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?
Rather then to confront the teacher, I think I would speak to the principal about this and ask her/him specifically what the school policy is. I would also let her/him know what you have experienced in suctioning your patient in class, the teacher's response, and what you have been asked to do. You can share your concerns regarding the patients rights at this time.
You really don't want to alienate the teacher by challenging her. It will make your work days miserable. Just my opinion.
I think we're all so used to suctioning, we don't think much of it. But I am thinking of the other kids. How many of them are bothered by it or freaked out? Are they able to understand with it and accept it? How does the pt feel about it? Does it embarass him to be suctioned in front of everyone or he is more embarassed by leaving class constantly. I think the decision should be his and the other students' opinion at least weighed.
Better yet, maybe you can talk to your Supervisor about the problem and see if you can set up a meeting with the teacher, parent, nurse, principal, etc to discuss the issue and try to come up with a solution that benefits everyone involved.
Hey all, I am a homecare RN & had a similar experience today and I am SO GLAD I found this post with everyones' feedback! I feel less frustrated. I was taught to provide as much privacy for the client as possible. Sometimes it is possible for my client to drive his w/c into a private room if nearby. Other times, suctioning occurs on the fly . . . we try to turn into the wall or a corner for privacy when we can't get out of the classroom. We are at a new school, FYI.
Today we needed to suction fast, during lunch. Client went to the main office which faces the cafeteria, because he didn't want to sxn with 100's of eating students watching. We found a private alcove near a handicapped bathroom inside the main office, and he faced the door of the bathroom, which was out of view from the office staff.
Later the school nurse came to talk to me, stating she had received complaints from the office staff who stated we made them feel uncomfortable & that we cannot suction in the office. She asked me to use the public handicapped bathroom or a private breakroom the school has given us a key to, which is in a different building accross campus. I told the nurse I do not sxn trachs in the most contaminated area in the school, therefore we do not use bathrooms, and this child can't drive his w/c accross campus to our designated "suction room" while he is suffocating on secretions. The school nurse sympathetically stated she is completely in favor of suctioning whenever and wherever we need to, but that these public school employees are not "medical people" and it makes them feel uncomfortable. We need to be respectful of them and their office.
I am so infuriated over this. I am infuriated that the client & I made the effort to find a private alcove, in the staff office, away from the kids, and the client's back was turned towards any eyes. I am angry because I thought I was using correct judgement. I am infuriated that the public school staff are more concerned about their own comfort level than the confort level of a child who feels they are suffocating on an airway full of secretions.
This is the first child I have accompanied to public school as I normally work in vent facilities, and the child is new to this school, so we are trying to figure out how to survive. Do you guys suction in the bathrooms? I normally wouldn't, but maybe the bathroom is where we are supposed to go in the school, when we don't have time to go to our "suction room"?? Good grief.
I think it really depends on the child and the situation. We have a few that we suction in the classroom. On the first day of school, the nurse who is with the client usually tells the "mainstream" class why the child has a trach/vent and needs suctioning. I've never had any problems with these children.
the other girl we have is in her teens, she is a typical teenager and in mainstream classes full time. she chooses to leave the classroom and face away from people before she gets suctioned. its her preference and i can understand why she is a little embarrassed to be suctioned in the classroom.
I am new to this as well after doing ER/ICU where suctioning is no big deal. I am in a special ed classroom but the pt is very aware and uses her wc independently. I have suctioned during art and I think 'read aloud' when with regular kids when I had to but we turned to back of classroom, teacher (special ed) stood in front of us and made sure 'all eyes were front'. I generally suction in special ed classrooom and hardly ever have to take suction machine with me unless she is coughing up a lot of secretions.
I would do my best not to suction in cafeteria but airway comes first.
But that said my pt is not vented, very stable and has an elective trach prior to a procedure. She eats and hardly ever needs suctioning.
I think you take care of your pt first, use privacy when possible but suctioning in BR or waiting till you get to a part of the school where it is 'convenient to teachers etc' is ridiculous.
Things have gone from bad to worse at my school. The school staff are still fighting the nurses over where the suctioning is to be done. I was being bullied by this teacher. I am working in a hostile work environment every time I take this child to school. I had to be very assertive and matter of fact with the teachers and staff. I told them that my boss said I could suction wherever and whenever I wanted. I have been reported as being "hostile"
and that I have greatly offended the teaching staff. In fact, the school has now filed a report against me to the main honcho-I think it is the superindentent of the entire school system in my area. I wonder what they are going to do next? Perhaps they will call the police and tell them of my terrible crime of suctioning this child!!!!!
Things have gone from bad to worse at my school. The school staff are still fighting the nurses over where the suctioning is to be done. I was being bullied by this teacher. I am working in a hostile work environment every time I take this child to school. I had to be very assertive and matter of fact with the teachers and staff. I told them that my boss said I could suction wherever and whenever I wanted. I have been reported as being "hostile"
and that I have greatly offended the teaching staff. In fact, the school has now filed a report against me to the main honcho-I think it is the superindentent of the entire school system in my area. I wonder what they are going to do next? Perhaps they will call the police and tell them of my terrible crime of suctioning this child!!!!!
I am presuming you work for a HH agency. Are they aware of these problems?
One of the nurses whom works for my agency had an incident where pt plugged and pt turned blue, school nurse fighting pdn, school nurse trying to remove pt trach!! Prinicipal tried to get involved (for what?)..long story short big meeting with school district and agency, new policy agreed upon that pdn has ultimate say as SHE/HE is primarily responsible for pt.
I have been away from pdn after 8 weeks as my pt has to stay home for several months but agency tried to offer me more work in interim which is fine but in a school I have heard has this hostile type atmosphere so I declined.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Things have gone from bad to worse at my school. The school staff are still fighting the nurses over where the suctioning is to be done. I was being bullied by this teacher. I am working in a hostile work environment every time I take this child to school. I had to be very assertive and matter of fact with the teachers and staff. I told them that my boss said I could suction wherever and whenever I wanted. I have been reported as being "hostile"
and that I have greatly offended the teaching staff. In fact, the school has now filed a report against me to the main honcho-I think it is the superindentent of the entire school system in my area. I wonder what they are going to do next? Perhaps they will call the police and tell them of my terrible crime of suctioning this child!!!!!
I really, really do not like these people. It astonishes me that adults in the office have their delicate sensibilities offended by that - mind boggling. It I was there I would be all up in their faces about that. How selfish.
I've found (thank God) and my patient (vent, trach adult) that children, once you explain something to them, are less freaked out and intolerant once they get used to the noise of suctioning - they tend to be more curious than afraid, at least the younger kids do. After a while, they tend to "see" the person and the medical apparatus recedes from their attention. It is the adults here that are fuelling the problems.
You know Blackcat - I'm not sure what the answer would be other than to bring the hammer down on them by seeking out different channels to remedy the issue. I wish I was better versed on his legal rights via the ADA and the Special Ed apparatus with the IEP and all the voluminous paperwork that is.
That patient - poor kid - imagine what he must feel like having all of this go on around him. I'll add you guys to my prayers.
Thanks all. Yes this situation is unbelievable. The mother and I have contacted my nursing agency about this matter. They have now started having weekly meetings at the school. That teacher is a control freak. She bullies the nurses and tells them what to do and how to do it. The teacher thinks she is the "nurses supervisor." I finallly had to tell her outright that it is not the teacher's job to tell the nurses what to do and how to do it.. I am just so tired of all of this non-stop fighting. I love this little boy.:redpinkhe That's the only reason I stay on this case.
At least Mom is on your side! What state are you in? Every state has a disability legal advocacy center. Some are better than others. And some law schools have legal clinics that may be able to assist. Keep up the fight. You know you are right!
You should bring that teacher a trach sim and a suction machine and tell her that the sim child needs suctioning and on the way to her bringing it to the bathroom (or wherever she wants you to suction) you should tell her that the child is now blue and just let the "code" go downhill so she can see what it's like to do your job. That it's not so easy and that A LIFE depends on YOUR ability to do your JOB as a nurse.
The school staff are still fighting the nurses over where the suctioning is to be done. I was being bullied by this teacher. I am working in a hostile work environment every time I take this child to school. I had to be very assertive and matter of fact with the teachers and staff. I told them that my boss said I could suction wherever and whenever I wanted. I have been reported as being "hostile"
I wonder what they are going to do next? Perhaps they will call the police and tell them of my terrible crime of suctioning this child!!!!!
I'll add you guys to my prayers.
Not_A_Hat_Person, RN
2,900 Posts
In an emergency, yes, I'd suction wherever I had to. My patient is NPO, with a G-tube, so he wouldn't eat in the cafeteria anyway.