Special Education

[SchoolNurseBSN]

Does anyone else feel dumped on by their special ed. department? It is a constant battle. They think that anything they do not want to deal with must be the nurse's responsibility. Like diaper changes, bad behavior, sleepiness (even after you have done a head to toe assessment and deemed the student fine). These are kids that are mainstreamed - we do not even have an inclusion room.

How do you handle it? I make extremely detailed Health Management Plans and talk until I am blue in the face. None of it seems to matter. One kid - I have basically babysat for 3/4 of the school day for the last week.

[Purple_Scrubs, BSN, RN]

Is your administration supportive? My principal is wonderful and although it takes a lot of abuse before I go to him with an issue, he will shut it down quick. If admin is no help, what about your health services department (if your district is set up like this, I know not all are). Do you have written policies and procedures that cover issues like toileting?

If all else fails, take them back to class and tell them verbally and in writing "this is a behavioral issue, not a medical issue." If they try to argue, just keep repeating that sentence verbatim and refuse to engage in arguments. They usually get pretty tired of this!

I know it is frustrating, hang in there. There is only a few weeks left until spring break and summer will be here before you know it (honestly I think the time off is the only thing that prevents the burnout that many bedside nurses experience).

[SchoolNurseBSN]

Administration is verbally supportive but their actions are not. I have everything in writing - all policies, etc. I will take you advice about being firm and consistent, though!

[Purple_Scrubs, BSN, RN]

I hope it works out for you!

[bergren]

Children in special education program increased from 8% to 14% from 1977 – 2006 (NCES, 2007).

Within special ed, rates of children with health conditions doubled since 2001 (NCES, 2007).

Typically, the only source of outside funding for the school nurse is through special ed funds. Even though the special ed kids are on average, 9 - 15% of the student population, it is estimated they require around 50% of the school nurses' time.

The diaper changes are clearly not a nursing activity, and should be part of the ed assistant job description.

Remember that lay people do not know what you know. Don't undervalue your knowledge and experience. I forget sometimes that something so obvious to me is not obvious to someone without a nursing background. The evaluation for bad behavior, sleepiness are reasonable requests and demonstrate that the education professionals recognize you have special skills and knowledge, and they do not know what you know and that you might have insight into whether the health condition or medication is creating the problem. You know the kind of questions to ask mom that the teachers and staff do not.

For the child who was hanging with you all last week - time for a call to mom for an interim assessment, and perhaps a team meeting.

Take their dependence on you and your skills as a compliment and as job security!!!