Diapering and toilet accidents

[Jocelyn Z]

Hello!I just started as a health room assistant at an elementary school. I have been assigned to special education pre-k to kindergarten students. Therefore I'm the one who needs to do the dirty and stinky task of changing poopy pull-ups and underwear. The problem is that I am not experienced in this task as I don't have a whole lot of experience with kids. Although I am looking forward to advancing in my career as a nurse no matter what I have to deal with. Another issue is that the restroom where the kids are changed do not have a changing table, as they change them standing up to help promote self confidence I guess. This does sound strange but how am I supposed to do this when they are standing? It seems really messy and unpleasant, but it has to be done I guess. Anybody else ever had to deal with this?

[PattyB RN]

Hi JZ...In my school district the nurse are not required to do the diapering/toileting of any child...whether early intervention at age 3, pre-school or special needs. Instead, the Board of Education requires paraprofessionals, who assist teachers, to perform any personal or hygenic need. The union contracts clearly define the roles of these paraprofessionals and they accept the job knowing what the duties entail. Since it seems that it's your responsibility, I would say to request a changing table; it will be better for your back and safer for the children. I don't think standing a person up to change them promotes self confidence, do you? How can it promote self confidence when someone else is cleaning your bottom? I don't buy that logic. Also, check to see if it's actually your responsibilty. If your school has "paras" it may very well be in their job description. I don't understand why it would be a nurses' job to change children. In our elementary schools there too many children to have the nurse do all the changing! The nurse would be constantly changing kids! There would be no time to administer meds, give first aid or tend to the sick children! Obviously if a child has an accident I will assist and help but it's very rare as I'm in the middle school. Good luck with your endeavor as a school nurse. It can be a lot of fun!