crich

The site to get this info is http://www.legislature.state.tn.us/ Scroll down and click on "text" found in the middle of the page. You can get all kind of info. That is bill # sb0878 to go to general welfare committee soon. Let me know if you need more detailed help with this site.

Dear iwrbr I am sorry to anger you so. I do not take your talents or your service to our country lightly. I very much appreciate it. The initial question I asked on this, which I did not see when I clicked on this time was to ask for comparison to the current RN training. I don't know whether you saw them, but I did get some Navy RN responses, and a corpsman response who basically praised the work of those positions, but said they did a lot of the "functions" that an RN does. LPNs also do a lot of these functions, but RNs are trained to do more than the functions. It is easier to think someone is working hard if you see them physically doing some kind of procedure than if they are sitting at a desk evaluating the lab tests that come back on a patient, symptoms that a patient is having and determining whether these are due to their illness, meds, or out of wack lab work. The doctors expect us to know this. For example, if I have a patient with a low potassium, I have to decide is it critical enough to call the doctor then or can it wait several hours for the doctor to come in. Another example, I am an OB nurse and have a questionable pattern on the fetal monitor, and have done all my treatments to correct the oxygenation of the fetus. The pattern still is the same. I call my doctor and tell him/her about the pattern and to please come to evaluate the pattern. They say they'll be in, in a few hours. I ask them to please come now. Do I just do as they say or do I go above them and call the medical director? These are just 2 of the multitude of situations that come up. Again, you are right, I don't know what all you do. That is why I put the question on this site. To hear from the people that work in your situations. Perhaps you do have the education and training to do this. But are you sure that "most" of the people listed in the proposed legislation get this education and training? I bet there are some of you who have some wonderful RNs that not only teach you the procedures, but why sterile technique is so important, s & Sx to watch for and how other body systems are affected by that procedure, etc., but there are those of us that don't do that. I started out as a nurses aid over 20 years ago. I was taught sterile technique by another nursing assistant. She taught me correctly. She was taught by the RN in charge many years before. When I started Nursing school, some of it was much easier for me than others, because I had that experience. I do believe that you should get credit in the schools for your particular experience. There are already programs for LPNs who want to enter RN programs to do this and it could be the same for our armed service medical personnel. The LPNs do not start in the programs at the same place as someone who has no experience.

Hi foxyhill 21 In TN there is a program called Comprehensive School Health. There were 10 pilot systems that wrote and received grants. One of them is the county system in which I live. Unfortunately the city system that I work in did not receive this benefit. One of the schools in that system is located about 20 miles out. The school health manager used some of this money to set up a clinic for students and staff. This was staffed with a nurse and NP. Salaray was paid from this grant. During the time of the grant, the manager worked with local MDs and HMOs to get a number to file for payment by TN care. This is similar to medicaid in other states. They did get this number approved for the school system and the NP and nurse is funded by the system via small payments from families and TN care. They are self-sufficient and the NP goes to different schools on different days. It is a God send for many of these students who would otherwise not get healthcare when needed, because their parents can't afford it. I wish my system had this. So there are possible options out there. Some systems may pay straight out. Have a great week.

Hi foxyhill, In TN the official title School Nurse goes to RNs, but LPNs are hired as nurses in our systems and do a wonderful job. Their care must be directed by a RN or physician. That is the law, however they do have a lot of autonomy. By NP are you referring to a practical nurse or Nurse Practicioner? I assume LPN. What state are you in? In TN, salary varies a lot. Of course our cost of living is lower than some other states. I was hired as the only school nurse in my system. If you are the only l, you have to be RN, unless your system has a contract with someone like the health dept. Then as an LPN you would work under their guidelines. My school system wanted a nurse with a bachelors degree, because I make the same as the teachers scale. They begin about 29 k with no experience. Of course this is only for 7 hr, 200 days of work. But I also have a health report that I have to do after school is out to turn into the state. When I took dollar for hours worked, I found that my salary is pretty comparable to hospital salaries. Not prn pay of course. But understand that not all school nurse RNs are hired on teacher's salary and may make less in TN. This year they added another position for an LPN, due to increase in number of procedures. Are you currently in LPN or RN school, or are you out of school?

Hi bergren, Thanks for clarification. Yes it is federal law, but my understanding per our lawyer at school nurse meetings is that a 504 plan is not REQUIRED, if there is no perception of descrimination on either side. We have no state law that trumps this in TN. Yet a parent or school staff may in some circumstances need 504 plan in order to get the others to comply.

In TN, you are not required by law to have a 504 plan. I have no 504 plans in my system, but I do have IHP (individual health plans). These are a little different than care plans, because they relate to how things will be handled at school only. I work very closely with my parents that have children with 504 type of illnesses. At the first of the year, I review all the student health histories that are returned, and send IHP specific to that child, home for parents to have input and take to MD. I don't get that many returned, but I call the parents of the ones I am concerned about, and also call parents of any students that I have incidents with, such as asthma, etc. My first year, I had a parent tell me that she only had a 504 plan, because the prior nurse and school was not cooperating with her. Her child has CF. At the first of each year, she and I just meet with the principal to see that everything will be taken care of, then I notify any involved teachers. This is a need to know situation. Same with other 504 type students.

I am in Tennessee. We have some basic IHPs for diabetes, asthma, heart, allergic reaction and a few others, that can be individualized with md and parent input. Your situation sounds ridiculous. One thing that you may want to do is get a copy of your school health laws. i'm sure someone at your school has them. Check with your Superintendent and if that is a problem because of your boss, call your Al. School Nurse Association or maybe State of Alabama health office. They can probably get you a copy. If you have laws that back up you and your student's needs, then if you make a formal request in writing, with the laws to back you up. This will make your boss liable and may make him and the Superindent (send him a cc of request) think again.

Thanks for the replys regarding the new legislation in TN. I may send some of these replies to our congressmen. Excuse my ignorance, but what does ncp stand for. crich

ATTENTION TN NURSES Did you know that there is a bill in our state congress, that if passed would allow a person who has served in the armed forces as a medical specialist advanced, medical service technician or advanced hospital corpsman tech. to be licensed as a registered nurse without course study, a diploma or degree from an approved school of nursing?? If passed, these "nurses" would be responsible for your family's care. This is house bill HB850. It is in subcommittee and will be voted on tomorrow morning. If you are opposed and would like to notify your congressman, I have the phone # and email addresses. Let me know. I will check the board later today.

In Tn, there is a bill being introduced for a person who has served in the ared forces as medical specialist advanced, medical service tech, or advanced hospital corpsman tech to be licensed as a registered nurse without course study, a diploma or degree from an approved school of nursing. This truely distresses me, but being in the service, what do you think about this. Would you want a person with this training to be responsible for the care of your family? I figure you will know a lot more about these positions and what they do. Thanks for your service Cynthia

I have a lot of nursing experience, so can easily get prn work. I work in ob a day or 2/ week in the summer. I also get paid year round, but like the extra cash for trips, etc. We hope to go out of country next year. But it is a nice idea to sit back and totally enjoy your summer. The first year I worked in school nursing, I took the summer off.

Hello What to do I have been in ob for almost 20 years and it is a wonderful field of nursing. 5 years ago I had a school nursing job drop in my lap. I decided it was a gift from above, with the wonderful hours. Some people say the pay is bad, but that depends on whether you are an RN, state and system you work in. Mine is pretty comparable to other nursing jobs. I took the job, because I had 2 children in school, but it has been a very rewarding decision. When I started, there was no sex ed. I started by convincing my director of schools to let me do a 5th grade puberty class and have now worked up to a choices and consequences class for 7th graders, and STD, etc class for the 8th graders. i believe that knowledge is power. I started the 8th grade classes by asking two MDs to present, but now have gone to an organization that is Abstinance based, but very up to date and has young people as instructors. Both have been very effective. One thing that I added that I thought was very important was a speaker to talk to the classes about self esteem issues.

Hi I have had been in ob nursing for a long time with some med/surg prn experience. I had a school nursing position drop in my lap. I had never thought about working in school nursing. I decided it was a gift from above and took the job. This is my 5th year in school nursing. The first year or so was a learning experience, but have been able to make an impact on the knowledge and health of the children in school. I love the well-child care. Yes there is a fair amount of paperwork, but you have this in most professional positions. Some of my favorite things have been providing puberty classes for 5th graders, setting up sex ed classes for middle schoolers, and taking care of the juvenile diabetics. I don't know where you are, but in TN school health laws are different from the usual nursing laws. Be sure to get a copy of your state's School Health Laws. It can be pretty frustrating. I encourage you to attend your state assoc. of school nurses meetings. They will help you in your new field of nursing and also keep you abreast of legislation that may be pending about your nursing practice that may not be safe or practical.