Spec. Ed RN, first aide/care

[BlueeyesRN]

Hi Everyone,

I am a new school nurse to mainly one student, but help as needed with other spec. ed students in my class. I am v busy and love it. My student has seizures, gets suctioned intermttently, has a GT and tube feeding, orthotics, standing frame, hoyer lift thru day, and is incontinent of B&B.

I am sort of on my own, even though in our very large HS there are 2 other nurses to help with general population. I know there is no ill-intent, (but since spec. ed $$ is paying for position and I am a FT employee of district). I am sort of excluded from the monthly nsg meetings. The previous nurse was a contract nurse and did not attend. My future plan on staying with the district, but may apply for sn with gen. ed if spec. ed sn unavailable. I have stated to head school nurse that I am interested in attending the meetings.

This is my lead in to why I feel a little ignorant in regard to my question.

With regards to first aid in schools: Can I cleanse abrasions with half hydrogen peroxide and saline, and/ or apply neosporin? . In the hosp. and home health you should have a doctor's orders.

By the way, I love my job! I worked in Summer school and had a blast. Please feel free to give me other info/advice. I am aware of the National Assoc of School Nurses, but have not looked there yet. Should I pay the $$$

Thanks,

Ro:heartbeat:confused::heartbeat

[kidsnurse1969]

Congratulation on the job! It sounds challenging.

I do not use antibiotic cream or hydrogen peroxide without a doctor's order. Soap and water works just fine and doesn't challenge the nursing practice act.

[BlueeyesRN]

I found a thread on first aid (camp nursing) and Hydrogen peroxide, rubbing alcohol, antibiotic ointment were listed as must haves. So this had me wondering working in a school setting with kids with similar injuries...kind of threw me off the protocols of hosp setting and nurse practice act.

Appreciate the reply. Since I was told to have a kit on the spec. ed bus for another student with hx of staph and supplies needed for abrasions. This student is self-injurious.

[geocachingRN]

Congrats on your new job! I'm in a similar position but my student isn't as medically fragile as yours. I did find out that there are no standing orders for abrasions in my district. In other words, no medication is given without a doctor's prescription and parent's permission, this includes hydrogen peroxide and hydro cream, so if it were me, I wouldn't use them. As to the meetings, make friends with the other nurses and see if over time you can't work your way in. Another way to go about it is that H1N1 is a concern for everybody, esp. the medically fragile popn, you could ask if there is a plan being discussed and if so you would like to be included. Good luck yo you and take care of yourself.

[bergren]

Welcome to school nursing !!!

Hydrogen peroxide is no longer the standard of practice for wound cleaning in any setting. It was found to damage healthy tissue. There is a standard of care based on evidence for wound cleaning in the school setting:

Abrasion and laceration wound care: pre-school through grade twelve.

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10196&nbr=5380

"I have stated to head school nurse that I am interested in attending the meetings. " what did she say? I would emphasize that you want to learn and that you feel the meetings would be eye opening. In the settings I have worked in, typically the 1:1 nurses were not included in the meetings. One reason might be that they are typically paid an hourly rate where the school nurses for the general population are on salary and were not paid extra for before and after school meetings. You may be allowed to attend, but may not be paid for them as they are optional for you.

I highly recommend joining NASN for the Journal and other publications including the electronic weekly NASN Digest. http://www.nasn.org You would also be connected to your local affiliate and would be more likely to hear about jobs in other districts that come up. I have been a member for over 15 years and the information I am exposed to as a member keeps me up to date on evidence based practice and standards of care and current political and legal issues.

Good luck!!

[geocachingRN]

Abrasion and laceration wound care: pre-school through grade twelve.

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=10196&nbr=5380

Good luck!!

Thanks for the link, Martha. I had been wondering if I should spend the $109 for CA registration of NASN. That's a lot of money and I wasn't sure of the value, I'll consider it after I get my first paycheck :wink2:

[BlueeyesRN]

Thank you for your responses. As for what the head nurse said...she didn't know what to say. The nurse prior to me was a contract nurse, and so I know she was sort of not included and probably didn't care.

I am newly hired and paid just like them as a employee, but the $$ are under Spec. Ed. When I called the head nurse, she called Spec. Ed dir. and dir. said something like the "she got really in a tizzy...about my call". Not mad or anything (head scl RN).... I feel she was confused about my call, and I believe it was a combination of: nerves before week of school, and feeling overwhelmed with responsibilty. Hope that gives more insight.

I think the whole H1N1 is a great lead into attending. I do have concerns and as a school nurse I am really interested in doing a good job to educate the spec. ed teachers and students (some are higher functioning than others). And thought of a board near my room in hall, or classroom would be great.

As for H. peroxide...I will not use. However, I have never used H. peroxide unless diluted with saline, H2O2. You are right it can literally be toxic eating good and damaged tissue.

Appreciate the links too...you all rock!

Sincerely,

R

[BlueeyesRN]

I copied the link to National Guideline Clearinghouse on school age children with abrasions and lacerations.

And I do plan on joining the NASN. :typing:redbeathe