Suctioning in the classroom?

[Not_A_Hat_Person, RN]

I'm a home health nurse, doing private duty. I go to school with my client. We spend most of the day in the special ed room, but we also attend band and chorus. My client is there to listen, and I try to be unobtrusive as possible.

Among other things, my client requires suctioning. I usually suction before class, but sometimes he needs suctioning during class. I hated the idea of suctioning in the classroom, so I asked Mom about it. She suggested doing it when there is music playing. When the family goes to church, Mom suctions my client during hymns, so the sound is drowned out. I followed Mom's suggestion, with mixed results. The chorus teacher asked me not to suction him in class. Taking him out to the hall from the chorus room is very tricky, so if he needs a lot of suctioning, we skip chorus. The band director has never said anything.

Today, band had a sub. My client needed suctioning, so I waited for a piece to start. When I pulled out the catheter and started suctioning, the band sub visibly recoiled. He looked like he was going to vomit. I ended up suctioning my client in the hall.

I don't blame the band sub for reacting the way he did, but part of me thinks I shouldn't have gone into the hall. The regular band director has never complained. Since I deal with this every day, I'm inured to it.

Should I suction my client in the classroom at all? How have other nurses handled in-school suctioning?

[caliotter3]

Make every effort to speak to a sub before class starts.

[PediLove2147, BSN, RN]

I too take care of a child that requires suctioning. I do it in the classroom unless the teacher is teaching a lesson. No one seems to mind and it would be a pain to bring him into the hallway every time he needed something.

[tothepointeLVN, LVN]

I would not be pulling the patient out in the hallway just to make other people feel comfortable unless you were providing privacy for the patient. Just have your stuff organized and you should be able to get in and out in the minimum amount of time.

Like a suctioning ninja nurse

[Kyasi]

Shame on that sub teacher. I used to take a child to school who needed frequent suctioning. We sat near the back of the class and I was told just to suction him there. But whenever I turned the suction on, every kids eyes went from the front of the room and turned to watch. I felt sorry for the teacher. During recess when I suctioned him and the kids would stand around to watch, I used that opportunity to educate them. I told them that when they got congested, they could just blow their noses, but that XXX could not so he needed some help so he wouldn't choke. A simple explanation that seemed to satisfy them and soon the novelty of it wore off. I did the same when I did his feedings or had to give him meds.

It is challenging for classes to incorporate these kids into the classroom as there is noise and disruption but kids do adjust, especially if they have a teacher who treats this in a positive way. I hope you find an appropriate way to deal with this.

Kyasi

[Blackcat99]

I have been told to take my patient to the bathroom every time I want to suction.

[ventmommy]

My child does not go to school because of his fragility but when we are out somewhere, anywhere, suctioning is done wherever we are. My child's ability to breathe is more important than whatever is going on around us and any discomfort felt by bystanders.

If my child were more aware of his surroundings and preferred to go somewhere private in a non-emergent situation, I would do that but I would never do it in a public restroom. That is germ central.

[Blackcat99]

Yes, I feel like I should be able to suction my patient wherever and whenever he needs to be suctioned period. However, it was his teacher who specifically told me that I could not suction him in the classroom or in the cafeteria. She said I am to take him to the students bathroom each time he is to be suctioned.

[tothepointeLVN, LVN]

I would tell the teacher NO I'm the nurse and suctioning in the bathroom is not acceptable and your patient has a right not to be alienated from his peers based on his disability.

That would not be acceptable for me. However when I when I had a similar patient he was going to a special ed school so things are different.

[Blackcat99]

Yes, it is strange. My patient is going to a special ed school. There are a lot of DD children with behavioral problems going to this school. I haven't seen any other students with a trach or with a private duty nurse.

[Not_A_Hat_Person, RN]

I wouldn't suction in the cafeteria when people are eating; it's like blowing your nose at the table.

I'm very surprised that a school for the disabled wouldn't want a student suctioned in the classroom.

[tothepointeLVN, LVN]

If the kid was aspirating from eating in the cafeteria then I wouldn't hesitate to suction him. Manners or not.