PDN role at school

Specialties Private Duty

Published

When you go to school with a child as his PDN, what do you do there? I am asking in terms of early elementary level, and I already can see that every district is different. That said......

What do the teachers and aids do for/with the child?

Do you find that the boundaries blur, and does that cause problems? if so, do you speak to the teacher? Principal? Parent?

Specializes in Peds, developmental disability.

Being at school I end up doing 3 times as much lifting as I do't at home. They don't act like they want to handle her. And for various reasons I am driving her to school. So I load corificeat, stroller and bucking preschooler in and out twice.

PDN and nursing are getting too hard. And yes, that is pain talking.

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Specializes in Peds, developmental disability.

Being at school I end up doing 3 times as much lifting as I do't at home. They don't act like they want to handle her. And for various reasons I am driving her to school. So I load corificeat, stroller and bucking preschooler in and out twice.

PDN and nursing are getting too hard. And yes, that is pain talking.

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Specializes in Peds(PICU, NICU float), PDN, ICU.
Being at school I end up doing 3 times as much lifting as I do't at home. They don't act like they want to handle her. And for various reasons I am driving her to school. So I load corificeat, stroller and bucking preschooler in and out twice.

PDN and nursing are getting too hard. And yes, that is pain talking.

It's against medicare/medicaid rules to drive a pt now. They say it's fraud because you can't do nursing and drive at the same time. You may want to check to make sure you are not committing fraud. We used to be allowed to drive patients about 5 years ago and prior.

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Specializes in Pediatric Private Duty; Camp Nursing.

Fraud? I don't think that's really the best way they can describe it, there's no ill intent here to cheat. It's not exactly "abandonment" either but that's closer. You can't watch a pt when you're watching the road.

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Specializes in Complex pedi to LTC/SA & now a manager.

Usually the school district is paying for nursing. In most states transportation provided by school district for preschool & kindergarten if distance is =>1mile as per IDEA. School districts are slow to follow but how can you monitor a child secured in the back seat while driving ?

ETA I asked my professional liability carrier & my auto insurance both explicitly stated I would NOT be covered if something happened while driving a client whether auto accident or medical issue. Something to think about.

I was asked to take a steady shift to drive a teen (not seizure but other medical needs) once a week to therapy & accompany to therapy in my car. Sad part is this particular child is covered by the state program that offers transport at no charge for patient & escort (whether parent, caregiver, nurse etc) to physician & therapy appointments even to respite recreation. Apparently mom doesn't like the vendor so asked for nursing to use private vehicle. It's been months and those that took the shift gave it up quickly.

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I'd be nervous about using your own vehicle for transporting a child. What does your auto insurance policy say about using your vehicle to do your job?

In my school district, anyone in special ed is eligible for bus service. There is a little boy that, no exaggeration, is in the house across the street from school and the bus picks him up so his mom doesn't have to push his wheelchair across the street (which is not a busy street at all and has a ton of crossing guards in the mornings and afternoons).

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Specializes in Peds(PICU, NICU float), PDN, ICU.
Fraud? I don't think that's really the best way they can describe it there's no ill intent here to cheat. It's not exactly "abandonment" either but that's closer. You can't watch a pt when you're watching the road.[/quote']

That's what medicare/medicaid says...that it's fraud. Because you can't provide the service that they are paying for if you are driving the patient. The agency and parents can't override that. It's the law. Intent doesn't matter. You could accidentally harm a patient in practice and end up in court over it. The court won't care when you say "but I meant well". Ignorance doesn't protect you from being held accountable by the law. (the word you isn't personal, it's in general)

Plus as the others said, your personal insurance may not cover you. When I was using my car when I worked for a DME company, I had to get extra insurance on my car just for business use and to cover the value of the equipment. That was simply equipment and not even a human life.

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Specializes in Peds, developmental disability.
Fraud? I don't think that's really the best way they can describe it, there's no ill intent here to cheat. It's not exactly "abandonment" either but that's closer. You can't watch a pt when you're watching the road.

Actually, I do watch my patient. It is not hard with the rear view mirror in the small care I drive. If need be I can quickly pull over and get back there in this small town setting. She is quite stable, with no history of respiratory issues, no secretions to deal with, etc. The trip is brief, and I can care for her much better than on a 90 minute bus ride, that will not stop unless we need 911. Without a nurse she cannot have the many benefits of school.

Thanks for all your comments, but the risks of driving are much outweighed by the benefits. I just need ideas for transferring, I guess. Got a lot of that from the rwcent thread on transferring the 17 year old.

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Specializes in Pediatric.

It's against medicare/medicaid rules to drive a pt now. They say it's fraud because you can't do nursing and drive at the same time. You may want to check to make sure you are not committing fraud. We used to be allowed to drive patients about 5 years ago and prior.

Very interesting...this won't come up as an option for me, since I live in SF and choose to not drive. (Don't need to.) One of my previous cases here, the day nurse drove the patient to and from school. At times she could be quite fragile. I wonder if the agency even knew. I'd wager that they didn't. I personally wouldn't feel comfortable. Can you imagine getting into a car accident and there being a fatality?!

Sent from my iPhone using allnurses.com

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I've always wondered this. Going to school with one child had

the teachers at one school didn't like the fact that I didn't help with teaching the child,and also many didn't like to help me change him.

He was 15,about 100 pounds,in a wheelchair,in a coma like state(he only had aw/as cycles,unresponsive,etc).

Oh yeah,he had a Vent,trach,GB,and a Picc line.

I don't think anyone knew what to do with him,because lots of them ignored him.

But anyways,I thought we were only supposed to do medical things?

Also,this same school,I had to eat lunch sitting next to the pt. The nurses who were employees of the school claimed they knew nothing about vents,and therefore,couldn't watch him for at least 30 min. They would come in if I needed a bathroom break.

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Specializes in Complex pedi to LTC/SA & now a manager.

I've been to school with quite a few students. Always expected to eat in the classroom near the child. Always responsible for changes. All but one tiny preschooler are two person lifts so the classroom staff does (and is expected by school policy) to help with lifts and transfers including w/c to gait trainer, activity chair and/ or changing table. The school nurses will only relieve for bathroom breaks. I am there for medical needs and to assist with positioning. Such as one low tone child learns best straddling a bench seat but requires a lot of support. I sit behind the child for support & positioning. The teacher/para completes the class activity whether hand over hand or various prompts/assistance.

The one class has had nurses removed for grossly overstepping their bounds (trying to teach the child, not wearing scrubs (well the class & therapy staff don't did not fly well as all nurses PDN or staff do), not following school medication policy, phone in class, interfering with class work... )

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Specializes in LTC, Memory loss, PDN.

holy cow

reading all the responses makes me

extremely thankful for my state laws

and the the schools i have worked with

all the teachers i've worked with are

very accommodating and helpful

transporting a pt. is a huge offense

in my state so nobody thinks about asking

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