Sharing Health Information with Teachers

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How obligated are we as nurses to share health information with school teachers and classroom aides? The LPN in our school needed to take a blood pressure for a child and the classroom aide demanded to know why she was taking his blood pressure? The LPN responded that she had a physician's order but that wasn't an acceptable answer for this staff person. Any advice would be appreciated.

Thank You.

Specializes in Critical Care, Capacity/Bed Management.

I will preface this by saying I am not a school nurse and have never worked as a school nurse and such do not know the policies and protocols in place.

I, however would not be forthcoming with health information regarding a student unless it would endanger their health, such as food allergies or that they are a hemophiliac (in case of injury).

If they are on a medication that requires blood pressure checks, then I would phone the classroom and inform the teacher/aide that Student Doe is to report the nurses office. I understand that politics are at play in any institution, but it is important to protect the patient and their right to privacy.

NightNerd, MSN, RN

1,130 Posts

Specializes in CMSRN, hospice.

I agree with the above poster. In this sort of situation, I find it helpful to ask, "What is your concern right now?" and see if there's something I can say to diffuse the situation without sharing too much. Sometimes works, sometimes doesn't, in which case, "Sorry, bruh; privacy laws."

Specializes in SICU, trauma, neuro.

I'm not a school nurse either, so hopefully someone can correct me if I'm wrong... Does the teacher/aide need to know due to educational implications? If not, I wouldn't share the info. My guess is that the licensed teacher already has the info s/he requires though. My oldest son has AVR, which I noted on his health forms; whenever we've had meetings with his teacher, his file that they have says "cardiac" under health concerns. Plus they know about kids' food allergies and have reminded parents that d/t a student's severe alleegy, they are a nut-free classroom.

LovingLife123

1,592 Posts

I would have said to the aide, not your concern because you know HIPAA. That was very wrong to demand such information. The teachers may know the general diagnosis and that a child needs medical treatment, but that should be it.

Think about it, technically CNAs and Techs are only supposed to have pertinent information to taking care of their patients, not the whole picture, and they are intricately working with the patient. Why would a teacher's aide be privy to all of the students medical info?

MunoRN, RN

8,058 Posts

Specializes in Critical Care.

If the child has medical issues that may occur in the classroom then the teacher and other staff working with the child need to be aware of what to watch for, sharing that with them is not a HIPAA violation.

From the description, it sounds as though the LPN went into the classroom to take the child's BP, which is inappropriate unless it's a clear emergency.

Editorial Team / Admin

sirI, MSN, APRN, NP

17 Articles; 44,729 Posts

Specializes in Education, FP, LNC, Forensics, ED, OB.

Thread moved to School Nurses forum.

NutmeggeRN, BSN

2 Articles; 4,620 Posts

Specializes in kids.
If the child has medical issues that may occur in the classroom then the teacher and other staff working with the child need to be aware of what to watch for, sharing that with them is not a HIPAA violation.

From the description, it sounds as though the LPN went into the classroom to take the child's BP, which is inappropriate unless it's a clear emergency.

Agreed, but it is not clear the nurse went into the classroom.

Specializes in School nursing.
Agreed, but it is not clear the nurse went into the classroom.

Agreed.

I would not be sharing why I'm taking this BP with teachers unless it is part of an overall health concern that is relevant to classroom needs. Sometimes I get orders to take a BP for a child as part of the diagnostic process - I'm not going into to that with a teacher. I may just say "the child's doctor has asked me to do this and they will need to be excused from classroom for a few minutes to do so for x number of days."

If they press I may say "I will share any more relevant info if needed but not at this time."

I do share relevant information with teacher as needed; but I do have a couple of parents that do not want me to do so. The principal is a always a need to know person according to FERPA.

(An aside: I do tell parents that certain health needs, like food allergies and asthma are relevant to be shared with teachers and that I'm not going to share their child's complete medical history, which some parents think I will. They usually relax and let me share the basic need-to-know stuff.)

And in case folks are interested:

Joint Guidance on the Application of the Family Educational Rights and Privacy Act (FERPA) And the Health Insurance Portability and Accountability Act of 1996 (HIPAA) To Student Health Records

https://www2.ed.gov/policy/gen/guid/fpco/doc/ferpa-hipaa-guidance.pdf

moreoreo

218 Posts

Specializes in School Nursing.

Any time a student has a condition that may cause "episodes" of any kind that may occur in the classroom (allergies, asthma, seizure disorder, hypoglycemia, etc.), I feel obligated to share at least bare bones info, because ultimately the teacher is the one watching the student every day, not me. I also share bare bones info with lunch supervisors, gym teachers, others who are directly responsible for the student for the same reason.

BUT depending on why I was taking a b/p I would not necessarily share those details with the classroom aide. For the same reason, if the teacher does not write out a pass to me, I leave out the "reason" on the pass I write to return the student to the classroom unless it is an obvious reason like "nose bleed."

kidzcare

3,393 Posts

Any time a student has a condition that may cause "episodes" of any kind that may occur in the classroom (allergies, asthma, seizure disorder, hypoglycemia, etc.), I feel obligated to share at least bare bones info, because ultimately the teacher is the one watching the student every day, not me. I also share bare bones info with lunch supervisors, gym teachers, others who are directly responsible for the student for the same reason.

Exactly. If a student has a cardiac condition (or is on a medication that can cause cardiac symptoms), then the teacher should be aware so that if the student says "I don't feel right. Can I go to the nurse?" the teacher knows to send them right away and with an escort. Or so the teacher can see that the student is flushed and beginning to lay on the desk and it's not from running last hour in PE.

KKEGS, MSN, RN

723 Posts

Specializes in School Nursing.

I don't think teachers or aides need to know why. What difference does it make? I would have said exactly what you said and if they persisted remind them that that is private health information and that I, as a nurse, am bound by federal laws that prevent me from discussing private health information with people who do not absolutely need to know it.

If the child may exhibit certain symptoms that require immediate attention (dizziness, headache, blurry vision, etc.) I share that but I don't feel the need to share a specific diagnosis or get too detailed with my information.

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