Nurses can educate I thought it was part of our job? Nurses can educate I thought it was part of our job? | allnurses

Nurses can educate I thought it was part of our job?

  1. 0 I have a little bit of an odd profession. I am a nurse paraprofessional. The county health department takes care of all the health plans and the lice checks etc. I monitor kids or help with insulin and carb counting especially disabled kids, administerd IV antibiotics, etc.......

    I'm not paid much a tiny bit more than a teacher's aid, but its worth it to me, to have the great hours and the stress of not having work call me every 8 hours begging me to come in 365 days a year. I played that game for 25 years. Tired of it!

    Anyway, yesterday I was asked if I could do diabetic training to teachers. Why wouldn't I legally be able to do this? I have a BSN but I am not a certified school nurse. I have trained a zillion new diabetic patients in the hospital and outpatietn setting on diabetes. I guess the health dept nurse even said she didn't know if I could do that. Can I? WHat do you think?
  2. 14 Comments

  3. Visit  Flare profile page
    1
    what do you mean by diabetic training? training the teachers what to look for in diabetic students as far as hypoglycemia? training the teachers in caring for a diabetic student (depending on state laws some can delegate glucagon or even insulin). Or do they mean new patient training to the adults that have diabetes? If it's the latter, i would decline. It's simply not a function of school nursing. I don't mind giving staff members a little insight on medical conditions they have if it's something i'm familiar with or if i read something i think they may be interested in, but beyond minor first aid I am not their health care provider.
    Supernrse01 likes this.
  4. Visit  NutmeggeRN profile page
    1
    I do not think there is any reason you cannot do this. You are giving general information on a disease that has TONS of evidence based teaching materials out in the public. I would be sure to make it clear that you are not a CDE, but that you are using the evidence based standards as far as basic care goes. I would be careful if it is a specific student related, because you don't want to be delegating something you are not hired for.
    Good Luck!
    bebbercorn likes this.
  5. Visit  Jolie profile page
    0
    To be honest, I am far more concerned about another part of your post than whether or not you can or should educate teachers about diabetes.

    If I understand correctly, you hold an RN license, and your job title is “Nurse Paraprofessional.” You also mention that you administer IV medications as part of your duties. That concerns me. Please check your job description carefully. Most Nurse Paraprofessionals are not licensed healthcare providers and so job descriptions typically restrict the types of medications that paras may routinely administer in non-life threatening situations. It seems unlikely that the job description of a para would include IV medication administration, unless yours was specially written to accommodate your professional licensure.

    I understand the limitations of funding and realize that a paras are necessary to supplement the limited presence of the RN and LPN in schools. But I am concerned that your district is attempting to “use” your expertise without compensating you and possibly without providing you with legal backing in the event of an untoward event.
    Last edit by Jolie on Sep 27, '13 : Reason: formatting
  6. Visit  Vtachy1 profile page
    0
    I would be training the teachers how to care for diabetic students according to their healthcare plan.
  7. Visit  Vtachy1 profile page
    0
    I am an RN with a BSN.

    You see compensations is not my concern. I am not interested in the money. I have been a nurse for 25 years. I will take $14 an hour with much gladness if it means I can be able to know which way is up. I am sick of the way nurses are abused. I am sick of being abused!!!! I want to be able to breathe. I want to be present instead of just existing. I have done this job for one year and have seen remarkable improvement in my life. They can take the money and shove it in their rectal orfice!!! I would choose a life over the money.

    I worked like crazy the last 25 years and I have my house paid for and no debt at all. What I need is a life. I need this job. I am so thankful to have a job like this!!!!!
    Last edit by Vtachy1 on Sep 28, '13
  8. Visit  Vtachy1 profile page
    0
    I would gladly give up my license if someone felt that badly about me that they wanted to sue me. They can take all I got, I would pretty much rather do anything than experience the abuse that I have in the field of nursing. I say take it its yours! Its not the job itself that I don't like, its the abuse. I love caring for people and building a nurse patient relationship and doing all the skills that it takes to be a nurse. But its not worth it to me. 100% not worth it.
  9. Visit  Spidey's mom profile page
    0
    Quote from Jolie
    To be honest, I am far more concerned about another part of your post than whether or not you can or should educate teachers about diabetes.

    If I understand correctly, you hold an RN license, and your job title is “Nurse Paraprofessional.” You also mention that you administer IV medications as part of your duties. That concerns me. Please check your job description carefully. Most Nurse Paraprofessionals are not licensed healthcare providers and so job descriptions typically restrict the types of medications that paras may routinely administer in non-life threatening situations. It seems unlikely that the job description of a para would include IV medication administration, unless yours was specially written to accommodate your professional licensure.

    I understand the limitations of funding and realize that a paras are necessary to supplement the limited presence of the RN and LPN in schools. But I am concerned that your district is attempting to “use” your expertise without compensating you and possibly without providing you with legal backing in the event of an untoward event.
    I was wondering about that too. The term "paraprofessional" here is a fancy way of saying "aide". As in teacher's aide or health care aide.

    Regardless of whether the OP cares about compensation, I am concerned about the legalities of this job position's definition and the fact that the OP is a Registered Nurse.

    I have "paras" working with me but they are not licensed in anything (medical or educational).

    Regarding the teaching of diabetes - if you are just teaching the teachers signs and symptoms to watch for, then yes I see no reason not to teach that.

    But if you are teaching them to care medically for the student, I'd have a problem with that.

    In California until recently, only licensed medical folks could give insulin. A court case went to the California Supreme Court (I have a thread on this in this forum). It may go to the Federal Supreme Court. In the meantime, the school nurses for the most part have decided NOT to teach volunteers to give insulin and the teachers have refused to be taught to give insulin . . they are busy enough without having to do medical care.
  10. Visit  LadyFree28 profile page
    0
    Quote from Spidey's mom

    In California until recently, only licensed medical folks could give insulin. A court case went to the California Supreme Court (I have a thread on this in this forum). It may go to the Federal Supreme Court. In the meantime, the school nurses for the most part have decided NOT to teach volunteers to give insulin and the teachers have refused to be taught to give insulin . . they are busy enough without having to do medical care.
    I really hope this spreads to other states...the schools nurses in my local school district were laid off and nurses were supposed to give meds; one known incident happened where the teacher gave their student the wrong pill...can't imagine insulin!

    They are currently suing the state.
  11. Visit  Vtachy1 profile page
    1
    Yes, you are exactly 100% correct. I just thought everyone knew that a parapro was a teacher's aid. And that is what I do.

    The legal part, go ahead and sue, I will give over whatever you want if I do something wrong. or if you think I did something wrong which I am human. It would be a relief to not be a nurse anymore!!!

    I sometimes wonder if I could get a CNA license and then get hired as a CNA or LPN? Those jobs are what I need right now.

    And sometimes I just think, forget the whole thing, I am ready to work at McDonald's or gas station or something. I love nursing, hate the abuse that we get. 25 years of abuse, I am worn. Tired of them expecting us to work 80 plus hours a week under very stressful conditions. I am beyond thankful for the job I have. Never been more thankful in my entire life. I am happy for the 18 years of hospital nursing in ICU, 3 years and counting as a hospice nurse ( I currently still work hospice), 4 years working for a general surgeon and assisting him in surgery, 3 years doing telephone triage, and now a nurse teacher aid. I would not trade anything for the experiences I have had. At the same time I am worn. Ready to experience life now instead of living in a state of constant fight of flight.
    Last edit by Vtachy1 on Sep 29, '13
    Marisette likes this.
  12. Visit  Vtachy1 profile page
    0
    I agree but there is no money. All schools in Illinois are in severe debt. It has to stop. I wish they would go back to one room school houses. Just the bus routes alone are over a million dollars. It has to stop so that my grandkids will not be slaves to the debt our country has accrued.
  13. Visit  Vtachy1 profile page
    0
    I know, it is a problem. And that's where I come in to administer the insulin to disabled child. Teachers are so busy and they do have too much on their plate, but unless every school has a nurse there all the time, what is the solution?

    We have some teachers that are bright and young and extremely competent at managing diabetes in the non disability kids. And then we have the teachers that do not know the "greater than" and "lesser than" signs in the care plan!!!! They never learned the <> and how the alligator always eats the bigger number LOL.

    We have some parents that come every single day and administer the insulin to their kids. I wonder how they get jobs that allow that, I have never had one. Some of the parents don't work at all.

    I am learning that the school is an entirely different world. I can teach parents how to care for their kids upon discharge of a new diabetic on the peds unit but I cannot teach teachers the same thing.
  14. Visit  Jolie profile page
    5
    Vtachy,
    I hear the passion in your voice and am grateful that your students have access to your experience, knowledge and desire to “do good.” I am also pleased that you have reached a point of security in your life that satisfaction is more important to you than income. But I encourage you to handle that with care and wisdom. In the event of an untoward occurrence, it could all be lost.

    You are not infallible. None of us are. That is why we utilize the legal protections available to guide our practice and lessen the risk of potential harm. Job descriptions exist to establish expectations for staff performance, including limitations of practice. They do not indicate that one is incapable of more, only that one is not authorized to do more. Performing tasks outside of your job description, regardless of the level of your expertise, is an invitation to legal troubles that could cost you your license, home and financial security.

    Think of it this way: Let’s say that despite your excellent care, a student develops a central line infection. Perhaps it happens because of an inadvertent contamination at school. Perhaps it has nothing to do with school, but developed following improper care at home. But the parents make an accusation that a “teacher’s aide” who wasn’t supposed to be touching the central line was doing all the care. The school district responds by stating that they had no idea that you were performing this task outside of your job description and sides with the parents, seeking action against you. Will your professional liability policy cover you since you were not working in a nursing position? How will you defend your practice? Do you have access to the student’s health records to check physician’s orders? Is there an individual plan of care for this student? Is there an emergency plan in place for management of a torn, dislodged, clotted, or infected line? Have you made daily notations documenting assessment of the site, medication administration, tolerance of the procedure, vital signs, s/s of infection etc.? How do you communicate with the child’s parents and medical team?

    If you are satisfied with your income, I still strongly encourage you to approach your district and ask them to re-write a job description to reflect your professional experience and licensure. Maintain your title and salary if that is acceptable to you, but PLEASE get a job description that reflects what you actually do, so that you will have legal standing to provide the care that you (apparently) are already providing.
    Jen-Elizabeth, fetch, NutmeggeRN, and 2 others like this.

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