Sports Physical Frustration

  1. Ok, many of you already know that I am a new school nurse. My biggest pet peeve has become sports PEs. The nurse that worked at my school before retired before I was even hired so I was never given any orientation or advice as to how to do ANYTHING.

    I would appreciate any advice any of the middle/high school nurses could give me on the best, most efficient way to get sports PEs accomplished. The AD at my school is, well, let's just say, a few sandwiches short of a picnic and has been little or no help. Apparently, the old nurse was something of an "enigma" and nobody has any clue how she went about things.

    For example, when a student played a sport in the fall and had a PE and wants to play a spring sport what is the procedure at your school. They have me "re-checking" every athlete, checking their blood pressure and making sure they haven't been injured between seasons in any way. I give the student a slip of paper to then give to their coach to let the coach know that they are ok to play. First of all, this method is just not working for me. All the kids seem to wait until the last second and I end up spending half the day rechecking kids. Second, and perhaps more importantly, the coaches seem to not really care who is cleared and who isn't and are letting kids practice who haven't had PEs AT ALL. Is this just happening at my school? Isn't this a huge liablity issue? What are all of you doing at your schools to prevent this?

    I thank you for any and all suggestions you can give me! AAAACCCKKKK!

    PS. I'm in NY so if anyone knows any of the laws or State ED rules about this stuff or where to get info that would be great!
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    About Mrs.B

    Joined: Oct '02; Posts: 30; Likes: 1
    RN @ Hampton Bays HS


  3. by   renerian
    This is so odd because all of my kids played sports and the school paid a Dr. to do the physicals. I would not want the liability in saying someone is healthy to do sports. Outside the scope of practice. what if you sign they can play and they fall over dead of sudden cardiac arrest and the family says, you said it was okay. Tell your school that some of the schools in Ohio have a Dr. do the physicals at the school one afternoon or the kid can see their own Dr. to sign off. Your being put in a crappy spot I think. JMHO.

    Last edit by renerian on Mar 4, '03
  4. by   valk
    In my experiance a physician must perform the sports physical.
    Usually the form is sent home on enrollment or at the end of the school year to be returned when school resumes in September, the physical must be completed before the student begins to participate in the sport. You should review the physical when it is returned. Sports physicals are good for 12 months.

    Have you tried the NASN or the NYSASN? They are good resources. NASN has various listservs & the NYSASN has a spring conference scheduled for March 21 to March 24.


    Good luck, Mrs. B.
  5. by   WashYaHands
    Sports is a mandatory requirement at my private school and it is mandatory that they have a physical in August that is acceptable for the entire year. If a student gets hurt and cannot play, I get that in writing from the physician, usually through the parents. They cannot participate again until I get clearance in writing from the provider. I notify the coaches that the student cannot play and document that in their chart. If the coach allows them to play anyway, they take on the legal risk. But, I work at a private boarding school, not a public school, so things are much different. So, no physical, no sport.

    At my daughters public school, a student absolutely cannot play an organized sport unless they have a physical on file with each season & sport checked off on the form. It it the responsibility of the parent to get the physical from their provider; however, the school does offer physicals at the beginning of the year at the school for a $10 fee. Again, even in my kids public school, if you dont have a physical, you cant play.

    Can you check with the school district administration to find out the official policy and give the policy to the coaches?

  6. by   cpgrn
    Im my middle school, the kid's have to have a sports physical on file to play. The office takes care of this. They are good for one calendar year only. If they don't have one, they don't play.
  7. by   Mrs.B
    Yikes! I was so furious when I originally posted I think I didn't make myself too clear on the situation. I don't DO the physicals, I just check the kids off saying that they HAD physicals. We have a school NP (not an MD) and she does PEs for us. We also allow students to go to their private MDs to get physicals. When we are doing PEs here at school, I help with the BPs, urine dips, hts and wts only. I'm not the one doing the actual exam.

    Do you think that I should still be concerned about medical liablity when all I'm doing is signing a paper that says they HAD a PE? I thought that wasn't too much of a big deal but I'd like your opinions.

    Anyway, I was really asking about what your procedures are. Do you only have one day a year where kids must show up for PEs? We do them before every sport starts during the school year and we do one day over the summer for the football players. Our PEs are good for a year too but a lot of the kids never get them. My point was, should I wash my hands of the whole thing and let the AD worry about who is eligible and who isn't? Isn't the liability ultimately the coach's if a kids drops dead on the field b/c he had an underlying cardiac condition and it wasn't found b/c he never had a PE? My job description doesn't go any further in regards to sports physicals than saying the nurse is responsible for scheduling sports physicals. My problem was agreeing to do more than that. I admit, that was totally my fault and won't be happening next year. I was new and was trying to be a people bad.

    So for all the nurses that said that their PEs are good for a year, my question is this: Do you maintain a list of athletes that have had PEs or does the AD do that? Do the coaches come to you to check if their athletes are ok to play? How involved is your role when it comes to sports PEs?

    Hey sorry for being so all-over the place...I really do have a legit excuse...I'm 12 weeks pregnant! So please forgive my hormonal rages
  8. by   frannybee
    I know you're probably aware of it but I'll bring it up anyway (pet awareness project). If any of your students are having fainting spells, please don't let them play sport until they've been seen by a GP or cardiologist and had an ECG to rule out Long Q-T and other 'hidden' arrhythmias. You more than likely do that anyway but it's something dear to my heart and gets missed far too often. If I can stop *one* child from having a cardiac arrest on a playing field, all the awareness-raising will have been worth it. I'm not trying to teach you to suck eggs, so please accept my apologies if it's come across that way!
  9. by   katscan
    I don't think you can be liable for just checking off the physicals. I am a school nurse in a large district in Ohio and we let the athletic secys take charge of making sure the kids have a physical for each sport, each year. As for the coaches letting kids practice without a physical on file stating they are fit to play, that is a big no no in my district. The liability is astronomical. I wouldn't care what they say or what pushy parents say!If your district has a policy that they need to be rechecked before every sport, in no way would I as the school nurse certify that they are healthy from the previous physical. In our district, a physical within the year is acceptable for any sport all year.After that the physical expires and they must obtain a new one-from a doctor. What concerns me, is that you may be putting yourself on the line for liability by recertifying them. The docs should do that if their previous physical within the year is not good enough. All it would take is ONE person having problems playing that you certified as healthy for it to come back on you. What if a doc missed a long Q-T as the above poster said, and you certified him to be healhy. Let the doc take the rap, not you, or the NP!
  10. by   Scuppernong
    All we do is place a copy of the exam in the health record. The coaches are responsible for all else. They setup the exams, they do all the paperwork. They make appt. with local MD to come to school. After it is all done a copy is sent to the clinic for placing in the record.
  11. by   DeeDee71
    I have grades 6-8, there is a standard sports PE form in the main office. The physicals are done by the student's own doctor then brought in to the coach of the sport the student is involved in. If the student is in more then one sport during the year the student goes to the last coach for the PE then takes it to the new coach. I never even touch the forms.