School Nurse = Employee Health Nurse?

Specialties School

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Hi all - I have a question for you.

A new law passed in January of this year that changes TB testing requirements. Basically it states that instead of a mandatory exam, candidates can now fill out a TB Risk Assessment Questionnaire instead of getting a TB test when initially hired and every four years thereafter. It has to be administered by a licensed healthcare provider - physician, PA, NP or RN.

Do school nurses do this for employees? My thought is that I don't work for employee health. I don't do TB tests. I don't draw blood for labs. I'm not part of that. I am the part -time nurse for the students. Although I do train school employees to recognize medical issue in students.

What do you guys do? Even cross over into employee health duties?

No. I will do vital signs height and weight on teachers if the medical director is coming for their pre emp. health screening, but no, I don't place or read PPDs, draw blood, etc.

I miss doing all that. I worked EH for 5 years. But no, not in the SN scope.

Specializes in school nursing, ortho, trauma.

i could theoretically place and read a ppd - i'd need a dr's order, which wold not be a big deal to get. The bigger deal would be getting the vials of Aplisol at around 80 bucks each which provide i think 10 tests but have to be discarded 30 days after first use. I told my district that i highly doubt i'd give 10 tests in 30 days to justify the costs between the tuberculin and the syringes. They agreed once i started speaking their language, dollars and cents.

Specializes in Pediatrics Retired.

I will read a PPD and send the report to our local health department office but that's the extent of my involvement. The hospital that owns the Urgent Care Center I work at has changed their TB policy to something similar but it starts with an initial blood test (supposed to me more sensitive) and a follow up with the questionnaires; but of course they have a department for all that stuff.

Thanks. My thoughts as well. When I first started they asked me about doing the TB tests. I also explained about the logistics and costs and of course, that is where you hit them. In the money-pot. :whistling:

This new form would take up more of my time as well. The California School Nurse Organization put out info about this that makes it sound like school nurses need to do this. Which is what I got from the district. I've sent CSNO an email as well.

This same kind of issue came up with the exemption law here a couple of years ago where the state decided to make it harder for parents to opt out of immunizations by making it a requirement that they had to go see a medical provider and get "the talk" about how this is the right thing to do and then if they still decided not to immunize then the provider could sign off. The idea was many parents just don't want to bother getting the immunizations so if they had to go to the doctor anyway, they'd give up and get the shots for their kids. Of course there was one little bugaboo in the law that stated A SCHOOL NURSE could do this. That sort of defeats the purpose and most nurses here decided to not do that. The truth is in my state, nurses are not on every campus, we only work part time, we don't have time for ALL the state mandates and have to pick the most important ones. Fortunately, some have died of their own accord due to RESEARCH that showed they didn't help anyway.

Vent over. Y'all can tell I'm ready to retire from this job, right? ;) I'm not bashing the job - just the bureaucrats. Our state is full of them and the legislature is bogged down with possible new laws every year.

(Ok - vent really over because I have to get to work).:)

I administer them for my district, but I think it's related to what our nurses have historically done. We held PPD clinics at each site so the plan for next year is to administer the questionnaires and PPDs if necessary. Having to administer the questionnaire is time consuming though.

Specializes in Maternal - Child Health.

My situation was unique in that I was not a school district employee, but was employed by a public health agency and was one of several nurses contracted into our school district.

We were employed to care for students and staff members alike, and because we had protocols and physician backing, we were able and expected to perform employee health functions like pre-employment health assessments, vaccination clinics for staff, chronic disease management, and emergency care.

I enjoyed it, but it was not yet another added responsibility. It was something that was planned time-wise, budget-wise and we had solid policies and procedures to follow.

Thanks Jolie - we have none of that - protocols, physician backing, etc. We can't even get a physician to write us a prescription for the mandated epi-pen legislation that the State of California passed last year that started January 1, 2015. Hardly any schools in CA have been able to implement the policy. The state didn't even consider HOW to get the prescription and very few docs want to do it.

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