504s ? for spidey's mom

NutmeggeRN, BSN · Dec 16, 2013

That does not makes sense. They may have been asked for a release of information to share with appropriate personnel. That is "not giving up HIPAA". Sadly some folks want every accomodation known to man, but do not want to share any information with those that need it most....makes it hard to meet the kids needs sometimes.

morte, LPN, LVN · Dec 16, 2013

hmm the person in question has an extremely sensitive celiac kid. perhaps the school was "fishing" to see if the mom was being truthful. Does the school actually need to talk to a doc about such a dx at all? or just receive it from doc? another parent has said her doc WON'T talk to school, (s)he, the doc, has been caused a problem by the school, apparently. so now, there is no communication, but for dx.

That does not makes sense. They may have been asked for a release of information to share with appropriate personnel. That is "not giving up HIPAA". Sadly some folks want every accomodation known to man, but do not want to share any information with those that need it most....makes it hard to meet the kids needs sometimes.

allnurses Guide · Dec 16, 2013

Hi - I was surprised to see this addressed to me. :nailbiting:

We always give the parents a form to sign (if they wish) that allows us access to the docs. They can sign or not.

That's not violating HIPAA in my opinion.

I especially need this access in relation to the diabetic kids. I share info back and forth regarding daily logs of blood glucose results. I need new orders every year for kids with 504's. How do I get this without access to the docs? Parents are notoriously NOT reliable to help us with this. I was told not to help the parents at all - it is their responsibility. But sometimes in cases where parents are not caring for their child very well, we call CPS and notify the doctors.

allnurses Guide · Dec 16, 2013

hmm the person in question has an extremely sensitive celiac kid. perhaps the school was "fishing" to see if the mom was being truthful. Does the school actually need to talk to a doc about such a dx at all? or just receive it from doc? another parent has said her doc WON'T talk to school, (s)he, the doc, has been caused a problem by the school, apparently. so now, there is no communication, but for dx.

We have to have physician orders. And they need to be updated once a year. We can't check blood glucose, give insulin, give inhalers, give ADHD meds, give antibiotic for an ear infection, send a note to the cafeteria about peanut allergy or other food related issue, etc., without a physician order.

Just because one nurse caused a problem doesn't mean we are all irritating .......(of course I'd like to hear the other side of the story in this one)

Flare, ASN, BSN · Dec 16, 2013

We have been going through a situation that is reminiscent of what the OP may be trying to get at - student with a diagnosis of one thing and the parent communication with the teachers only (and not me despite requests for info) about the possible surgery and home instruction. I had a teleconference with the doc finally to just figure out what was going on and what was fact and what was speculation. There was no break in HIPAA, this didn't break down and barriers or give me a green light to talk to anyone else than the people that needed to be involved with their case or care.

morte, LPN, LVN · Dec 16, 2013

oh, I addressed to you because you were the one in the group I "know", for no other reason. and yes there is always "the other side" but that is true from the parents side also. If anything, I think this mom is REALLY involved, lol. and feels/was told, that if she didn't sign, there would be no 504 at all. so....what would be required for a 504 for celiac disease? that is, from the doc/np? Because many times the parents are going to know more about it than the peds. what would you be looking for, that the parent couldn't provide?

and thanks all!

We have to have physician orders. And they need to be updated once a year. We can't check blood glucose, give insulin, give inhalers, give ADHD meds, give antibiotic for an ear infection, send a note to the cafeteria about peanut allergy or other food related issue, etc., without a physician order.
Just because one nurse caused a problem doesn't mean we are all irritating .......(of course I'd like to hear the other side of the story in this one)

JenTheSchoolRN, BSN, RN · Dec 16, 2013

oh, I addressed to you because you were the one in the group I "know", for no other reason. and yes there is always "the other side" but that is true from the parents side also. If anything, I think this mom is REALLY involved, lol. and feels/was told, that if she didn't sign, there would be no 504 at all. so....what would be required for a 504 for celiac disease? that is, from the doc/np? Because many times the parents are going to know more about it than the peds. what would you be looking for, that the parent couldn't provide?
and thanks all!

Usually the development of a 504 Plan involves needing/getting the child's individual health care plan and a letter is needed from child's PCP about the disability, related issues, and any medication or treatment needed. I'm in Massachusetts, some of my state's guidance is here: 504 Plan.

schooldistrictnurse · Dec 17, 2013

If we are making accommodations for a child, it is helpful to have an accurate diagnosis from the physician. Just because the parent says "my child has...." Doesn't make it so. yes, truly, the parent knows the child best, but I have seen parents claim that their child can't participate in gym due to asthma. ( what?). The physician can give parameters and I feel better with more definite guidelines than "participate as tolerated."

morte, LPN, LVN · Feb 24, 2014

update: mom has pulled kid from school, r/t noncooperation from school. dr provided dx, any accommodations would be child specific.

In this case, I don't think the school could have accommodated this young man, episodic flare ups, and playing catch up with school work. apparently able to do so, but school unwilling (I think) to allow what may look like a lazy student to other students.....