can a school do this?

cookiemomma · Apr 22, 2007

just a thought...wasn't she required to take a tb test before entering nursing school? It seems to me they want to make sure that they have no financial or moral responsibility toward her. BOO-HISS...SHE DESERVES TO FINISH HER DREAM AND CONTINUE MAKING THE BEST DECISIONS FOR HERSELF..Good luck and I will keep praying over and around her....

LilPeanut, MSN, RN, NP · Apr 22, 2007

We had two students in my class who were immune compromised; one with RA, one with SLE.

They just are very careful and use proper precautions when in higher risk areas.

locolorenzo22, BSN, RN · Apr 22, 2007

My school has us sign a waiver every year with HepB liabilities, health insurance coverage, etc. If you're at clinical and you have to go for to the ER for a UNRELATED problem to what you're doing, you have to pay. Schools aren't going to cover YOU, they'll cover themselves with the malpractice insurance....sad, but true. Schools only care about pushing out the bottom line.

chase4myheart · Apr 22, 2007

My best friend was diagnosed with malignant melanoma at the beginning of our 3rd semester of clinical rotations. Because she was taking radiation treatments she wasn't able to get the immunizations that she was required to have. In spite of this, our school let her continue her clinicals and just observe at a distance and do the business part of clinicals (checking meds, reviewing physician orders, etc.). Sadly enough, she had to drop out at the end of our 3rd semester. In just a few weeks, she passed away due to various metastasis throughout her body. I still feel the pain every day. Tell your friend to fight this. Anyone that wants to take care of others when they are fighting this dreadful disease is an inspiration to the entire class. When any of us would start to complain about an awful clinical, all we had to do was look at my friend and all of our problems seemed insignificant.

TrudyRN · Apr 22, 2007

Tell her to get a lawyer.

TrudyRN · Apr 22, 2007

Hi there. I have a friend in my adn class that had cancer as a child. She still goes for a yrly physical and this time some tests came back questionable. A couple of wks ago, her doc told her that her cancer has likely come back.
We were in clinics this week and one morning she was told that her patient had been transferred because he has TB. She was scared because she was around him the day before with no protective gear. She asked the clinic instructor what needed to be done. THe instructor contacted the school and now she (my friend) has to pay for the TB CXR and whatever other things that need to be done. Niether the hospital or school helps with those expenses. This girl has no insurance, not unlike many other college students.
Now they are also thinking she needs to be removed from nursing altogether. Can they do this???

I think her doc should decide what she must be removed from, if anything, not the school. Still, the school must protect itself, and has the right to do so. Just curious, how does she pay the doctor if she has no insurance? Also, she doesn't need a CXR yet, and even the PPD wouldn't likely show anything accurate just yet.

chris_at_lucas_RN, RN · Apr 22, 2007

Question: Were the students asked about their general health and any chronic conditions? If so, was she honest and disclosed her history?

Question: If either there was no asking about histories, or there was and she was honest, does she feel they are being unreasonable by requiring her to pay for care that is now required because they failed to take adequate care to protect their students?

First, I would point out that the exposure could have been prevented if the school and the clinical setting had been on their toes.

Second, if the school doesn't pony up for the CXR, I would visit the dean of students.

Third, if she doesn't get anywhere there, she needs to consider her legal options.

I don't think she can be removed from school, for no other reason than the Americans With Disabilities Act--and trust me, they get federal money, so they either have to follow the law or give up the money.

But lastly and most importantly--if your friend feels as strongly as you do, that is one thing. If she is in fact ill, and at her age and with her history, the odds are not very good if she does have a recurrence, maybe she is interested in the quality of her life?

Now is a wonderful time for you to be a friend, find out what she wants and ask how you can help her achieve that. Advocacy is a wonderful thing--but not if your friend wants something different.

(With no insurance, I worry more about her ability to treat her cancer.)

Do take care, give our best wishes to your friend/classmate, let us know how things go.....

herecomestrouble · Apr 22, 2007

However, there should be some arrangement for cover students exposed to something like TB so that she can be tested. But why would she need a CXR? All she should need is a PPD.

If a person is immune suppressed they may not react to a PPD and so would need a CXR.If her ca has returned that might could suppress her enough.

HikingNinja, BSN, MSN, DNP, RN, APRN, NP · Apr 22, 2007

All the programs in southern nevada require you to have preapproved health insurance before you start your actual nursing courses and clinicals. They wont let you advance into these classes if you don't and you must prove you still have the medical coverage every semester. I think its a good policy, even if it is pricey for those who have to take out extra student loans to cover their health insurance costs.

Dee

jill48, ASN, RN · Apr 22, 2007

How would malpractice insurance help her?

You're right. I don't know what I was thinking. Another brain fart I guess. :uhoh3:

BBFRN, BSN, PhD · Apr 22, 2007

But why would she need a CXR? All she should need is a PPD.

Is she immunocompromised, maybe? Because if she is immunosuppressed, she could have false negative results. Remember that a PPD reaction (wheal) is caused by immune mechanisms. If your immune system is impaired, you're not as likely to produce a larger wheal and could still be Tb positive. This is why I always ask for a CXR to r/o Tb in my AIDS patients.

chris_at_lucas_RN, RN · Apr 23, 2007

If a person is immune suppressed they may not react to a PPD and so would need a CXR.If her ca has returned that might could suppress her enough.

The biggest problem with a PPD and people with cancer is that their depressed immunity means they can develop an infection from the PPD. Not a good thing if you are fighting cancer too.

The reason I happen to be that aware of this is I had a social worker in my office when I was director and no one could remember when they got their last PPD. I said, OK, everybody's getting one, we'll all have the same anniversary date.

He let me in on the reasoning when he refused his.