Agency Nurses And 1:1 Students

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Looking for feedback...if you have 1:1 nurse for a student, contracted by  your district, from an outside agency, WHO is writing the initial plan of care for the student? Obtaining orders for feeds, treatments etc. The agency or the school nurse where the student is. Keeping in mind, the school nurse presumably has no authority over an agency nurse. Thinking about delegation, especially with when a substitute is needed. 

Specializes in pediatrics, School LVN. Has 30 years experience.

I hope you had a good thanksgiving and a restful break.

For our district, I believe, the school nurse, (my supervisor) writes the plan of care. She is also the link between the agency, the agency nurse and the parent. She does not have authority over the agency nurse, but since agency nurses can come and go, she is the consistent factor. Also if a student is in need of a 1:1 there is usually a 504 or IEP in place that the school nurse is responsible for the medical/nurse portion. I hope this helps. 

NutmeggeRN, BSN

8 Articles; 4,569 Posts

Specializes in kids. Has 40 years experience.

I did and I hope you did as well. Thanks...the lines seem to be murky and it seems that the agency's thoughts are we only provide the body, that the school hired us for. Yet, as stated, we have no authority over the person in that role. So no authority yet, all the ultimate responsibility? I worry about the different levels of licensing. In particular, the agency nurse is an LPN and I am an RN. 

Specializes in pediatrics, School LVN. Has 30 years experience.
55 minutes ago, NutmeggeRN said:

I did and I hope you did as well. Thanks...the lines seem to be murky and it seems that the agency's thoughts are we only provide the body, that the school hired us for. Yet, as stated, we have no authority over the person in that role. So no authority yet, all the ultimate responsibility? I worry about the different levels of licensing. In particular, the agency nurse is an LPN and I am an RN. 

I did as well, Thank you,

That is the agencies attitude here as well. It is an odd dynamic for sure.

The agency nurses we have had have been good about talking with the CSN for questions and guidance. 

For scope of practice check the LPN licensing board and ask you public health dept. if they have some kind of guidelines delineating the various role in a school setting. I attached what I have for California.  

Good luck

lvn role.pdf

NutmeggeRN, BSN

8 Articles; 4,569 Posts

Specializes in kids. Has 40 years experience.

Thank you!