School nurse questions.

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Hi. New school nurse starting tomorrow. I am contracted thru a health services company and will be going one day a week to a private school. A health aide is present the rest of the week. I am just curious if this is common in your area? Are you the school nurse the whole week or does your school have health aides?

I am also thinking about the school nurse certification if I decide to pursue this career on a more regular interval. Right now this is supplemental income for me. For this current position with the health services company I did not need the school nurse licensure, the positions just require RN license. Any advice? Bonus if you are an Ohio school nurse. ?

Side questions: Do you like to bring your own nurse bag for personal supplies? I don't mean the school emergency bag. I bought some supplies since I wasn't sure what to expect when I walk in this week. Any nurse bag/tote brand recommendations.

I am excited to start but am nervous being the only licensed medical person in the school. I just feel odd only being there once a week.

Thank you for reading this long post! Take care everyone!!

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Specializes in School Nursing.

My situation is different because I am a school nurse in a public school district. I work 8-3 Monday through Friday. I have a budget to purchase supplies although, just like teachers, I end up buying lots of things out of pocket.

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Specializes in kids.

You need to familiarize yourself with delegation laws pertaining to your state nurse practice act.

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I agree with @NutmeggeRN. Schools put us nurses in difficult situations where we delegate to unlicensed personnel and I think this is one of those difficult situations.

I am a full time nurse that manages multiple buildings. I very much dislike that I'm not in 1 building at all times. I think your main concern right now should be to find out if the aid has any medical background and what exactly you will be professionally responsible for when you are not there the other 4 days. If there is an emergency, will you have to be available via telephone? Do you train this unlicensed personnel to care for students with chronic medical conditions and emergencies that could result from those conditions? What about medication administration-can you legally delegate that to an unlicensed personnel in your state? You need to research that yourself because the school certainly won't and they'll justify anything that they're asking you to do. I'm not trying to scare you, but unless you were hired on as a pure consultant, you're technically delegating and professionally responsible for everything that health aid does whether you're there or not.

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Thank you all for your comments so far. It is greatly appreciated! I am currently looking at my employer website and reading the scope of practice guidelines for the RN, LPN, MA, and health aide positions.

ORC 3313.713 Policy for employees to administer drugs prescribed by physicians to students.--- Designated persons employed by the board are authorized to administer to a student a drug prescribed for the student. Effective July 1, 2011, only employees of the board who are licensed health professionals, or who have completed a drug administration training program conducted by a licensed health professional and considered appropriate by the board, may administer to a student a drug prescribed for the student. Except as otherwise provided by federal law, the board's policy may provide that certain drugs or types of drugs shall not be administered or that no employee shall use certain procedures, such as injection, to administer a drug to a student.

(I copied/pasted the above)

I guess this is why they only have a school nurse one day a week because they have staff who have completed the drug administration training program?

I am certainly looking into my state laws. I am actually at the library now as I type this.

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3 hours ago, ihavealltheice said:

I agree with @NutmeggeRN. Schools put us nurses in difficult situations where we delegate to unlicensed personnel and I think this is one of those difficult situations.

I am a full time nurse that manages multiple buildings. I very much dislike that I'm not in 1 building at all times. I think your main concern right now should be to find out if the aid has any medical background and what exactly you will be professionally responsible for when you are not there the other 4 days. If there is an emergency, will you have to be available via telephone? Do you train this unlicensed personnel to care for students with chronic medical conditions and emergencies that could result from those conditions? What about medication administration-can you legally delegate that to an unlicensed personnel in your state? You need to research that yourself because the school certainly won't and they'll justify anything that they're asking you to do. I'm not trying to scare you, but unless you were hired on as a pure consultant, you're technically delegating and professionally responsible for everything that health aid does whether you're there or not.

How can she be responsible for the aide? She is an Agency nurse. She is filling in, one day per week.

I agree she needs to get this all clarified, see it in writing, immediately, before starting her job.

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Specializes in kids.

I don't think I would want to be in that position.

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I don't know why it won't let me quote anyone...

Anyway, much like in the hospital, when you as the professional RN delegate something to a CNA, you are still ultimately responsible for it. Still works the same way when you are in the school setting.

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Specializes in School Nurse.

I would bring my own stethoscope

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Specializes in School Nursing.

I am an LPN working in a school in Ohio, I am also through a health services company (maybe the same one lol)

This seems to be common. A lot of schools hire the aides and LPNs to save money. I have an RN supervisor but she is over the entire region. Most districts have an RN that manages all the schools, but my district does not.

I bring my nursing bag, stethoscope, BP cuff, pen light, Pulse Ox, etc. basic stuff is provided but I have heard some of the inner city schools are very bare bones and you show up and there aren't even band aids.

I am hoping to get my RN and eventually become certified as a school nurse, but right now I am happy where I am.

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On 11/19/2019 at 9:04 AM, ihavealltheice said:

I don't know why it won't let me quote anyone...

Anyway, much like in the hospital, when you as the professional RN delegate something to a CNA, you are still ultimately responsible for it. Still works the same way when you are in the school setting.

I can see it on the 1 day per week that she is there. But not the rest of the time. She does not make the job description or policies.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Check out:

School Nurse Resources - Ohio Department of Health - Ohio.gov

https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/school-nursing-program/school-nurse-resources/

Quote

The School Nursing Program supports the provision of quality health services in schools to promote student health and success. In addition, the School Nursing Program assists schools with an all-hazards approach to emergency preparedness. School nurse consultants are available as resource experts to school nurses, school administrators, local health departments and other interested individuals, organizations and agencies.

Services are provided by:

  • Telephone and e-mail technical assistance and consultation
  • Development and dissemination of resource documents
  • Annual statewide training of new school nurses
  • Annual topically focused regional conferences
  • Recommendations on policies, procedures and standards of care for the provision of quality health services in schools
  • Electronic communication through the Ohio Department of Health (ODH) School Nurse Bulletin Board
  • Collaboration with agencies and organizations to provide appropriate information, guidance and training for those involved in the provision of health services in Ohio schools
  • Facilitation of local and regional partnerships related to school emergency preparedness

The ODH electronic School Nurse Bulletin Board is now available. To subscribe to the bulletin board, Click here for registration instructions: https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/school-nursing-program/media/subscribe_to_school_nurse_bulletin_board

Resources For Nurses New To School Nursing:

https://odh.ohio.gov/wps/wcm/connect/gov/3bf77735-a266-4080-921a-7c2ebd8525dc/School+Nurse+Resources+updated+8+23+2019.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTWORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-3bf77735-a266-4080-921a-7c2ebd8525dc-mRf2bFm

Under the above link, will find Ohio Nursing Delegation information:

Delegation Law & Rules for Ohio’s School Nurses (Search at http://codes.ohio.gov)

▪Ohio Administrative Code (OAC) Chapter 4723-13 Delegation of Nursing Tasks http://codes.ohio.gov/oac/4723-13o

Practice Statements: http://www.nursing.ohio.gov/Practice.htmoSchool

Nurse Decision Making Model (updated 2018) http://www.nursing.ohio.gov/PDFS/Practice/SchoolNurseModel0907.pdfo

Medication Administration: School Nurse Scope of Practice and Non-Medication Related Nursing Tasks: School Nurse’s Scope of Practice

Scopes of Practice: Registered Nurse and Licensed Practical Nurse (June 2015 )http://www.nursing.ohio.gov/Practice.htmo

Decision Making Model Registered Nurses and Licensed Practical Nurses (Adopted 11/17/94 Last Revision: March 2015) http://www.nursing.ohio.gov/PDFS/Practice/Decision_Making_Model.pdfoMomentum.

Online quarterly publication http://www.nursing.ohio.gov/Publications.htm

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