School nurse VS school secretary

Published

Hey fellow nurses,

I have been working per diem as a school nurse (elementary, middle and high school). My duties are caring for students who walk in as well as some paper work.

I recently got a part time job in an elementary school. My contract says my duties are walk ins and paperwork. Paperwork in a different level now since I am part-time.

When I walked in today, I was surprised by the secretary telling me she cares for all walk ins, that it is HER job. She has no medical training besides CPR. She told me my job is paper work only.

As students came in, most because of head injuries, she did not assess them (neuro check) at all. Instead touched their head, if they did not have a bump or cut, she gave them ice pack and let them sit for 5 minutes, then sent them back to class.

I felt VERY uncomfortable because I know better that a head injury not always presents with a bump or cut. I said to her my license was in line, I was concerned.

She said in a very defensive way she has been doing that for 9 years, she knows how to do her job and continued jumping in front of me to take the students in.

I have no problems with her doing that, but I have problems if I am on duty, and she cares for a student who happens to have a bigger problem and gets to be sent back to class without further examination.

My questions is, if I change my contract to state I am on duty to do paperwork only, not walk ins, would I still be held liable for any problems or mistakes the secretary might do?

Up Vote Up Vote ×

who do you directly report to? discuss with them

Up Vote Up Vote ×
Specializes in Med-surg, school nursing..

Admin please move to school nurse forum

Newgrad, you need to come visit the school nurse forum, we are a blast!

To answer your question, I would talk to your principal, let her know that as the licensed (I am assuming you are licensed) medical professional, YOU should be handling the medical assessments. You can bet your sweet bippy if something went wrong and the secretary missed something in her "assessment" you would be thrown under the bus as the nurse in the school should've been doing the assessment.

I would go to the principal with this wording "I feel that it is placing the school at a huge liability by having a non-medical professional assessing (improperly I might add) students. Taking temperatures and putting on band-aids is something she could do, but assess head injuries is a dangerous practice for someone who isn't properly trained. If you would like her to continue doing this, I will need it listed in my contract that I am not legally responsible for anything that comes of her "assessing" students. If you would like me to be the medical professional in the building as that is what I am licensed for, you may need to speak with her to let her know that she needs to refer medical needs to me."

Up Vote Up Vote ×

Yeah, I could barely sleep last night thinking about it. Her point is she has been doing this for 9 years and nothing ever happened. But as we all know it only takes one child for us to lose our license. Yes I am an RN, and that has taken me years of schooling, seat and tears for this to happen. I need to speak to a lawyer on the legality aspects of me being in the premises and her doing her job, even if they change my contract as paperwork only. On the other hand, I am also concerned for the children there, including my nephew and niece. Its such an awkward situation, cause we share the same office and she is friends with everyone there since they all have been there for 10 + years. Maybe that is not the right place for me :-( I heard 7 other nurses worked there but did not stay, and I was wondering why, I guess now I know. Thank you for your reply.

Up Vote Up Vote ×
Specializes in School nursing.

Yes, come on over the School Nurses forum - we have all been there!

NewgradZ, you need to talk with your principal. Because directive coming from a person higher than you is usually the only thing that can help in a situation like this. At one school I was at, they had never had a full time school nurse. Now they did with me, but one of administrative assistants was used to stepping it to "triage" and even medicate students with OTCs like ibuprofen, acetaminophen, or benadryl (Yeah...ugh). Asking her to stop did not work. I finally took a deep breath, looked at my school guidelines (that she was violating) and brought them to my non-nurse boss. That did that trip and my boss spoke to her and poof! It actually changed dramatically overnight. The administrative assistant even apologized, not that I'd expect that to happen.

You can also meet this person halfway if you are part-time and set up some head injury guidelines when you aren't there. I do that with all of my coaches and require them to go through the CDC concussion training online (and print the certificate as proof).

Welcome to school nursing!

Up Vote Up Vote ×
Specializes in Pediatric Critical Care.

Yeah somebody needs to tell her to let you do your job.

I did get a bit of a chuckle imagining her very seriously "assessing" all these head injuries by touching their foreheads, though.

Up Vote Up Vote ×

I think that is not the right place for you, just as it was not the right place for seven of your predecessors. It is safe to assume that you will have no better results in trying to make things right. Those in charge would have figured things out after seven or more exits from the building, so they are quite satisfied with the status quo. Find another position.

Up Vote Up Vote ×
Yeah somebody needs to tell her to let you do your job.

I did get a bit of a chuckle imagining her very seriously "assessing" all these head injuries by touching their foreheads, though.

I imagined Jesus doing this and getting the correct diagnosis. In fact, I can't picture anyone else doing it, and He has been right for more than nine years.

Up Vote Up Vote ×

You are right about this. For the past week, my agency has been trying to clarify the scope of the secretary vs me, the RN. Unfortunately, the district nurse seems to be friends with the secretary and I was told nothing will really change. It is so unfortunate since this school is right behind my house, and it is my nephews school. I am currently in the process of getting hired to work in a detention facility (jail) which scares me even more than being a school nurse at that place. Oh boy.... decisions decisions....

Up Vote Up Vote ×
Specializes in ICU.

Sad that she has been playing nurse for 9 years, yet hasn't made an effort to become a real one.

Up Vote Up Vote ×
Hey fellow nurses,

I have been working per diem as a school nurse (elementary, middle and high school). My duties are caring for students who walk in as well as some paper work.

I recently got a part time job in an elementary school. My contract says my duties are walk ins and paperwork. Paperwork in a different level now since I am part-time.

When I walked in today, I was surprised by the secretary telling me she cares for all walk ins, that it is HER job. She has no medical training besides CPR. She told me my job is paper work only.

As students came in, most because of head injuries, she did not assess them (neuro check) at all. Instead touched their head, if they did not have a bump or cut, she gave them ice pack and let them sit for 5 minutes, then sent them back to class.

I felt VERY uncomfortable because I know better that a head injury not always presents with a bump or cut. I said to her my license was in line, I was concerned.

She said in a very defensive way she has been doing that for 9 years, she knows how to do her job and continued jumping in front of me to take the students in.

I have no problems with her doing that, but I have problems if I am on duty, and she cares for a student who happens to have a bigger problem and gets to be sent back to class without further examination.

My questions is, if I change my contract to state I am on duty to do paperwork only, not walk ins, would I still be held liable for any problems or mistakes the secretary might do?

This is all wrong.

If it ca't be resolved with your higher ups, you should leave.

Please come see us on the SN Forum.

Up Vote Up Vote ×
Sad that she has been playing nurse for 9 years, yet hasn't made an effort to become a real one.

The secretaries always think they are nurses, until you go to lunch and someone comes in high and seizing.:sarcastic:

Up Vote Up Vote ×
+ Join the Discussion