RN left our school; Now what?

[smudges.blips]

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.

[MrNurse(x2), ADN]

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.

[lvnforschool]

I had a similiar experience except the RN left right after I started my first LVN job EVER! I had to buck up and tell my Principle, sorry Not my scope of practice to do IEP's. They were not happy and started to work on getting contract RN. I was lucky that HR kinda had my back to say LVN could not perform those duties, but honestly the ADMIN has no clue what nursing licenses are responsible for.

[ArryOtter]

I had a similar situation last year and basically forced them to get a contract RN. I only did med pass and basic first aid until they found someone. Our school wasn't closing though. I would just tell them IEPs are out of your scope. Not worth you getting in trouble for. And like a PP poster said keep any and all documentation that you can.

[smudges.blips]

Thanks for all the input! I reached out to our state board of nursing because things seemed so gray. I mean, what is the difference between being allowed to "assign tasks" to unlicensed staff vs. "delegate" them- I can do one but not the other...what?!

Her input was basically the same as yours- step back and make teachers and staff deal with all the meds for field trips, etc. Sounds good in theory, but what am I supposed to tell teachers when they ask how to use the inhaler/spacer or an epi-pen? "Hey, here's the package insert. Good luck!"?

I did draft an email (which I saved) to our Administration and School Board Pres that noted my concerns, attached the legal documents from our state for support, and stated that I wanted a statement on the field trip forms that states:

I understand that any scheduled, as needed, or emergency medications normally given during school hours will be given by designated, responsible school staff based off the directions on the medication label. Health services staff do not accompany students on field trips. Students with a health action plan related to a chronic health issues (such as asthma, food allergies, etc.) will have any copies of their plan currently on site available to staff. I realize as a parent it is my responsibility to make sure these are up to date.”

And that I would not be doing IEPs or any medication set-up for our 3 day school trip and that this would need to fall to the teachers. I also included the documentation that shows that our state med guidelines show that staff need to be trained by an LSN/RN and that failure to do so and document would put them at liability. All very professionally and respectfully worded of course *wink*