Policy for students in a minor school bus accident

[edgwow]

My school does not have a written policy about who evaluates the children when they are involved in a minor fender bender accident on the school bus in route to the school. If there was ever a question, the bus company calls 911 and the ems crew checks them out. I Have a problem with this because they release the children, who obviously can not give consent or denial of treatment. Many times, there is a minor accident and I am responsible for calling these parents. Doing an evaluation of the children and make referals to either be seen by the ER or have the child's family physician evaluate them. This is not in my scope of practice, I am not a trained ems person, I am an RN in a special needs school. I am the 2nd nurse and not responsible for major policy decisions. Do states have policies on this? I live in NJ. I do not feel that I want the responsibility that if there were injuries not recogniized by me, harm could be brought on the child later.Please let me know both what you do in your school and if you are aware of laws and where I could find them. Thanks Betty

[michigooseBSN]

I'm not sure about laws but I'm sure about my professional responsibility.

If the MVA is minor and the child is brought to me upon reaching school, I do feel that it is within my scope of practice to treat and triage the child. I call the parents in to evaluate the child with me if I think it is OK for him/her to remain in school for the day (This actually happened last week where a child got a small cut and a hematoma on the forehead from a tossed seatbelt buckle). Otherewise, I have the parents come in to pick up the child and take him/her to their PCP or to the ER. Of course, 911 is used if the issue is serious. I feel that using my professional expertise and personal judgement is part of my job and is certainly my responsibility. That is why I carry professional Liability Insurance. It is not expensive and provides a certain amount of peace of mind.

[Jeanine]

It's up to the district to make a bus accident policy.

If the accident is on the way to school, I just call the entire bus down to my office, and there is usually a police officer there with me Everyone gives me their names and gives the officer their location on the bus. If they don't have an injury, I write "student denies injury" on the report, as does the officer. I make a call home and leave a message to that effect. If there is an injury, I assess it, take appropriate action, the officer includes that in the report, and the parents are notified. If the accident is in the field, an administrator takes a copy of the emergency contacts to the scene, ems is called, and they do their thing. If it's on the way home, and is minor, the kids report to me the next morning and transprotation notifies the parents.

The bus driver must always fill out your Worker's Comp Accident Form (even if they deny injury) and the State of New Jersey Employer's First Report of Accidental Injury or Occupational Illness as well.

I'm sure that it's more difficult for you because you are in a special needs school. Check your policy manual, I bet that the Transportation Dept. has a policy that nursing can use as a baseline to make a policy that is specific for Nursing.