Non-Nurses calling themselves a Nurse

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The school district my child goes to has a CNA in the school clinic, who refers to herself as "The school Nurse". I thought she was either an LVN or RN until last week when she had me come pick up my child from school. She had a little nausea but, she said she needed to stay out for two days due to a small rash on her face that she diagnosed as "Wingworm"! She told me to get an over-the-counter anti-fungal and treat for two days when she would be allowed to return to school! (I think that is practicing medicine w/o a license?!) I asked did she mean ringworm-she said no, wingworm...so, I had her write that down on the standard form they use when children are sent hm. Maybe the school board is exempt from following the law?!

Well, I took her to our family Doctor who said, she doesn't have ringworm-it's impetigo and prescribed bactriban.

My beef is that the teachers even refer to her as the school nurse-I wonder if

they even know the difference between an LVN or RN and a CNA? I sent a letter to the Assistant Superintendant for the district but, have not heard a reply. I think I am no different than most of you who have worked hard for your RN or LVN license and earn the respect of being called a "Nurse". I was a CNA before I was an LPN and have now been an RN over 20 yrs. As a CNA, I knew my place and my limits of practice. Any other parent or Nurse concerned about this?:nono:

It is against the law in Texas for anyone to falsely present themselves as a nurse, PERIOD. The District Atty for your area has the right to prosecute. The school district does know better but is trying to get by without paying a nurse. I would contact the school board and the BNE both. As a nurse you have the responsibility to protect your license and your profession. What would you do if someone said they were a doctor but had no license?

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Specializes in ICU, PACU, Cath Lab.

I had been reading this thread with interest the last couple days...as this is my ds first year in school and I had never even thought about his "nurse" not really being a nurse....Then I go and pick him up today and another mother, who volunteers in our kids room, says to me..."You know "A"...I say sure...well she had a seizure in class today...they called her mom and had her come pick her up!! WAIT...WHAT!!!! She has a new onset seizure..no history...and they did not call 911...seriously!! If that girl had seized on the way to the hospital in her mom's car...ohhhh I cannot imagine!!! So I also get a note today from the "Nurse"...or Health Associate...whatever that is...I have to do some e-mailing and find out the credentials of this person that is making health decisions for my child while he is at school!!!!

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Not quite the same thing, as I'd imagine that the formal policy is that the aide or secretary would have had some kind of instruction in administering a routine medication to a child with a stable, chronic condition. One could argue that parents aren't qualified to give their children such routine meds, either. Or that a responsible, capable child would need a licensed professional to administer their routine meds for them. I'm not saying that it's okay to not provide licensed personnel in the school. I'm only saying that it's not the same as housekeeping personnel happening into a hospital room and administering a medication.

I do agree that school districts should provide for licensed school nurses.

I think you are assuming that the secretary, etc., does have training. Or the reverse, that the housekeeper doesn't have training. As for the statement about parents not being qualified to give their own children medications...unfortunately might be true in some cases. My point is, people all want their children to be in a safe environment in school. There may be a delegated person at a school who has had some training in medication administration, but thier knowledge of the pathophysiology of a chronic illness is, most likely, nil. Their knowledge of drug interactions, half life, side effects, etc., is also compromised. Our districts are asking people who are not nurses, and never intended to be nurses, to take a huge liability into their hands when administering medications without a license. Parents are taking a big risk by assuming that the person giving the medication is a nurse. The liability issue is huge. And it only takes one student to prove a point. Take Utah as an example. The legislature in Utah just approved $1million dollars for school districts to hire additional school nurses. While this isn't nearly enough $ to meet the needs of the students, it's much better than the current ratio of one school nurse for (sometimes) 8 to 10 thousand kids. School nurses in Utah have been advocating for this increase for a number of years. Guess what happened? One student in one school in one town used her inhaler repeatedly (after being set in the hallway by a delegated non-licensed person) because she was young, scared and couldn't breathe. She eventually passed out and ended up in the hospital. Her mother was very, very vocal and instrumental in getting legislators and school districts to listen and pay attention. If that child had died...the cost of the liability to the school district would have paid that $1 million many times over.

Sorry, stepping down from my soapbox.....

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Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.
I had been reading this thread with interest the last couple days...as this is my ds first year in school and I had never even thought about his "nurse" not really being a nurse....Then I go and pick him up today and another mother, who volunteers in our kids room, says to me..."You know "A"...I say sure...well she had a seizure in class today...they called her mom and had her come pick her up!! WAIT...WHAT!!!! She has a new onset seizure..no history...and they did not call 911...seriously!! If that girl had seized on the way to the hospital in her mom's car...ohhhh I cannot imagine!!! So I also get a note today from the "Nurse"...or Health Associate...whatever that is...I have to do some e-mailing and find out the credentials of this person that is making health decisions for my child while he is at school!!!!

If this was the first seizure this little girl had, then you are right and 911 should have been called. But if the child has a diagnosis of seizure activity, such as epilepsy and the like, there is no reason to call 911 every time someone has a seizure. Unless of course they sustain an injury during the seizure. If they are prone to seizures, all you can do is make sure there isn't a lot of stuff around them that they can hit, just make room for them. I know that sounds scary if you are not used to it, but there is really nothing 911 can do for a seizure. I had a neighbor once who's teenage daughter had seizures and she called 911 every single time. I suggested following her physicians advice and actually taking the depakote he prescribed and actually going to get the levels drawn at the appropriate intervals. But i'm not a school nurse and they may have rules that say 911 must be called, I don't really know. That is a good question though.

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Specializes in Geriatrics, Cardiac, ICU.
Not quite the same thing, as I'd imagine that the formal policy is that the aide or secretary would have had some kind of instruction in administering a routine medication to a child with a stable, chronic condition. One could argue that parents aren't qualified to give their children such routine meds, either. Or that a responsible, capable child would need a licensed professional to administer their routine meds for them. I'm not saying that it's okay to not provide licensed personnel in the school. I'm only saying that it's not the same as housekeeping personnel happening into a hospital room and administering a medication.

I do agree that school districts should provide for licensed school nurses.

I was waiting for someone to make this point.

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Specializes in CNA, RN Student.

I have a friend that applied to the school district where I live to be a school nurse as an RN and was turned down. The school district only employed BSN's as school nurses. Initially I felt bad for her as this was something she always wanted to do and then, thinking of my own children, I thought that that was a good call on the school district, especially considering that they are the only medical staff on site and the first line of action should something go wrong at the school, which unfortunately wrong things happen at school time and time again. I, having done CNA training cannot understand how someone with minimal medical training can be responsible for children? How is a CNA authorized to diagnose a problem. And, there is no "wingworm" section in the CNA program, let alone in my RN studies so far. As a fellow parent I agree that action must be taken. Perhaps this is something the media should know about as well? I am so sorry you had to deal with this.

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Specializes in ICU, PACU, Cath Lab.
If this was the first seizure this little girl had, then you are right and 911 should have been called. But if the child has a diagnosis of seizure activity, such as epilepsy and the like, there is no reason to call 911 every time someone has a seizure. Unless of course they sustain an injury during the seizure. If they are prone to seizures, all you can do is make sure there isn't a lot of stuff around them that they can hit, just make room for them. I know that sounds scary if you are not used to it, but there is really nothing 911 can do for a seizure. I had a neighbor once who's teenage daughter had seizures and she called 911 every single time. I suggested following her physicians advice and actually taking the depakote he prescribed and actually going to get the levels drawn at the appropriate intervals. But i'm not a school nurse and they may have rules that say 911 must be called, I don't really know. That is a good question though.

I agree...but this was her first seizure...had no history still have no idea what caused it...they say she was dx with Strep Throat....yes I would agree if she was an epileptic and had a hx then it may have been appropriate to call mom...in this case not so much...IMO. If my kid has a siezure at school...and they called me I would say call 911 and I will meet them at the hospital...but that is just me!

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OMG, this is scary.

On another note, might the state medical board be interested in this one? Some medical boards have been upset about NP's making dx, I wonder how they would feel about an NA Dxing a person?

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Specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.
I agree...but this was her first seizure...had no history still have no idea what caused it...they say she was dx with Strep Throat....yes I would agree if she was an epileptic and had a hx then it may have been appropriate to call mom...in this case not so much...IMO. If my kid has a siezure at school...and they called me I would say call 911 and I will meet them at the hospital...but that is just me!

I agree 100%. If this child had never had a seizure before, or even if the school wasn't aware of any previous seizure activity, I would be calling 911 pretty darn fast and I would hope they would if it was one of my children. ;)

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Specializes in Postpartum, Antepartum, GYN surgical.

I was visiting a small town in Colorado. My boyfriend and I went to a local bar and was talking with the bartender. We were busy talking about the town and then started discussing medical facilities in the area. She proceeded to tell me she was a Nurse and was making really good money. I replied with more questions about the pay and such and informed her I was also an RN. She got quiet and said "well, actually I am a CNA for home care." Wow.. that is a huge difference to me! I felt kinda upset at first because I had worked really hard to get through school and earn my RN status. It made things a little uncomfortable for a bit, but the conversation continued.

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I was visiting a small town in Colorado. My boyfriend and I went to a local bar and was talking with the bartender. We were busy talking about the town and then started discussing medical facilities in the area. She proceeded to tell me she was a Nurse and was making really good money. I replied with more questions about the pay and such and informed her I was also an RN. She got quiet and said "well, actually I am a CNA for home care." Wow.. that is a huge difference to me! I felt kinda upset at first because I had worked really hard to get through school and earn my RN status. It made things a little uncomfortable for a bit, but the conversation continued.

It's unfortunately all too common. I'm not sure I even like the term "CNA"; the public hears "nurse's aide" and thinks they actually "aide" us in doing all our same work, just like an assistant, or that they are nurses in training. And the reality is, they don't, and aren't (as a job description, that is). A great CNA is like gold, but the public confuses them with who is doing their assessments, who is checking their orders, who is administering their meds and hanging their IVs, doing transfusions.

So when someone like this bartender states to everyone in earshot that she's a nurse and then supposedly "comes clean" by saying she's a CNA, it doesn't clarify it for anyone BUT a nurse. To them, she's "almost a nurse" or just like a nurse anyway because she's been doing it for a long time and she's their first assistant....right?

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Specializes in Case Managemnt, Utilization Review.

In the area where I live, there is an undercover investigator that runs a weekly series on TV called "What's buggin' you". 2 points clear, your child had a rash tht is contagious and should have been home until you followed up with the doctor regardless of who told you, an /LPN/NA/RN, you followed up with a physician, as any prudent parent would. But as a former school board member, of a small district in NJ for 7 years, I have an issue with this person running the school clinic, as some others have said, practicing medicine without a lisence. This is a set up for a lawsuit. I would not leave this alone. You are an advocate for your child and all his/her friends and classmates. Let everyone know at the PTA meeting about your experience. Make sure to go to the Board of Education meeting, to let the Board be aware of this unethical practiceby this school. Research the laws in you state. If you can't find the info you seek, call the Department of Education in your state. I work in a state(NJ) where the minimum requirement for school nurse is a post baccalaureate certificate, if an LPN?RN work, they must be on the same campus as the certified school nurse. Also, I would call the state board of Nursing, find out who "Certifies" the CNA's standing for certified nursing assistant, and find outt if this type of work is out of their scope of practice. I would bet it is.

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