Role during school settings

[gardenpartyy]

So I'm a little unsure about my role while I'm at school with the patient. As a private duty nurse, when you are at school with the patient, do you mostly work with them or are the teachers predominately supposed to do that. I do as much as I can, but I'm limited because of patient's comprehension level and attention span (teen-aged, non-verbal, unknown comprehension level-but likely that of a toddler). The only type of instruction that is done for the patient is either myself or the teacher will show patient two flash cards & ask patient to identify the correct one. Patient usually will look away and just grab the closest one to patient's hand. Sometimes patient gets it right, but I think it's just a guess.

The classroom has about 8 other kids in it- all of which are at elementary school level comprehension, so they are certainly more advanced than patient, which leaves patient usually just sitting in their w/c, throwing around the toys that are tied to the w/c (which patient seems totally okay with). There are three teachers for the classroom and they will do activities as a class, but patient is left behind because patient is definitely not at a level to write the days of the week (or hold a crayon without throwing it). Sometimes they split off into groups of 2-3 kids per teacher and the teacher works with those in their group on things like words & number identification. So ultimately, because there isn't much patient is able to do and seems incredibly uninterested in anything presented to them other than throwing whatever they can, patient is left just sitting there.

Patient will only allow you to go through flash cards once or twice a day, and after that, will refuse to look at them or will just grab them and throw them as far as they can.

I don't know if I'm supposed to be trying harder to work with patient, or if that's even my role. I do the personal care stuff for patient while I'm there and administer meds through the tube, but other than that, I don't know what else to do.

Is this the norm? Anyone want to share their experiences with what they do while they're at school with their patients? What about during summer break? Should I be required to work on patient's schooling with them during the summer break at the family's request?

[realnursealso/LPN, LPN]

When I attended school with my homecare patients, my responsibility was for nursing related care only, all academics were the teaching staff's job. Where I am from, you are the nurse, not a teacher.

[caliotter3]

When I first went to school with my patient, the teacher talked with me about my role. We both knew what my limitations were but I had no problem interacting the same way as the staff. It would have been problematic for me to sit away from everybody and ignore what was going on in the classroom because I had to be within arm's reach of my patient anyway. A major component of my duties was the patient's physical safety. There was never any problem and I certainly enjoyed myself. One of the best extended care assignments I've had.

[CloudySue]

I don't have too much experience w going to school w the client since I only worked day shifts for half a year once, but every teacher had a different expectation. The head start preschool had all nurses outside the classroom in a small room across the hall on standby for feeds and care. A middle school had three aides and a teacher in a life skills class of 8 kids, yet somehow I got roped into instruction and assisting w art projects, in addition to nursing care and ADLs. A third class didn't use me for instruction but I had to stay very close to her and constantly provide stimulation and distraction to keep her from hurting herself during free play, which was a lot of the day.

For another case, I accompanied an alert/oriented girl to a summer camp-like thing put on by the township. The activities were way above her first grade level and they made no effort to include her in any activities modified for her (themed weeks, like Harry Potter, for example, was over her head and she was not familiar w the series yet.) So the client sat away from the other kids in a corner with me, and played w me for three hours every day. So did her twin sister who also wasn't ready for the program, and was not my responsibility. I tried to talk to the college students who were running the program to help them get included, but they complained about me to their director who called the parents to complain about me. The parents, however, were grateful that I brought it to their attention that they were wasting their money on a program that was providing nothing for her. Through that experience I learned that when you go somewhere w a client, unless you want to deal with a lot of drama and be seen as the bad-guy troublemaker who's putting her nose in where it doesn't belong, you just keep your mouth shut and deal with whatever program the client gets.

[AdobeRN]

One case I was on the child was in Kindergarten - the child was alert & oriented just a little slower than the other students. I was there for her safety, medications & feedings. I just sat in the back of the classroom and kept my eye on her. I never got involved with any of the teaching.

[LadyFree28, BSN, LPN, RN]

When I first went to school with my patient, the teacher talked with me about my role. We both knew what my limitations were but I had no problem interacting the same way as the staff. It would have been problematic for me to sit away from everybody and ignore what was going on in the classroom because I had to be within arm's reach of my patient anyway. A major component of my duties was the patient's physical safety. There was never any problem and I certainly enjoyed myself. One of the best extended care assignments I've had.

This.

My client had adaptive devices to help with communication; the teachers made sure if there was an activity that wasn't appropriate for her, there was an activity that I would help engage with her, or I would take her on a walk, just to keep her stimulated; things I would do if she wasn't in school and was in the home setting.

[gardenpartyy]

Thanks for all the replies so far! It really makes me feel better about how I've perceived my role while there.