Students without clothing

[NurseKitKat]

I have worked at three schools in the past 13 years & have always been told school nurses are not to see students without their clothing unless their is a Drs order for a cath, Diastat admin, etc. However, I have been asked to clean up students who have had accidents at my current location. I am on my own here, there is no "lead" nurse, so I really have nobody to get clarification from. I assumed if I have been told not to do it as my previous employment, it is the rule for our state. I attempted to contact my school nursing association for my state (Georgia), but as I cannot afford the membership, I was not able to get into the site. Does anyone have any knowledge that may be of help? I don't want to anger my current boss, but I want to make sure I am following the state law.

Thanks in advance :)

[NurseKitKat]

I just wanted to thank everyone for taking the time to respond

[JustBeachyNurse, LPN]

I'm just being asked to clean up students who have had accidents, something I've never had to do anywhere else, and was actually told specifically NOT to do.

The district was forced to hire an appropriate trained para in the one school. Some states with wraparound services allow for a Medicaid paid PCA to go to school with the child for ADLs and toileting. I believe PA is one.

[pistolchick]

So, as a substitute, I've walked into a situation where there is a particular student that sometimes has soiling and the staff (either the old nurse or office staff) have always helped her clean it up. To be honest, it's a sticky mess, and would be difficult for her to do herself.

It never occurred to me that I shouldn't be doing this until finding this thread. There is a precedent that has been set here, and it would be difficult to challenge. Thoughts?

[Flare, ASN, BSN]

if a child needs help, i'm not above helping them - it happens from time to time - but i'm not going to do it unless there is another adult present that can attest that everything being done was necessary and appropriate.

[chasinRT]

I have a spina bifida student that self caths and i monitor (with a doctor's order of course) and I do help him with cleaning up as needed after BM. I don't have a witness which I know is risky but I do it.

[Spidey's mom, ADN, BSN, RN]

I actually tried to contact them, but because I am no longer a member of the association (school nurses in my area are not paid well at all), I was unable to e-mail them

I'm not a member of NASN or my state association anymore - haven't been for a couple of years. But I can still access info on the websites of both and contact members. There should be email addresses in the "contact us" part.

I didn't help with clean-up. We did have some clothes stockpiled just in case and the kids for the most part can change their own clothes with urine. BM entailed a call to parents while they sit and wait in the office.

[txbootsy]

Pre-k and special needs classes have para help.

k-5, change in my bathroom and I check them out before they leave.

[lifelearningrn, BSN, RN]

We have four full preK classes along with K-5 so accidents are pretty regular at my school. For the most part, the older kids are given clothing, wipes and a bag for their messy clothes and directed to the bathroom to clean themselves up. I can also do this with some of the PK kids, but some of them need assistance, and if they ask for help, I will help them. They're 4, and parents generally appreciate not having to come up to the school to do this. What is crazy is that I have more issues with older kids having accidents than the PK! :/

[peacockblue]

Our paras refuse to assist a student with toileting or cleaning. They feel it is "nurse" work. I tried to make the case that if I am toileting a student, I am unavailable to take care of real medical needs if they arise. My principal backed the paras. I have been called out of lunch (on the rare occasion I take one) to assist with toileting because it is nurse work.

[txbootsy]

Awful

[RatherBHiking, BSN, RN]

I have to clean up students occasionally. If the parent doesn't answer the phone and their class doesn't have an aide then it falls to me. I hand the students wet wipes and clean clothes and have them clean up. Once in a while I have to step in if they're making a bigger mess.

I've had people look at me strange as if I'm shirking some duty when I won't check a kid's rear end if it's itching or whatever. I've had parents ask me to check and I tell them no I can't diagnose them anyway.

I wish we we could get some type of policy on this such as requiring two people if it involves undressing, not changing kids, etc. but we're told just to take care of it if the issues arise on our own if no one else available because we're nurses.

[SassyTachyRN]

One of my schools is prek and k only. I end up changing prek kids the majority of the time I am there. It's awful. The paras won't do it, they never have and have a belief that they can't. They are very resistant to change and the principal is trying to get them to help with it but it hasn't been going well. I spend about 48 hrs at that school a month and change about 30 kids a month there.