Student with a new trach and feeding tube

[shsnurse]

What are things that need to be in place BEFORE he/she returns??

-CFST meeting?

-Medical release of info (for communication with the doctor)

-Orders signed by the doctor for special procedures

-Diet order

-EAP/IHP

-Staff training

-504 plan

-Emergency equipment for student (extra trach, ambulance bag for trach, etc.) that stays with the student.

-A qualified full time nurse or resp therapist to assist him/her at school and classes. Do they need a nurse or therapist to follow them at school? I would think so.

-communication board/laptop (student is now nonverbal)

These are the things that I thought of while brain storming. I've taken care of patients in the hospital with new trachs and feeding tubes but not the school setting. Also it's only been two weeks since he/she received the trach/tube. It seems too soon for him/her to return in my opinion. I think the student should be homebound the rest of the school year to recover (geez we only have 5 weeks left).

Please help me! If anyone has a student with a trach and/or feeding tube..tell me how you care for the student in the school setting. What is your routine? Do they have 1 on 1 care at school...a personal nurse?

Also can someone send/ upload an IHP for feeding tubes and trachs.

Thanks soooooooo much in advance!

[GmaPearl BSN RN]

In my district all our trached kids have a one on one nurse.

[doodlebuttRN]

How old is the student? They should have ST involved for the communication issues, also working on determining the appropriateness of an assistive communication device. They really should have a one in one nurse. You can't be expected to respond to an emergent situation such as patient or peers pull the trach out (in classroom, on playground, on the bus) in a reasonable time frame. Where I am, these kids have a nurse with them at all times ( nurse must keep patient in sight at all times), either through a PDN agency or sometimes through the school district. What a liability nightmare for you if they don't. Imagine if you're on one end of the building and the patient decannulates... Some non medical person has to realize the nature of the problem, call for help, get you there so you can intervene.

[lifelearningrn, BSN, RN]

What type of classroom was this child in prior to this? Are they putting student in a self-contained classroom or regular classes? Students like this should have 1:1, or at the very least in a classroom with a nurse in the room.

[shsnurse]

Thank you all! We had a meeting today with parent/student, administration, his/her teachers, and some of the support staff. I found that state guidelines require a 1:1 nurse at all times and I will check his/her go bag (trach emergency kit) routinely. The decision we came to is that the student will be homebound these last few weeks of school and we will be working on his/her transition to school for the next school year by getting orders, proper staff training, IHP and IEP, AND the 1:1 nurse. In the mean time I had the parent sign a medical release, gave her the specialized procedure forms and, diet order form to get completed.

[shsnurse]

What type of classroom was this child in prior to this? Are they putting student in a self-contained classroom or regular classes? Students like this should have 1:1, or at the very least in a classroom with a nurse in the room.

Regular Ed. The plan is to keep the student in regular Ed but with an IEP. With a 1:1 nurse.