff but wasn't full time, it doesn't mean the school wasn't meeting the accomodations but perhaps the parents wanted one there for the full day.

[The Harpy]

Speaking as someone who has a diabetic in the family, it isn't something to take lightly so I am glad to see they have someone who is fully trained there w/ the child.

Public school is a right, not a priviledge.

[Belleweather]

My children, so far, don't have any ongoing medical issues that would require a school nurse to be present. But honestly, I'd have some deep misgivings about sending them to a school where there wasn't ANYONE who was a trained medical staff person available during the school day. Yeah, I know that teachers and aides and janitors can clean wounds and put on band-aids, but what if something more serious happened? What if a judgement call needed to be made?

Plus, what if one of the kids gets sick and someone needs to be with them away from the class until a parent can be found? Who handles that -- a teacher? an administrator?

At the moment, I work for a company with ~300 onsite employees. We're all adults, but we're required to have one trained EMT in the building and two people trained as first responders. I can't imagine that my kid's school would have lesser requirements than my workplace.

[vtgirl]

my dd in first grade was dx'd with type 1 diabetes in march of this year. we have a *very* small school (37kids k-6) in a rural community. our school shares a nurse with 3 other schools in our district and she is only in our school one day a week.

when dd first went back to school after the diagnosis we had a meeting with all the school people who would interact with her in her day. this included her teacher, the lead teacher (principal so to speak), the cook and the school nurse.

everyone was taught (by me!) exactly how to care for her. this included the nurse who had never had a diabetic child in all her years of school nursing. she offered to come every day at luchtime and give dd her shot but tracey, the COOK stepped up and said that since she is aware of what every single kid eats on a daily basis, she would be willing to give the shot at lunch.

she has risen to the occasion and i feel very confident when i drive away from that school every day because i know she understands exactly what dd needs. we have had a couple "incidents" but nothing that has made me question tracey (things that happened when tracey was not in charge ie: after school). we feel very lucky that she is the one in charge of dd. in fact when the kids had a field trip today, she came to me in the morning and filled me in on exactly how the day would go and the school nurse gave her a shot for the very first time today since she was on the field trip and tracey wasn't.

our school is a bit smaller than yours (not by much, tho!) and we are pretty laid back people. also my dh is T1 as well so we are well aware that you can live a "normal" life with this disease. you just have to be surrounded by people who understand diabetes and are capable of helping you when you need help. IMO THAT is the schools responsibilty, not neccesarily providing an RN at all times. a diabetic child does not need an RN, they need an adult with a good grasp on the disease who can see if they are in distress and also help with keeping up with testing and giving the accurate amount of insulin.

but thats just my opinion and my kid has only had this since march..............so............take what you will!!
i hope it works out for your school, i know how it is with small schools........sometimes it seems like you're just one more budget expense away from being shut down.
trina

[CarrieMF]

Yeah, I know that teachers and aides and janitors can clean wounds and put on band-aids, but what if something more serious happened? What if a judgement call needed to be made?

Something more serious like what? a broken bone? we call 911 or a staff member would drive them to the hospital. Everything in this city is 10 minutes away. It would take just as long(or longer) for an ambulance to drive here than for us to drive a child to the ER. If it is something that 911 needed to be called on most people would have the capability to make that judgement call without having medical training.

Plus, what if one of the kids gets sick and someone needs to be with them away from the class until a parent can be found? Who handles that -- a teacher? an administrator?

Most likely the receptionist, she's the one who truely runs the school. she is right across from the infirmiry closet. If she couldn't there are a number of TA's or staff who are doing prep work at any time of the day who would be able to leave what they are doing in order to take care of the child. There are roughly 27 staff members in the building at most times, only 10 classrooms which would leave 17 people not teaching at any time. There'd be even more people if there were parent volunteers in the school(and there often are)

obviously it hasn't been an issue if none of the schools in this district have nurses on staff.

[annethcz]

vtgirl, thank you for sharing your story!

The thing I've discovered since moving to a rural area and enrolling my kids in a small school is that things are so much more informal. So many people are willing to step up and help in an informal capacity. While there may not be a formal protocol for everything, things get done nonetheless. I do understand why formal processes can be important, especially in bigger schools. But in tiny schools where everyone knows everyone else, sometimes it's just not necessary.

My kids' school doesn't have any school nurse, and it doesn't bother me a bit. I can't think of a 'serious' situation that would be handled differently by a nurse than by a teacher/administrator/aide/etc. If any sort of judgement call needs to be made, an ambulance can be called. We don't have a nurse at home or at dance class or at sports practice, and that doesn't worry me either.

[meowee]

Originally Posted by Flor

I guess the alternative is to have kids with special needs all together at a special school and I hear that is done in other countries, but I hope we are past that here.

And what would be so horrible about that? I would much rather my special needs child be in a facility designed for such children with expert staff than expected to function in the mainstream, particularly at a young age. There could still be a lot of opportunity for integration with the mainstream while still maintaining a specialized facility for medically frail and otherwise special needs children. No one's talking about locking them up and throwing away the key...

[alegna]

Originally Posted by meowee

And what would be so horrible about that? I would much rather my special needs child be in a facility designed for such children with expert staff than expected to function in the mainstream, particularly at a young age. There could still be a lot of opportunity for integration with the mainstream while still maintaining a specialized facility for medically frail and otherwise special needs children. No one's talking about locking them up and throwing away the key...

If that would be a good match for *your* child then it should absolutely be an option. HOWEVER, it should not be the ONLY option. Legally schools are required to offer the least resrictive environment. And for a "normal" "average" child who just has diabetes or needs a wheelchair or fill in the blank, it is not right to insist that the ONLY way they can attend school is in a special needs school or facility.

-Angela

[J-Max]

Originally Posted by Belleweather

My children, so far, don't have any ongoing medical issues that would require a school nurse to be present. But honestly, I'd have some deep misgivings about sending them to a school where there wasn't ANYONE who was a trained medical staff person available during the school day. Yeah, I know that teachers and aides and janitors can clean wounds and put on band-aids, but what if something more serious happened? What if a judgement call needed to be made?

Plus, what if one of the kids gets sick and someone needs to be with them away from the class until a parent can be found? Who handles that -- a teacher? an administrator?

Originally Posted by annethcz

The thing I've discovered since moving to a rural area and enrolling my kids in a small school is that things are so much more informal. So many people are willing to step up and help in an informal capacity. While there may not be a formal protocol for everything, things get done nonetheless. I do understand why formal processes can be important, especially in bigger schools. But in tiny schools where everyone knows everyone else, sometimes it's just not necessary.

My kids' school doesn't have any school nurse, and it doesn't bother me a bit. I can't think of a 'serious' situation that would be handled differently by a nurse than by a teacher/administrator/aide/etc. If any sort of judgement call needs to be made, an ambulance can be called. We don't have a nurse at home or at dance class or at sports practice, and that doesn't worry me either.

annethcz makes a good point. Living in a rural area has different expectations. We are 1 hour from a hospital (on good roads in good driving conditions). Our fire and medic crew are all volunteer and depending on time of year and day (winter evenings, they tend to be home) response time can be any where from 5-15 min before someone can respond and get to the trucks and then driving to where the problem is (we are over 20 min from the station), that is just a part of living where we do - most of us have some sort of basic first aid training, just as a necessity of living here.

I have no problem with my kids being at a school with no permanent on staff nurse. And yes, injuries do happen, one of the elementary students broke her leg on the playground early this year, and kids get sick, and the staff handles it very well.

What if a judgement call needed to be made?
Then it is made, but the teacher, staff, administrators, or parents (there are always some at the school and we all know and deal with each other on a daily basis)

Plus, what if one of the kids gets sick and someone needs to be with them away from the class until a parent can be found? Who handles that -- a teacher? an administrator?

They can sit in the office and someone will sit with them, or they will lay in the teachers lounge until a parent or someone can get them.

[LiamnEmma]

But at times I do struggle with the amount of resources that are made available to children with special needs. It's not that I think kids with special needs shouldn't have those needs met, but when such a large percentage of resources is spent on such a small percentage of the population, it seems unfair.

Can you give something more concrete than this? It's not so much that I disagree, it's that I find people often have an idea about special education or 504 that is not based in reality in terms of funding, etc. To me, fair is getting what you need, not the same as everyone else. I don't have a problem with some additional funds going to a child with impairments. There but for the grace....go I.

Obviously you are not familiar with small communities and rural schools. We just don't handle things like that here.

Yes, actually, I am. I completed my entire graduate work in school psychology on reservations in very rural areas. For example, it took us two hours to get to a school that we were only able to get to once a month, we did our thing, and then made the two hour drive home in the one-room school house K-12. I was one of the very first people to submit a Healthy Start grant while I was a graduate student, co-written, co-researched and co-presented with my site supervisor and my thesis chair. I'm familiar. I currently work in a district that is 100% free and reduced lunch and approx. 80% English Language Learners.

That child has the right to be educated in a public school with his or her peers. Regardless of where that child lives.

I reiterate. I hope the parents are suing that school so that the school learns. It would have cost them less to do what they were supposed to do for the child in the first place.

Do I disagree with the lack of funding by the federal government and think they are awful for placing people in the position of preferring not to do what's right for a person? Absolutely.

But a child with a medical or cognitive condition has as much right as a child of color, a child of a different sexual orientation, or a less than popular religious belief, to be educated freely. That is one of the principles of the country I live in and I hold fast to that.

[annethcz]

Originally Posted by LiamnEmma

Can you give something more concrete than this? It's not so much that I disagree, it's that I find people often have an idea about special education or 504 that is not based in reality in terms of funding, etc. To me, fair is getting what you need, not the same as everyone else. I don't have a problem with some additional funds going to a child with impairments. There but for the grace....go I.

What comes to mind more than anything is my mom's experiences in special education classes. My mother was responsible for students who were severely physically and cognitively handicapped. My mom started working in the schools because she wanted to make a difference in kids' lives. But she became disillusioned and eventually quit. My mom came to realize that despite the massive amounts of time and resources and money that was devoted to these students, there would be no long term impact on the children. These were children who were in wheelchairs, unable to communicate, unable to feed or toilet themselves. And yet the children were being provided with an incredibly resource-heavy and expensive "education" despite the fact they would never become functioning members of society. It didn't matter how many years my mom worked with the kids, or how many aides or therapists were provided for these kids, the fact is they would never truly learn anything or be able to do anything on their own. And at the same time special education enrollment was increasing and more special services (therapists, etc.) were becoming common, class sizes for mainstream classes were going through the roof and other cuts were being made.

I will admit that my view of special education may be outdated, since my mom quit working in the schools about 15 years ago. I don't hear stories about what's happening day-to-day anymore. But I do tend to follow general trends, out of my own interest. If anything, it seems like there are even more accomodations made for children now than 15 years ago.

Again, I'm NOT anti-special education. But it does seem that the scope of schools has changed, and I wonder if that's for the better. Schools are no longer responsible for teaching students the 3Rs, but also for keeping kids healthy, providing therapies, and so on. We as a society are asking our school system to provide more than just an education. In some ways, I think this is a good thing. In other ways, not so much.

[alegna]

Originally Posted by annethcz

What comes to mind more than anything is my mom's experiences in special education classes. My mother was responsible for students who were severely physically and cognitively handicapped. My mom started working in the schools because she wanted to make a difference in kids' lives. But she became disillusioned and eventually quit. My mom came to realize that despite the massive amounts of time and resources and money that was devoted to these students, there would be no long term impact on the children. These were children who were in wheelchairs, unable to communicate, unable to feed or toilet themselves. And yet the children were being provided with an incredibly resource-heavy and expensive "education" despite the fact they would never become functioning members of society. It didn't matter how many years my mom worked with the kids, or how many aides or therapists were provided for these kids, the fact is they would never truly learn anything or be able to do anything on their own. And at the same time special education enrollment was increasing and more special services (therapists, etc.) were becoming common, class sizes for mainstream classes were going through the roof and other cuts were being made.

What would you suggest be done with those students instead?

Because classrooms for students of that level that I have observed focus on life skills. Giving the children some level of independence. Pottying. Transitioning in and out of wheelchairs if possible/appropriate. Feeding themselves. Washing themselves. For slightly higher functioning kids it may include simple job training, etc.

-Angela

[CarrieMF]

But a child with a medical or cognitive condition has as much right as a child of color, a child of a different sexual orientation, or a less than popular religious belief, to be educated freely.

Free education isn't the issue in the OP's post, it is the insulin injections.

I hope the parents are suing that school so that the school learns. It would have cost them less to do what they were supposed to do for the child in the first place.

You have to keep in mind that the OP said it was a RUMOR that they left because there was no school nurse on duty full time. The rumor may not be true, the child may not need a nurse on full time, the parents may have been fussy about what they wanted and demanded things that were way beyond what the child needed, maybe there is a full time nurse & the parents didn't like that one & wanted a new/2nd nurse, the school may not have the funding to provide that service for that school year or maybe they lost funding for the school year coming up.

Suing the school it going to hurt every child that goes to that school.

[alegna]

Originally Posted by CarrieMF

Free education isn't the issue in the OP's post, it is the insulin injections.

For the child in question, insulin injections are mandatory every day for her to have a free education. So of course it's the issue.

-Angela

[LiamnEmma]

Free education isn't the issue in the OP's post, it is the insulin injections.

Diabetes is a medical condition that impacts a major life activity, in this case, education. It's an issue under Section 504, the Americans with Disabilities act.

You have to keep in mind that the OP said it was a RUMOR that they left because there was no school nurse on duty full time. The rumor may not be true, the child may not need a nurse on full time, the parents may have been fussy about what they wanted and demanded things that were way beyond what the child needed, maybe there is a full time nurse & the parents didn't like that one & wanted a new/2nd nurse, the school may not have the funding to provide that service for that school year or maybe they lost funding for the school year coming up.

Yes, I do keep that in mind. Which is bothering me immensely, because to me, this becomes something of darwinianism at its worst. "We don't do that here" is not acceptable to me. Not when you're gay. Not when you have color to your skin. Not when you have an accent. Not when you're blind, or deaf, or can't walk. Not when you're sick. To me, it's all the same. Discrimination is discrimination, and rampant rumors are ugly and often wrong. How sad for this family, moving to a new home, a new school, arriving to the looks, whispers and wonderings, maybe feeling intimidated, almost certainly not feeling welcomed. Too bad, "we don't do that here."

Suing the school it going to hurt every child that goes to that school.

Maybe, maybe not. Schools have reserves for this very issue, and frankly, I think it might be good for the kids to have their school district learn a little tolerance.

Believe me, I understand. I've been doing this for fifteen years. And in fairness, there is a family in my district currently that I hope sues the pants off of us. And administrator had the audacity to tell the parent, "We don't do wheelchairs." Really? 'Cause last I heard, the federal government says you do. I believe in public education. I just don't always believe in the people who are running it, or the people involved in it, and sometimes you have to fight fire with fire. So, if the rumors--which are apparently fine when they are about the child but not so much when objected to--are true, I do hope the parents are suing the previous (keep that in mind too) district.

eta; And I agree. The child does not likely need a full time nurse. A nurse is probably going to have to supervise an individual who can monitor blood sugar levels and administer insulin shots until the child is able to do so for him/herself. However, that does not negate the initial question, which was, "Should" a district be required to provide this service. My answer remains absolutely yes.