CMA oversight

[MrNurse(x2), ADN]

Hi, hope all here had a marvelous summer. I am coming to my awesome coworkers here for yet more of your invaluable advice. We are getting a CMA to cover our office in the afternoons and are trying to figure out her limited scope. Our plan is to be available by video chat for any involved injuries or cases requiring meds, as our protocols involve assessment. We have one afternoon Ritalin at this point, which Md. law says is covered for a CMA to pass. She will have her own computer access and will be differentiated when emailing parents and we are asking her to document when the nurse has been consulted. Our entire documentation gets emailed to parents, so they can "see" the entire visit. So far, those are the issues we have come up with, I am asking for other issues we may not have foreseen from these wise nurses here.

[ruby_jane, BSN, RN]

What else can she do per MD law? I am assuming things with orders, but she has no nursing judgment, so how often should she be calling?

My day has been full of stomach ache , headache, stuffy noses. We have protocols that put parameters on assessment, but most of it's nursing judgment.

[JenTheSchoolRN, BSN, RN]

Do you have students with diabetes? I ask because perimeters after written in my state for school include school nurse judgement upon assessment to adjust insulin dosing up to 20%. This is not something a CMA can do, so would need RN assessment more often than not as most students with diabetes are ever just straight forward (see my other post).

As ruby_ jane said I feel like every visit is assessment, assessment, assessment. I assume you will right some assessment guidelines? (i.e. student c/o stomachache, afebrile proceed to do xyz?)

[MrNurse(x2), ADN]

The video consult should not be cumbersome, we normally have 2 or 3 visits in the afternoon. We also have a state provided manual for when the nurse is off campus. This covers us when not available.

[LikeTheDeadSea, MSN, RN]

Is the school providing the equipment for the video consult? If not, I'd be pushing for that.

[ruby_jane, BSN, RN]

1 hour ago, MrNurse(x2) said:

The video consult should not be cumbersome, we normally have 2 or 3 visits in the afternoon. We also have a state provided manual for when the nurse is off campus. This covers us when not available.

Good! Something in place. When I am out and do not have a sub I can, by state law and district procedure, delegate medication tasks to the campus designee (the secretary). But when I'm out unless it's minor, she calls the parent every time. Which is fine. No problem at all with that.

[MrNurse(x2), ADN]

On 8/28/2019 at 10:01 AM, LikeTheDeadSea said:

Is the school providing the equipment for the video consult? If not, I'd be pushing for that.

I buy my own meds, I don't think they have the resources. Skype will be sufficient. The parents were made aware and I had no concerns voiced at back to school night.

[Amethya]

What should be limited is assessing. Basic first aid, typical treatments. (i.e, Headaches= laydown, check temp.) To call the parents for any injury and if they come visit. I'm not sure what's the protocol there, but for my last job, I had to call all the parents for every visit, so that may be a thing.

Diabetes training, CPR training and Basic First Aid, ,AED, Epipen... etc.