My friend (in another state) just got a position as a Health Room Tech at an elementary school with a large special needs population. She has ZERO healthcare experience (not even a CNA course) and is being trained on the job. She is working under the direction of a full-time RN. I was shocked to find out she is responsible for inserting/removing catheters. I asked her to verify that she wasn't just doing peri/catheter care but she said, no, the RN showed her how to insert and remove them. She admits she is in way over her head but is learning the best she can. I don't see how she is able to legally do these things. Is she working beyond her scope of practice?
Oct 19, '12
If she does not have any certification or license, she has no scope of practice to work outside of. In the school setting, the catheterization she is refering to is most likely clean intermittent catheterization of a student with spina bifida. A health room tech can be trained to perform this procedure, as can any lay person. This was mentioned in a Supreme Court case-Irving ISD vs Tatro-
"In accordance with accepted medical practice, clean intermittent catheterization (CIC), a procedure involving the insertion of a catheter into the urethra to drain the bladder, has been prescribed. The procedure is a simple one that may be performed in a few minutes by a layperson with less than an hour’s training. Amber’s parents, babysitter, and teenage brother are all qualified to administer CIC"
If the Nurse Practice Act in her state allows for delegation of that procedure (it varies from state to state), and she has been trained by an RN and has been checked off with documentation that she has been observed performing the procedure properly, then there is not a problem.
Oct 19, '12
I delegate this procedure to UAP (unlicensed assistive personnel). ie, educational aides. We work together for about a week and then I observe quarterly. I have a check off so that I am sure to cover all pertinent points and maintain that in my staff training file.
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