Private duty nursing and going to school with patient

[Alyk3309]

Is it a nurses responsibility to be responsible for behavioral intervention for their patient at school or is it the schools responsibility?  For example, if the patient was told to do something by their teacher and refuses and then starts breaking down and having a tantrum because they don't want to do their work (even though they are capable of doing so) is it the nurses responsibility to calm the child down or is it the behavioral team at school/ teachers? 

[FolksBtrippin, BSN, RN]

Great question.

I think there needs to be a behavioral plan for the student, and the plan needs to define who is responsible and what kind of intervention will happen. The nurse should be part of the planning. 

[k1p1ssk, BSN, RN]

I agree with the above - it also depends on whether or not the nurse is employed by the school/district or an agency/the family. If the former, the nurse can certainly be asked to intervene as part of a plan. If the latter, I don't think it's appropriate for the nurse to intervene as the district has likely not trained that nurse in their specific de-escalation/restraint techniques and the nurse isn't necessarily going to be versed in other school policies/procedures - they're there as a *nurse* not a behaviorist, and essentially could be considered a shadow/extension of the student. It could open up the nurse to be liable for any injuries/lost class time sustained during de-escalation. The student should be treated as any other student in these instances.

The lines certainly do get blurred however, as the school staff gets comfortable with the nurse, and as the nurse and student become more familiar with one another as well as the family... As hard as it can be, making the boundaries ultra clear as early on as possible is best.