LPN restrictions in school setting

tining, BSN, RN · Apr 12, 2021

At a school? This is for school nurses.

cowboysandangels, BSN · Apr 13, 2021

15 hours ago, tining said:

At a school? This is for school nurses.

I have had it prescribed a few times for us to keep at school in case of emergency for a couple of children. I, thankfully, have never had to administer it though. We only employ RNs so I have no idea about delegating that to an LPN.

NutmeggeRN, BSN · Apr 13, 2021

16 hours ago, tining said:

At a school? This is for school nurses.

It could be given to a student in adrenal crisis (severe illness or injury with a diagnosis of adrenal insufficiency) Addisons Disease

Flare, ASN, BSN · Apr 13, 2021

So... this one's a bit of a mess, in my humble opinion. Back in 2019 there was a law passed: https://www.njleg.state.nj.us/2018/Bills/PL19/118_.PDF

allowing the self administration of hydrocortisone sodium succinate with appropriate Dr's order. Slid into the end of the law is a section permitting delegation. The law ALSO calls for the NJ DOE to establish training. So, while schools are expected to delegate this, I have yet to find any appreciable training offerings from the state nor any sort of training device that would encourage a comfort level with using an act-o-vial to give solucortef. I am sure they exist, but I don't see School health prominently featuring them. And a check of the DOE site finds resources for delegating epi, adminning narcan, asthma action plans... etc, but nothing as far as I can see for solucortef. https://www.state.nj.us/education/students/safety/health/services/ - maybe one of my eagle-eyed e-colleagues will see something I'm missing here...

So... can an LPN give solucortef in NJ? I'd say it depends largely on the context of how and when it's being given. Is this for an LPN providing 1:1 care to a student? I am not positive that a school can legally have an lpn, even as a contracted 1:1. They might be able to - but as far as I know you need at minimum of RN to work in a school (for a school). Agency rules may differ. I would imagine that it possibly could be delegated to that person. At this point, I am dissatisfied with the training process and not comfortable delegating anything until something is put in place. I suppose I'd be OK with a bonafide self administer as long as it's signed off by the parent and Dr.

palli · Apr 13, 2021

Hi Flare,

This is everything I read as well, and just couldn't decipher exactly what they were allowing. It's like they say no, but kind of yes, but really wouldn't but might be able to.

Thank you for reaching out.

Yes, Tining in a school setting.

raebabelvn, LVN · Apr 15, 2021

I think it would all depend on your scope of practice as well as your schools policy and procedures guidelines. I'm in Ca, and here as long as it's an order from the doctor, I would be able to give it. The district RN's would probably review IM injections with me and I'd be good to go.