Hemophiliac child...question?

[itsnowornever, BSN, RN]

My nephew has hemophilia. His school district shares 1 nurse to 30 schools (or so says my sister) so 10/10 times she has to come infuse him if he gets a bleed (keep in mind I know NOTHING about hemophilia so I have to go on what she says, correct me if she's wrong please!). This is keeping her from working (she says) because a few times a month she has to go infuse him at school and each job she has had has fired her for having to leave so often to take care of him. My BIL is a military recruiter so he isn't reliable to go do the infusions. She says no one at the school will take the certification to do the infusions (insurance would pay for it) and I dont blame them! No medical experience, I wouldn't do it either (the aides or secretaries)...would the school nurse be required to go to the school to do the infusion every time he needs it? Is she being over protective in doing it herself every time? They are trying to teach him to do it himself, but he's still kinda young, he's 10. Can she get a certification as a home health aide and get paid to do the infusions on him? She's kinda lost. My BIL is looking at getting kicked out of the military (rank, lack of promotion, other issues) and she's trying to figure out how to get a job that won't fire her (Shes looking at night jobs) and where she can still take care of my nephew at school. I have NO CLUE how to help her, so I'm kinda hoping that you school nurses will have resource information to help her out! She's in Ca.

Thanks in advance!

[traumaRUs, MSN, APRN]

Here are some resources:

http://www.stepsforliving.hemophilia.org/section2_4_3

Hemophilia

These two sites advocate kids as young as 8 or so doing their own infusions.

I would caution you though that a child who has hemophilia has given his parents many a scare. While yes, they may be overprotective, they may have come perilously close to losing this child too.

[itsnowornever, BSN, RN]

Since thi is my nephew I can say that YES he has given them quite a scare several times! My sister is afraid do their financial future with my BIL situation and she diorama know what to do! I figure you wonderful group of school nurses would have some ideas and you did! Thank you! My poor nephews condition was NOT handled well by his bio mom and my sister ha ha a steep leaning curve, but had managed amazingly and now is pretty much mom! Thank you so much! I will check out the link and pass it on!

[caregiver1977]

At my school there are children who have their own CNA/medical assistants to take care of their medical needs. The school district has a contract with a local home health agency. Could this be provided for your nephew? Your sister might want to investigate what the school is required to do in order to help her child. Many times you have to dig; the schools don't aways tell you.

[itsnowornever, BSN, RN]

At my school there are children who have their own CNA/medical assistants to take care of their medical needs. The school district has a contract with a local home health agency. Could this be provided for your nephew? Your sister might want to investigate what the school is required to do in order to help her child. Many times you have to dig; the schools don't aways tell you.

Thank you! I'm copying and pasting this to send to her!!!!!!!!

[Flare, ASN, BSN]

Caregiver1977 is right - but your sister will probably have to get papaerwork from the doctor stating that your nephew needs to have a 504 plan in place. it's not that big of a deal, kids get them established all the time, but it will set the wheels in motion to get him the type of assistance he needs. The sticky point is that it sounds like he doesn't need a nurse at all times, rather only when he needs to have an infusion. So getting a personal health aide wouldn't necessarily be logical, as i assume that his need for infusions isn't necessarily something he can plan or schedule. The options then are for him to learn how to do his own infusions, but then depending on state law, it may not be helpful as students aren't typically allowed to give their own meds in school in some states. Another option may be to sign an agreement with a local healthcare provider, like a local md's office or urgent care center to have somebody approved by the school board available to call to do the infusions when they are needed. The sticky point there is timliness of getting the infusions done - without having a nurse in the building, you are at the mercy of whomever the school board contracts with.