CNA's in school nursing

PetsToPeople · May 9, 2012

Another bad idea on trying to cut/limit costs, especially with a growing population of children with health problems and on multiple meds. I wonder what the parents think of this? They should be educated on the difference between a CNA and an RN because a lot of the time they simply think all nurses are RN's.

Purple_Scrubs, BSN, RN · May 10, 2012

My district has health assistants and for the nurses that split time between 2 schools, when the RN is at one, the HA is at the other. They work closely together and it works out fine, in fact, it works out much better than the alternative which is training office staff to cover in the nurse's absence. I only have one school, but when I am out, the clerk takes over my duties, including diabetic care and bladder caths. She is incredible, and I am encouraging her to apply for a HA position since she already does a great deal of that work when I am out.

Ideally, sure, an RN would be at every school 100% of the time. In reality, in the smaller schools where it is not practical to have an RN there all the time, having a specially trained HA or CNA to cover can be the next best thing. My colleagues who have HA's adore them and they work very closely together to care for the students.

OnlybyHisgraceRN, ASN, RN · May 13, 2012

My district has health assistants and for the nurses that split time between 2 schools, when the RN is at one, the HA is at the other. They work closely together and it works out fine, in fact, it works out much better than the alternative which is training office staff to cover in the nurse's absence. I only have one school, but when I am out, the clerk takes over my duties, including diabetic care and bladder caths. She is incredible, and I am encouraging her to apply for a HA position since she already does a great deal of that work when I am out.
Ideally, sure, an RN would be at every school 100% of the time. In reality, in the smaller schools where it is not practical to have an RN there all the time, having a specially trained HA or CNA to cover can be the next best thing. My colleagues who have HA's adore them and they work very closely together to care for the students.

Could not have explained it better. I worked as a school health aide/CNA for about 3 years. I loved it! The RN floated between two schools but stayed mostly at her home school.

The only down side is that students, staff, and parents assumed I was the "school nurse" all the time. I got tired of correcting them, time after time. As a CNA I was trained to pass meds, manage diabetics, and students with seizures. If a student ever needed an assessment by a RN, I called my boss. We had a great working relationship. It would be great for LPNs/RNs to be in every healthroom but its' not economically possible. I think it works out just fine as long as the CNA and RN have open communication and trust.

Flare, ASN, BSN · May 14, 2012

my state requires Certified School nurses in every campus - RNs can be used to "fill in". I have a clerk in my office - but she only does clerical type tasks - though she is not opposed to doing small helpful things like graaing an ice pack for a student or taking a temp when i am busy with something else.

CNAs and health room assistants don't really come into play in NJ the way they may in other states

mc3, ASN, RN · May 17, 2012

Liability, liability, liability....................who are they going to blame if something terrible happens?

mc3:nurse:

mommyrn06 · May 17, 2012

Liability, liability, liability....................who are they going to blame if something terrible happens?mc3:nurse:

Exactly the thought of many of the nurses in my district are thinking concidering the cna's would be working under the license of the RN they are paired with.

Purple_Scrubs, BSN, RN · May 17, 2012

As long as the RN trains the unlicensed personnel or CNAs and documents this training, the person is responsible for their own actions or omissions. It is a myth that someone "works under" another person's license. As long as you have trained them properly and supervised them correctly, you are not responsible for their actions.

We had a situation recently with a student when I was out sick and my office staff was covering for me. Long story short, the parents claimed they were negligent in their care and she took it to the superintendent, the news media, you name it. Ultimately, my staff was cleared of any wrongdoing, but they did make an error by not documenting the student's visit in my daily log per policy. If there had not been witnesses to what happened, it could have been bad since they had no documentation to refute the parent's claims. Regardless, I have documentation to show that I trained them and we went over proper procedures, and I have observed them in performing the duties expected of them, and they had access to myself and other on-call RNs for questions. Since that was done, I was totally in the clear even if that had been negligent (which I reiterate, they were not).

caregiver1977 · May 17, 2012

I work at a school where there is a large population of of health and metally challenged students. Some students do have a CNA/medical assistant that follows them around all day assisting with their medical needs. I do know, at my school, they are giving meds to students.

bleemadden · Oct 23, 2012

At my district, we hire "health aides" for our 5 schools and have a floating RN at the district level. We've been doing this for 3 years and have had no problems. The health aides don't have to hold any certification however, one of our aides is an EMT and I'm a CNA/finishing school to become an EMT. Our other 3 hold no certs and have been doing the job the past 3 years we've had this system. When our district first implicated this system, it raised a lot of concern...and rightfully so. Now it's all a thing of the past and works really well. We are retrained by the RN every year and renew our CPR/First Aid. We have specifics to when we send students home, very rarely give OTC's (15 minutes of rest usually does a kid a world of good), and for accidents that cause bumps and dicoloration we call parents and let them decide if the child stays in school or not. Most of the RN's on here that I've seen blasting systems like this have a main concern of medication administration. We have all done a training with the RN and parents if they choose to be a part of it (none of mine did) but I was already med tech certified from working in LTC. Our RN is very close with all of us health aides and we communicate daily. Our comminity has expressed an appreciation of the system and I love my job!

angelicious05 · Nov 1, 2012

I am currently working in a school district as an LVN, of course under the Credintialed "School Nurse" (RN). There are also health aids. For invasive things like insulin, caths, gtube, etc only the LVN or RN handles it. For schools with kids with no special needs there is a health aid most of the time then the RN above them who checks in during the week.