School Nurse Athletic Assistance

[rachelRN21]

Hello,

I've been a school nurse for 6 months (started November of last school year) and am still getting the hang of everything after switching from the hospital (NICU for 2 years) to school environment. I am working at a middle school. The athletic director recently asked me to help with football, softball games, etc. I agreed to work the games, but I have to admit I am a little intimidated because I feel like this is more of a job for athletic trainers and I will be the only medical professional at these events. In nursing school they don't do clinicals on the football field haha. Though they did teach about injuries, are there any veteran nurses with experience in this area with tips/advice on how I should prepare for the season and better equip myself to handle any injuries that happen on the field?

Any other school nurse tips would be appreciated as well!

Thanks everyone :)

[peacockblue]

We do not do games. Our athletic trainer does that. I would be concerned that was out of the scope of my practice.

[akulahawkRN, ADN, RN, EMT-P]

You're going to be in way over your head. You do not have the training or experience to safely do that job. Sorry if that's harsh sounding but please understand this is coming from someone that was a DIII assistant athletic trainer for 2.5 years. You need to be able to assess the field for hazards, be familiar with the equipment and how to remove it so that you can assess your athlete's injuries. You need to be able to actually assess the injuries to determine what actually likely is injured, how badly, and if you must send that athlete out to the ED or if you can manage it on the sidelines and refer to Primary Care. This means being able to differentiate between strains, sprains, and fractures based solely on clinical assessment. You need to know how to detect concussions and what to watch for. You need to be able to watch the play and see if and how an athlete gets hurt. Mechanism is horrible at telling you if an injury has taken place but it is great at showing you where to look, if you know how to "read" the mechanism of injury.

Your instinct is correct that this is more properly a job for an athletic trainer. I think you're putting yourself at high risk for doing something you're not adequately educated to do. This isn't something you can learn in a weekend or a short course. If you want to learn the basics of this, try to take an intro to sports medicine course if there's one offered by a local college or university. At least that'll help you get a better understanding of what you'll need to do at least while you're on the sidelines. It would take the better part of a year, or more, to teach you all of what you need to know to safely function in an athletic trainer role.

Even Paramedics do not get an appropriate education to do this either. Teaching them this stuff would make them better medics but for what they do and what they're for, it would be overkill.

[Flare, ASN, BSN]

I agree with akulahawk and peacock. With the info provided it sounds like they are looking to have you there just to cover there own butts and say they have medical personnel there without having to get a athletic trainer. Nursing and athletic medicine have some similarities but there is a reason that people go into that specialty - it's to learn about those specific injuries. I agree - you can get the training, and if you are willing, should. Are they paying you for your extra time to be at those games? If they are not, then you should not be at those games. But then if they are willing to pay you, they should be willing to pay a properly trained athletic trainer - it's the right thing for the safety of the students.

[akulahawkRN, ADN, RN, EMT-P]

I agree with akulahawk and peacock. With the info provided it sounds like they are looking to have you there just to cover there own butts and say they have medical personnel there without having to get a athletic trainer. Nursing and athletic medicine have some similarities but there is a reason that people go into that specialty - it's to learn about those specific injuries. I agree - you can get the training, and if you are willing, should. Are they paying you for your extra time to be at those games? If they are not, then you should not be at those games. But then if they are willing to pay you, they should be willing to pay a properly trained athletic trainer - it's the right thing for the safety of the students.

Nursing and Sports Medicine, while they do have some similarities, Sports Med is much closer to Medicine than Nursing as Sports Med primarily follows the medical model. An AT, in terms of knowledge, is probably nearly equivalent to a PA in the specific area of Orthopedics, though not as deep in knowledge outside of that, but also quite knowledgeable in sports physiology though not to the depth of someone who studies exercise phys. When my athletes got injured, I would evaluate them using identical techniques and processes that the team Doc or Orthopod uses and would usually arrive at the same conclusion.

You also bring up a great point: OP, your AD should be paying you for the extra duty of attending the games. If your pay rate is high enough, over the course of a year, it may end up being sufficient to hire a part time AT to do what you're being asked to do and actually expose the school to less liability and save them some insurance money as well because nurses aren't AT trained and shouldn't get the school quite the same insurance premium break...