Sports clearances and clerical help

Farawyn · Sep 9, 2015

Okay, so my question of where the hell have you been is answered by your post!

(((((((RNqueens))))))) I'm sorry. This is a lot.

Okay, this is what we do. Remember, I have a much smaller school than you, and I am STILL overwhelmed, so I cannot imagine your workload.

In the end of the year (June) we have the district doctor come and do sports clearance physicals on students that want to do sports. We do them on the incoming 7th graders at the middle school AND the HS kids at my school. In NYS, as you know, 7th and 10th graders need physicals...but say their yearly physical is in October and the kid wants to play football, this will at least clear them until they get their yearly physical.

The middle school nurse works summer school in my school. Since she is the senior nurse in the district, she takes in the incoming physicals.

I work five 1/2 days (needs to be more) before school. We have the doc come again in August and also in September to do sports clearances. A nurse has to pre screen each child for a sports physical, BP, ht, wght, eyes, ears, etc.

I get the team roster from each coach. I will not start my own roster- I did that last year, too much work. The coach, who gets PAID EXTRA gets to hand me a NEAT legible roster with the kids' names and ages. I then look up kid and see if they are cleared- either through the computer, or the paperwork in front of me. I indicated clearance and give it to my COMPETENT secretary to put into excel.

We then trade excel sheets back and forth and add to it.

I do not do permission slips. I don't care if the parents give permission for the sport, I care if they need an epi pen on the field, right? That is the coaches' job.

I do not stay late, except the day sports starts, for the stragglers and then only maybe 45 minutes, because I DO NOT GET PAID do to so.

I also do not answer texts about "is so and so cleared?" after I've left for the day.

The baby's head is not crowning. This is NOT your emergency.

(You need me to work with you again, dontcha?)

Text me sometime my friend.

RNqueens · Sep 9, 2015

Love you Farawyn . I just can't deal. My system is similar to yours expect for the permissionext slips and I'm responsible for the junior high school as well as high school. I also worked 5 days I the summer. I think I going to have to talk to my ad about the coaches taking their own permission forms. I feel the same way you do I don't care what sport they get permission for.

Farawyn · Sep 9, 2015

Love you Farawyn . I just can't deal. My system is similar to yours expect for the permissionext slips and I'm responsible for the junior high school as well as high school. I also worked 5 days I the summer. I think I going to have to talk to my ad about the coaches taking their own permission forms. I feel the same way you do I don't care what sport they get permission for.

I do JR high too, but again, my school is half the size as yours.

The coaches must own their rosters and permission slips. This is not fair.

akulahawkRN, ADN, RN, EMT-P · Sep 9, 2015

Love you Farawyn . I just can't deal. My system is similar to yours expect for the permissionext slips and I'm responsible for the junior high school as well as high school. I also worked 5 days I the summer. I think I going to have to talk to my ad about the coaches taking their own permission forms. I feel the same way you do I don't care what sport they get permission for.

You really need to talk to the AD about having the Athletics Department deal with the Athletics Permission forms. They need to provide you a list of students that have obtained permission to play sports. It's not your job to ensure that the students have the required academics to play, right? That's the job of the Athletics Department. Same with parental permission forms. The Athletics Department collects those forms, determines who is eligible to play and provides you a list. Once you have the list, you can then distribute the medical clearance forms to the players and schedule the pre-participation physicals, if done by an in-house physician, an/or set a deadline for receipt of medical clearance forms. You then obtain the completed forms/clearances for all athletes and relay back to the Athletics Department the roster of athletes that are medically cleared for play. If they're not on that roster, then they're no-go until cleared.

I used to be an athletic trainer. If you have one of those on staff, their education in sports medicine easily exceeds yours, if they're ATC certified, so let them do that work for you if they're available. Nurses do not have the requisite education to function in the role of an ATC safely. The ATC is more than capable of pre-screening athletes, and often can do it in more depth than you can.

Farawyn · Sep 9, 2015

Agree that the trainer can take over some of the duties, but honestly, this should fall on the coaches.

We can't "clear" anyone to play, nor can a certified trainer, only the doctor does that.

The pre screenings are often eye and ear screenings as well as medical history, sometimes psych history or discussion of seizure meds, inhalers, etc...not the ATC scope, the RN scope.

Our trainer focuses on traumatic injuries on the field and works with me on our concussion team. She is also a teacher and teaches health class and gym.

Another point, RNqueens. I do not enter anything into the computers until after the rush of sports clearances are done. I put them aside, as well as my immunizations, and enter after the main teams are set. I was going to begin entering data tomorrow as a matter of fact.

akulahawkRN, ADN, RN, EMT-P · Sep 10, 2015

Agree that the trainer can take over some of the duties, but honestly, this should fall on the coaches.
We can't "clear" anyone to play, nor can a certified trainer, only the doctor does that.
The pre screenings are often eye and ear screenings as well as medical history, sometimes psych history or discussion of seizure meds, inhalers, etc...not the ATC scope, the RN scope.
Our trainer focuses on traumatic injuries on the field and works with me on our concussion team. She is also a teacher and teaches health class and gym.
Another point, RNqueens. I do not enter anything into the computers until after the rush of sports clearances are done. I put them aside, as well as my immunizations, and enter after the main teams are set. I was going to begin entering data tomorrow as a matter of fact.

You're correct... only the physician can clear an athlete for play. My focus was on the management of the process. The ATC or the RN is capable of managing the preparticipation clearance process. The ATC, if one is on staff, should be part of the process from the beginning because they're going to be involved in the injury/concussion evaluation, referral out to the appropriate physician, and through post-injury rehab and return to play.

Farawyn · Sep 10, 2015

You're correct... only the physician can clear an athlete for play. My focus was on the management of the process. The ATC or the RN is capable of managing the preparticipation clearance process. The ATC, if one is on staff, should be part of the process from the beginning because they're going to be involved in the injury/concussion evaluation, referral out to the appropriate physician, and through post-injury rehab and return to play.

Yes, agree!

akulahawkRN, ADN, RN, EMT-P · Sep 10, 2015

Yes, agree!

On this one particular detail, yes we do. However, unless the RN has an ATC, Exercise Science, or Physical Therapist education/background, or is an Orthopedic NP, there's just too much specialized knowledge to learn to safely do the job of an athletic trainer without additional extensive education. There's a lot more to doing that job than simply "dealing with traumatic injuries" or evaluating concussions.

Farawyn · Sep 10, 2015

On this one particular detail, yes we do. However, unless the RN has an ATC, Exercise Science, or Physical Therapist education/background, or is an Orthopedic NP, there's just too much specialized knowledge to learn to safely do the job of an athletic trainer without additional extensive education. There's a lot more to doing that job than simply "dealing with traumatic injuries" or evaluating concussions.

Like what?

I'm not being facetious. What is the job?

NutmeggeRN, BSN · Sep 10, 2015

I do the roster check for physicals. I run ImPACT testing. Coaches do permission form. AD does grade check. Busy busy time of year for sure! I started preseason jet lagged from travel, not pretty!

akulahawkRN, ADN, RN, EMT-P · Sep 10, 2015

Like what?
I'm not being facetious. What is the job?

This is an article that provides a small window into the job of an ATC: Athletic Trainer - Career Information

I'm not saying that the ATC is "better" than an RN or that an RN is "better" than an ATC overall. What I am saying is that an ATC and an RN are ill-equipped to do "the other" job because the RN's education is too generalized and the ATC's education is too specialized, both to the point where a LOT of additional education would be required to "switch roles." Incidentally, the ATC follows the medical model.