137 Posts
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.
2,602 Posts
37 Posts
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.
37 Posts
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.
GmaPearl BSN RN
283 Posts
In my district all our trached kids have a one on one nurse.