Quote from akulahawkRN
What I would have done and what you did would have been very different. This is partly because I have been trained as an athletic trainer. That's very different than an athletic director, though they usually have some training in basic taping, splinting, and bracing. In my (previous) capacity as an athletic trainer, I worked under the team physician and was given broad latitude to evaluate and treat athletic injuries and also to refer to appropriate outside entities as I deemed necessary. I've also been through Paramedic School and Nursing school and given that both are likely fairly representative of Paramedic and Nursing education for entry to practice, neither came close to the physical exam depth that I received as an athletic trainer. Yes, I have a Bachelors in Sports Med. Now then, for people that wandered into the training room that were asking for first aid, I'd give them first aid help and send them on their way. If they've already got a finger splint, it's in hand, and it just needs to be re-wrapped, I'll do that and send them on their way.
The only liability you normally would face from re-taping a finger splint would be if you taped it back on with the tape being applied too tight or the elastic wrap being applied too tight. What would I have done? I would have wrapped the split in place after doing a quick eval and sent the kid on her way. I would also have required the parent obtain a physician's note excusing the kid from PE as I'm not going to want to keep treating an aggravated injury from PE activity. How long would that take me? Far less time than it would take to type this post. If the parent (and AD in this case) refuses to get the Medical Excuse, I'll draw a very hard line at the first PE injury... no treating in-house, it's off to the MD for evaluation.
If I was not previously aware of the injury, I won't issue notes to get out of PE or anything like that, that's something I would require the physician to do. My athletes? That's a slightly different story. All I'd generally have to do is contact the athlete's PE teacher and advise them of the injury, what I've done, and what the athlete must avoid. The PE teachers do respect what I tell them because they'll have their athletes under my care soon enough... and if they push the issue, I'll send the athlete out to the team Doc and obtain a formal medical note. The team Doc and athletic department would provide me the authority to excuse athletes with sports-related injuries from PE.
No, I'm not a physician and I don't pretend to be one. Athletic trainers usually follow 1 of 2 major tracks if they stay in healthcare. They often become PAs or they become Physical Therapists. I became a Paramedic and an RN.
I looked deeper into the situation and apparently that "athletic director" was the former "athletic trainer" for the high school.
But I am not an athletic trainer, so no, I still would have not re applied the splint. Considering the fact that the daughter told me that "her cast came off" and she told me her "doctor was the one that applied it". I'd rather have called the parent. I was also going through my districts policies on ace bandages and other wraps, and unless it was for initial tx for a "suspected fracture" we are to not use wraps or ace bandages, because it would seem as if we are diagnosing a client to have to use one. One of our CN's can't even apply one, and she's a nurse practitioner.
I understand where you are coming from for what you would have done, I think the difference is that you have that training and I do not. Hence why we would have dealt with it differently. It's nice to hear another point of view. Maybe that's why she was so irritated. I still don't like how she tried to tell me how to do my job and she knows my "scope of practice." I have a license to keep, and I'm not going to lose it because I had applied a wrap wrong. If I don't have a doctors order, I won't do it. It's different from working in the hospital vs public schools. Lots of differences...
My district nurse talked to her, and the mom is bringing a doctors note on Thursday. She also told me I did the right thing.