Boarding School

[RNshy]

I'm trying to help my wife who works as an RN in a boarding school find some answers for things going on at her school. I work in a totally different nursing field, so I thought I'd reach out to you school nurses. This is long, sorry!

Who regulates medication administration at a private boarding school that is approved as a "special education facility?" I looked on the state website and the school is listed as "approved," so I assume they'd have to follow the Department of Education regulations for medication administration, right?

There are staff at the school who are teachers, administrators, etc who are "med-certified" to pass meds when the health center is closed, but they seem to be outside their scopes more often than not. They call doctors and take verbal orders for medications for sleep, anxiety, etc. and have these medications started before a nurse even knows they were ordered, usually in the middle of the night. They are also the staff who determine whether a student needs PRN medications for anxiety during the day. Isn't this nursing assessment?

Furthermore, where does HIPAA come in to play? My wife told me she is required to type up a report everyday that includes every single visit to the health center (who, what, why, treatment, etc) and email it to the entire staff of the school (teachers, therapists, coaches, etc). There is no encryption, no need-to-know basis, just a direction that it must be sent out every night. If a parent finds out about the emails, will it be my wife on the line for the HIPAA violations since she's the one who sends them?

I could go on forever. Thanks for any insight you might have!

[Farawyn]

Hi! Why isn't your wife asking us these questions?

Just curious.

I have no knowledge of boarding schools.

[RNshy]

Thanks anyway, Farawyn! She's not on AN. I've sent her some links to the state websites, but told her I'd "ask around" too. I've been trying to convince her to speak up, but she's not sure she's right in these particular situations, so I thought if she had some other nurses (aside from me!) who felt the same way, maybe she would speak up to administration about the issues.

[OldDude]

Based on what you've shared, I think you already know her license is being used as an umbrella to CYA the facility and its practices. I would tell her to run as fast as she can away from there. Just my opinion, however.

[MrNurse(x2), ADN]

She is the only medically minded person in the facility. Her opinion should matter most when addressing these concerns. HIPPA is what it is, you have answered this question. After hours stuff comes down to whether your wife is willing to do on call to back up her point. The real answers are going to come from your state's NPA. Private "accredited" schools meet educational standards only, they can do what they want for medical issues, many don't even employ a nurse. She should get facts, either by consulting with local school nurses (just call, most are very approachable) or calling other boarding school nurses, then approach administration with her concerns.