Teacher's aides emptying/changing colostomy bag - safe? reasonable?

[systoly]

An acquaintance, a teacher's aide at a high school, asked for my input on her new duty which involves the emptying and changing, if necessary, of a special ed student's colostomy bag. The training was provided by another aide who, in turn, was trained by a family member. While it quickly became obvious that training was inadequate, I'm not sure what to make of the whole thing. Do you think it would be reasonable and safe provided adequate training could be secured?

[kakamegamama]

First, the school policy regarding this should be the "go to" document for legality/etc. Second, if the school policy supports the training of a non-medical person for this---why not? Would it be any different that the family member doing this? School districts usually have in place policies for this sort of thing, and the school nurse is responsible for delegating, just as she/he would be for delegating in a healthcare facility.

[brownbook]

Kakamegamama said it all. It is even allowed for school aides to give insulin. Way more complex and dangerous than changing a colostomy bag. Depends on the schools, district, county, state, national, nursing, and medical, policies and laws.

I know that sentence sounds awkward, can't figure how to re-word it.

[beast master RN]

changing a colostomy bag is extremely easy, cut out the hole, clean the area and slap it on, other than assessing the area for infection or other things its a really strait forward no brainer task

[merlee]

Obviously, more than one person needs to be trained, and explicit written instructions with illustrations need to be available. Maybe the family could take actual photos of how it should be done. No faces, of course.

Almost anyone can be trained; people do this at home all the time. The school district needs to have a policy about this.

[KimberlyRN89, BSN, RN]

Where's the school nurse?

[canoehead, BSN, RN]

Same risk as changing a diaper.

[kool-aide, RN]

We teach family members how to do this all the time. I don't see why these TAs couldn't with proper training and permission from the school district and parent of the student.

[schooldistrictnurse]

Remember that the nurse delegates the task (if the district has a nurse) but the task cannot be further delegated by the person to whom it was delegated. By that I mean the nurse can delegate but the aide cannot delegate to another aide. I'm not sure how this applies if there is no nurse in the school or district.

[fuzzywuzzy, CNA]

Oh geez. She's not performing surgery. And she's not in a hospital. So she doesn't need a nursing degree to change a bag. Here's a scary thought- an UNLICENSED person gave me a Midol the other day! Parents dole out medicine to their children! They use ice packs and medicated creams and put bandaids on people all the time, and the world goes on. Just because you need an order for practically everything in a healthcare facility (dandruff shampoo? really????) doesn't mean it's like that everywhere else.

[OCNRN63, RN]

If I were a teacher (and I actually considered teaching instead of nursing), I would be furious. Teachers are being expected to do all sorts of nursing skills lately d/t the integration of special needs students. Not to mention they're supposed to be cops, social workers, etc.

Teachers are in schools to teach, period.

Why can't this student be responsible for caring for his own bag? Is he not competent to do it himself?

[Horseshoe, BSN, RN]

If I were a teacher (and I actually considered teaching instead of nursing), I would be furious. Teachers are being expected to do all sorts of nursing skills lately d/t the integration of special needs students. Not to mention they're supposed to be cops, social workers, etc.

Teachers are in schools to teach, period.

Why can't this student be responsible for caring for his own bag? Is he not competent to do it himself?

I used to be a teacher before I was a nurse. Now that you mention it, I would probably have been really taken aback by being asked to change a colostomy bag. I think a lot of teachers would as well, and many would probably outright refuse...I can see how someone not related to the child or someone particularly squeamish might well gag or puke, and that would be sad for the child. As nurses or parents or professional caregivers, we get used to this kind of thing, but a teacher might have great difficulty mentally/emotionally doing this. Though I agree it's not a dangerous or particularly difficult task, I can see how some teachers or teachers aides might feel that this was venturing far outside of their job description/scope.