Field trips and medicine and diabetics

bergren · Oct 16, 2004

I think I can tell from your post that you know you can invite a parent to go, you cannot make them go. They may wish to go. If they can or will not, and if in your state an RN must administer the medication, then you or an RN sub must go.

For the child who can self medicate, I am assuming the care plan has the self medication procedure in writing, then why would the teacher have to carry the medication? As part of self medication, why is the student not carrying it. (I am used to self administration including carrying the medication on the child's person).

If the child has to ask the teacher for the medication, then I would say the teacher is administering, and you are delegating the administration to the teacher. You need to provide the medication in a pharmacy container with the medication and the teacher would need written instructions on what it is, dose, when to administer, take with water or whatever, and side effects, and it would need to be documented that it was given. The teacher would need to verify the student's identity. A school photo of the student could be included on the written instructions. The teacher is responsible for locating the student at the scheduled time of administration if the student does not present themselves.

Resources:

The green legal book covers this and other Section 504 situations: Schwab N. & Gelfman, M. H. B. (2001). Legal issues in school health services: A resource for school nurses, administrators and attorneys. North Branch, MN: Sunrise River Press. available through http://www.macgill.com

Another good article: Thies, K. M. (1999). Identifying the educational implications of chronic illness in school children. Journal of School Health, 69(10), 392-397.

There is good information on field trips for students with health conditions on the web. What to do on field trips should be a part of a student's Section 504 plan. Do a Google http://www.google.com search on the search terms: Section 504 field trips.

How do you deal with a student that goes on a field trip and requires a fingerstick with coverage? Ideally I would like the mom to go. I am not sure that will happen though. I think that I would have to go because I would be having to dispense a medication. Also, it is feasible to send a medication with a teacher who has a student that can self medicate right? The student is in 6th grade and takes a med at 1pm. She would just have to say I am Susie and that is my medicine right? I think I answered my own question but would like to know what others do. Thanks.
Stacie

presC. · Feb 4, 2005

hi bergren, i'm learning a lot from you. since i'm a newbie in school nursing (actually, will start this feb15,'05) would like to ask some questions.

- what are the things i need to bring during field trips? (we have no doctor's in our school)

- can you share some website where i could learn different types of bandages/splints and how to apply them? i hardly use this stuffs in our area before and totaly forgoten :uhoh21:

- what are the skills/seminars must i attend to be more efficient school nurse?

thank you so much for taking time to answer..:)

bergren · Feb 4, 2005

i am sure everyone can contribute to this. i was a school nurse in 4 different states and i now teach in a online school nursing masters class and coocrdinate the school nurse masters program at the university of illinois-chicago.

what to bring on field trips. i actually did not usually go on field trips, but what i would bring is contact information on all the kids with their health conditions, of course any epi-pens and medications that need to be administered. i probably would not bring a first aid kit unless we were going to be in the wilderness as most museums parks etc have them. i would bring a ice pack or two, wet wipes and a cell phone.

"websites for bandages/splints and how to apply them? " again, most school nurses are not trained in splinting, and therefore should not do it. most first aid classes now say not to splint, but protect the limb and get the child to an er primary provider. bandages, again it is temporary until you get the child to care, so i would just makes sure the wound is clean and cover it.

school nursing is also public health, primary prevention and health promotion, so don't forget that aspect of the position, which is easy to do if kids are swarming the office. so handwashing classes, dental care, finding out why so many kids are getting injured on the playground and gym, headaches due to no breakfast, a rash of asthma flareups due to the science teacher bringing in a guinea pig or mol under the carpet (these both happened in my schools) etc and then implementing programs to address these issues. and then the whole special education aspect. you cannot learn this all overnight. i have a website, but a lot of the links are outdated, but it has a bunch of information in one place: http://www.usinternet.com/users/bergren/

skills seminars: each year many states have the school nurse orientation over the summer and it is an excellent kick off. you may even have an advantage since you will have some context to put all the information into. ask you district for a mentor, or call the state association and ask if they could match you with a mentor for your first months. the state can also tell you what conferences and programs are available in your area. go over the www.nasn.org website for background materials. the state links are at: http://www.nasn.org/community/affiliates.htm once you join your state association and the national, you will be on all kinds of mailing lists and get this information in the mail.

good luck!!!!

hi bergren, i'm learning a lot from you. since i'm a newbie in school nursing (actually, will start this feb15,'05) would like to ask some questions.
- what are the things i need to bring during field trips? (we have no doctor's in our school)
- can you share some website where i could learn different types of bandages/splints and how to apply them? i hardly use this stuffs in our area before and totaly forgoten :uhoh21:
- what are the skills/seminars must i attend to be more efficient school nurse?
thank you so much for taking time to answer..:)

presC. · Feb 4, 2005

THANK YOU so much for quick response. such a great help for me to read all your advises/tips/infos. will keep this at my "favorites" will soon visit all the websites you shared.

hope you won't mind if i keep coming back here and ask for some of your wisdom/expertise in school nursing..

again, THANK YOU.:)

sls4083 · Feb 4, 2005

Funny, I just asked the same question of our NY Statewide School Health Services Administrator (NY state) last week and this was her answer to me:

IF the child is considered "Self-Directed"....and administer their own insulin, then a UAP can assist/monitor the student with the blood glucose testing. ONLY a Licensed person, parent, or parent designee (not a school employee) can administer the insulin if the child is NOT self-directed. The law states schools can't keep a student from attending....the field trip might have to be cancelled.

Sue