Nurses can educate I thought it was part of our job?

[Vtachy1]

I have a little bit of an odd profession. I am a nurse paraprofessional. The county health department takes care of all the health plans and the lice checks etc. I monitor kids or help with insulin and carb counting especially disabled kids, administerd IV antibiotics, etc.......

I'm not paid much a tiny bit more than a teacher's aid, but its worth it to me, to have the great hours and the stress of not having work call me every 8 hours begging me to come in 365 days a year. I played that game for 25 years. Tired of it!

Anyway, yesterday I was asked if I could do diabetic training to teachers. Why wouldn't I legally be able to do this? I have a BSN but I am not a certified school nurse. I have trained a zillion new diabetic patients in the hospital and outpatietn setting on diabetes. I guess the health dept nurse even said she didn't know if I could do that. Can I? WHat do you think?

[Jolie, BSN]

Vtachy,

I hear the passion in your voice and am grateful that your students have access to your experience, knowledge and desire to “do good.” I am also pleased that you have reached a point of security in your life that satisfaction is more important to you than income. But I encourage you to handle that with care and wisdom. In the event of an untoward occurrence, it could all be lost.

You are not infallible. None of us are. That is why we utilize the legal protections available to guide our practice and lessen the risk of potential harm. Job descriptions exist to establish expectations for staff performance, including limitations of practice. They do not indicate that one is incapable of more, only that one is not authorized to do more. Performing tasks outside of your job description, regardless of the level of your expertise, is an invitation to legal troubles that could cost you your license, home and financial security.

Think of it this way: Let’s say that despite your excellent care, a student develops a central line infection. Perhaps it happens because of an inadvertent contamination at school. Perhaps it has nothing to do with school, but developed following improper care at home. But the parents make an accusation that a “teacher’s aide” who wasn’t supposed to be touching the central line was doing all the care. The school district responds by stating that they had no idea that you were performing this task outside of your job description and sides with the parents, seeking action against you. Will your professional liability policy cover you since you were not working in a nursing position? How will you defend your practice? Do you have access to the student’s health records to check physician’s orders? Is there an individual plan of care for this student? Is there an emergency plan in place for management of a torn, dislodged, clotted, or infected line? Have you made daily notations documenting assessment of the site, medication administration, tolerance of the procedure, vital signs, s/s of infection etc.? How do you communicate with the child’s parents and medical team?

If you are satisfied with your income, I still strongly encourage you to approach your district and ask them to re-write a job description to reflect your professional experience and licensure. Maintain your title and salary if that is acceptable to you, but PLEASE get a job description that reflects what you actually do, so that you will have legal standing to provide the care that you (apparently) are already providing.

[camprn1]

For providing education services to the teaching staff I would contract that service separately than the para job. And charge the district a hefty PROFESSIONAL hourly fee.

[bub&sis]

I recently applied for a job at a high school. School is looking for an lpn to be a health paraprofessional. The job description clearly states I would be following doctors orders, tube feedings, transporting students safely, etc. I think they add paraprofessional to the title because the job description also states that we may be asked to help out in the classroom with clerical duties, etc. There are many forms of nursing. If this type of nursing makes you happy, I say go for it! I'm certainly interested in the same thing. To be on my kids schedule, summers off with a paycheck. I've been an lpn in peds home health for 2 yrs and I'm ready for a change. I'll still work home health prn. Good luck!