Going to school with patient

caliotter3 · Aug 1, 2019

Another level of third party to deal with (teachers, aides) with resultant possible problems. I have found there is little worse than having a third party butt in your job to the point of actually causing you to lose your job (not likely, but possible). Possibilities for physical problems (travel to and from, accidents at school, etc.) Extra energy required to go out in public rather than be confined to patient bedroom. Of course there are the positive aspects for patient to interact socially with others and with their environment. There could be changes in your work schedule hours that interfere with your routine. Try to store some of the patient required supplies (diapers, wipes, containers of tube feeding, etc.) at the school to lessen your daily load as the pack mule. Try to develop a positive relationship with school personnel. If you help them, they will usually help you.

Nursee1234 · Aug 1, 2019

Thank you. Those are exactly the things I have had going through my head. Pros and cons to any situation. I think what is stressing me most is mom. She is decidedly high strung and does things her own way. We manage fairly well at home. Some days are better than others. I just don't see her having a realistic view of this situation. Three hours a day of school is NOT going to free her world for her to get a job outside the home and go to school. Especially with the 5 year old sibling starting kindergarten. She originally thought she could just give me a key, put corificeat in my car at morning drop off at school and I would drive pt home and carry on with the shift. When informed that my agency policy does not allow for transport of patients (and something I would not want/take liability for personally) she reconsidered the school bus. I really don't want the school bus scenario for myself. Sorry I'm rambling. The mom waited until yesterday to pick up the paperwork from the school district and is not communicating anything with agency staff. So frustrating. I called the info into staffing coordinator before my shift today so I will just wait and see how it plays out. I just felt really ambushed by mom wanting me to commit on the spot without any concrete details about shift times and travel logistics etc .We shall see...

caliotter3 · Aug 3, 2019

I would not want to be in a situation where the mom is making arrangements outside of the agency, and your, knowledge, and then planning to spring these changes on you. Go to the home as usual. When the agency tells you otherwise, iron it out then. Until then, tell the mother that you will receive your instructions from the agency because the agency has to ok anything and insure that any necessary changes are made to the care plan. Should this start looking like more and more (and it gives a hint of this already) "change-ups" on the part of the mother, it might be wise to seriously consider a new case. You know now what you are willing and not willing to do. Don't leave it to the mother and the agency to dictate to you things that you don't want to do.

Christel Moss · Aug 4, 2019

I have been doing home health for about 10 years. I've only been to school twice one horrible experience one uneventful experience. The worse: family moved into a new subdivision that was forced to open up a special ed class upon assistance by mom. They stated there wasnt a need in the neighborhood. the class quickly filled. One year later the parents all commented on how much progress their kiddos made because with the presence of a nurse the teachers were forced to get off their phones and apply splint rom exercises..... when I took on the case they tried to stop me from using my computer. I dont follow their rules so i ignored that. Then they felt I was watching them.... small room hard to not look around so they moved me out of the class and made me sit outside. The window on the door was not at chair height so I had to stand and watch him. They said they would call me if he was having seizures. This lasted a day because when quizzed on how the seizure would present noone had a clue. Also when class was done they made the poor child wait until the whole class was dismissed and buses were gone because mom picking him up disrupted the busline. The worse was when another child was having a seizure and I rendered aid. This in their eyes was a HIPAA violation. Noone else knew what to do amd I knew i had a legal and moral obligation to help. it all ended in a big school board meeting and thats when i said peace out too much.....

Nursee1234 · Aug 4, 2019

Wow! Awful. Did they report that as a HIPAA violation?

Kitiger, RN · Aug 5, 2019

I have always enjoyed going to school with my kiddos. All had trachs; several were on vents. All but one were in wheelchairs.

All the vent kids were in wheelchairs, so I just loaded up the wheelchair with all the equipment (Go-Bag, suction machine, oximeter, vent, etc.) and off we went.

I was responsible for the seatbelt, and for the chest restraint (if needed). I rode the bus with the child, as I was also responsible for any medical needs the child might have. The bus aides were responsible for loading the wheelchair & securing it, and seeing that the seatbelt & chest restraint were on. They also unloaded the bus, and I took over outside the bus.

In the classroom, my first priority was the child's safety, and seeing that she got all of her routine treatments. The teacher ran the classroom, and I helped with "my" kiddo; I didn't do anything with the other kids in the classroom. Sometimes, I was just nearby, ready to intervene if needed. Usually, that would be for trach suctioning, etc.. Sometimes - especially in a special-ed type of classroom - the teacher would have me do hands-on activities with my kiddo, things like range of motion, sensory activities, working with standers, or maybe using a Little Room. I found it interesting, and I learned a lot.

You do need to have your agency involved, and school should be included in the care plan.

Nursee1234 · Aug 6, 2019

Thank you all so much. Yes. My agency is involved and doing their thing with school district and nurse supervisor. I have basically told the family that I will not ride the bus but will walk through the process with them to see if it is a good fit or not, logistically and schedule wise for me. On that note, let family and agency know that a back up nurse oriented to this patient is well overdue. Mom requires meet and greet and for a month now has not had a nurse if I am not on duty. It will all unfold as it will. Kudos to traveling with all the baggage with vent patients. I am only 5 feet 1 inch and a 105 pounds and find that daunting!

caliotter3 · Aug 6, 2019

One is always concerned that they will accidentally leave something behind somewhere. One of the worries of the nurse pack mule.

NurseCelia · Aug 12, 2019

I go to school with my pt and I love it because the teacher and the aids are great people to be around. If they were unpleasant I still would like it better because my pts mom is quite unpleasant I’m always trying to get her to leave so she can leave me alone while we are at home. As long as your agency approves and you are willing to do the extra, my patient lives about 15 minutes from her school and I still go home with her after school. The only con is that she is in a class with other special needs kids and the bathroom is constantly occupied and some of the other kids can be alarmingly noisy and annoying but at the end of the day I am the nurse and she is my patient and I don’t butt into classroom affairs I’m just a visitor

Notmyscreenname, RN · Nov 14, 2019

Does anyone know what to do when the Teacher's are super nice to your face, and you have a feeling (an a strong one) that these teacher's (main and aid) are spreading exaggerations to your pt's parents?

Example: Pt wants to tell me she isn't feeling well. Teachers say I'm keeping the patient from the class.

Notmyscreenname, RN · Nov 14, 2019

On 8/12/2019 at 6:37 PM, NurseCelia said:
I go to school with my pt and I love it because the teacher and the aids are great people to be around. If they were unpleasant I still would like it better because my pts mom is quite unpleasant I’m always trying to get her to leave so she can leave me alone while we are at home. As long as your agency approves and you are willing to do the extra, my patient lives about 15 minutes from her school and I still go home with her after school. The only con is that she is in a class with other special needs kids and the bathroom is constantly occupied and some of the other kids can be alarmingly noisy and annoying but at the end of the day I am the nurse and she is my patient and I don’t butt into classroom affairs I’m just a visitor

Question: What if the teacher asks you to help with something? Like playing (Insert Game Here) with groups of children. Then you find out its actually measuring if they can do a certain task or not. I'm not a teacher, I am a nurse. I always try to make my immediate surroundings 100% comfortable (like getting along with the other adults) however I truly think these 'women' (more like children!) are setting me up for failure... What's your take?