How high tech should we go?

[Hilundlass]

I realize that some schools have one nurse per school, and some have one nurse per district. BUT>>> How high tech should the public school health room be and who sets the limits? The nurse? The District? The Parents??

Many of you are seeing insulin pumps, vagal nerve stimulators for seizures , g-tube med administration, external defibrillators, and cardiac event monitoring. What other things do you see that you didnt see a few years ago? IV medications?

When the parents start bringing in their own equipment for use at school, who's decision is it to determine when the level of care exceeds the normal standards? Doesnt this make finding a competent substitute nurse even more difficult? PS>>I'm a nurse sub in our district, and am always learning new things at each school.

[bergren]

I had two kids on ventilators in my last school. You go as high tech as the care demands because the children are protected by federal law - IDEIA - to be educated in the least restricted environment. See 1999 Supreme court ruling Garret vs. Cedar Rapids School District. http://www.law.cornell.edu/supct/html/96-1793.ZO.html

The final paragraph (read the dissent also):

" This case is about whether meaningful access to the public schools will be assured, not the level of education that a school must finance once access is attained. It is undisputed that the services at issue must be provided if Garret is to remain in school. Under the statute, our precedent, and the purposes of the IDEA, the District must fund such "related services" in order to help guarantee that students like Garret are integrated into the public schools."

[Hilundlass]

Thanks so much for your specific information on this question. As a sub school nurse I encounter many different opinions on what each nurse deems acceptable for routine procedures and what is "parent's responsibility". For example, I accepted a cardiac event monitor in one nurse's absence for short term use for one student, and that nurse did not think it her responsibility to transmit the events by phone. Another nurse at a high school will not accept prescription pain meds (Lortab, etc) for dispensing, and insists if the child requires it, they should be at home on medical absence. Since I keep hearing that the district leaves many things up to the nurses' judgement, I'm sure you can see how I became confused. I imagine the needs and demands of the health room staff change with each year and each set of students. Thanks again for the info.

[jen42]

Oh, now, I think that high school nurse is being unfair. There are kids with ankylosing spondylitis (sp?), nerve disorders, and recovering from cancer that need prescription pain meds. They also should attend school if they can. That shouldn't be the only thing keeping them out, especially if the pain med works well and doesn't make them fall asleep and out of their chairs.

[Keepstanding, ASN, RN]

I do not have a problem with "whatever" comes into our school as long as I have full knowledge of just what is needed and I am on the same page as the phy, parents, etc. I often encounter parents who don't quite fill me in on all of the info about their sick child. That really gets to me because I want to be able to provide good care for that kid, but am undermined by a parent who won't be up front with us. I actually see this a lot..

But I love being able to facilitate a child coming to school just like all of the other kids. I try to develop a good rapor with the parent and student so that we can work well for this child.