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Discussion

RN left our school; Now what?

We have just over 30 days left of the school year and the RN/District nurse has now left leaving me in charge of the nearly 700 kids that come here.

As an LPN I feel fine giving out meds and treatments under the provider orders we have, but I am wondering if I legally allowed to complete the health summary of an IEP that is being written? If I follow the form it is essentially information gathering and not an "assessment", correct? Child has a serious medical condition in addition to behavior issues, but does have a health care plan from provider that would be of help in planning around his medical needs.

Also, we have many complex health kids that will be transferring to a new district this year and the IHPs and 504s are not current. Does this put me at any type of liability to be working from these (most are only 1-2 years old)?

Our school does not plan to contract out for services and I don't want to do anything that puts my license at risk.

Featured Replies

  • Expert

Not in your job description, is it? Who is your supervisor above the RN who left? I would not volunteer to do those tasks not trained on. Run these questions up the chain of command and document. Sure as ever, someone intends to hold you responsible without training you.

  • Author

Yes, it would be the RN that has left. I have run it up the chain of command, but like all good things no one really cares until it's an issue and doesn't understand that this could possibly put me at risk if I am working beyond my license. Just because I can do it doesn't mean I'm licensed to do it *wink* Our school is set to close (for good) at the end of the year so they don't want to deal with the paperwork it would take to contract out with someone for items on an "as needed" basis (despite me handing them someone on a platter).

  • Expert

An LVN coworker was proud of the fact that one of her home health agencies was using her to do admissions assessments. Besides the fact that in our state LVN's don't do "assessments", an RN is required to do the admissions assessment. So another RN signed her assessments. The extent of winking and turning a blind eye can be astounding sometimes. Of course all is well until something goes wrong.

  • Author

The other issue I just realized is that we have a bunch of end of year field trips coming up. Previously when meds were given by teaching staff it was on our LSN's license to "delegate and train". This is beyond my scope of practice and I fear would leave me liable should someone mess up. Not sure how to respectfully, but blatantly refuse....

  • Expert

This looks like it might become untenable for you. Have you started looking for new employment?

  • Author

Sort of. Have an unofficial opportunity-hope it pans out. If not, I would normally be off work until fall so I feel like I have some time.

Find out and PRINT (to share with administration) your scope of practice, as to what it ds does and does not allow you to do. Check with your state school nurse consultanat if you have one or your state association, they will help you.

It sounds by the way you write that you are dedicated to your job and your students and it is unfortunate that your school is closing and from what I gather you will be losing your job at the end of the school year. (please, correct me if i misinterpreted)

That being said - It is not your responsibility to complete IEP health documentation. Granted, it's late school year, so that *should* hopefully be down to a minimum by now, but every school is different and yours may be inundated. That is work that is not at your licensure level. Send your administration a written memo telling them as much because even though you will not be employed there, there could be some recourse of a future employer looking to this employer as a reference and you do not want to be labeled by then as being insubordinate. Keep copies of everything you send them. Print out copies of all of their written responses. Keep a notebook and document conversations, date, time, and with whom.

but I am wondering if I legally allowed to complete the health summary of an IEP that is being written? If I follow the form it is essentially information gathering and not an "assessment", correct? .

Our school does not plan to contract out for services and I don't want to do anything that puts my license at risk.

You need to thoroughly review the LPN scope of practice in your state. I suspect that the completion of an IHP/IEP would not fall there, but your state may be different than mine. I agree with the previous posters about documenting EVERYTHING. Did the departing nurse not share this with administration?

I have found that I have to resist my inclination to be helpful if it bends any kind of policy or rule. Good luck!

Not sure how to respectfully, but blatantly refuse....

"I can't do this - it's not in my scope of practice." Let the administrator sort it out....and good luck this summer!

So, if Flare's account of your situation, which is how I read it, too, is accurate, then you are in a good position. You are it for the rest of the year, your refusal will not cause untoward repercussions (read: termination) and you can stick to your job description. The RNs work will fall to another RN, namely your supervisor. She has a vested interest in pawning off on you. Stick to your guns and protect your license, as this may come back to bite you years later.

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