terminally ill child

I would go to the school administrator. But Iwould say that yes there should be something in the file (Legal) school lawyer or personal lawyer as long as it is legal and there is a copy in his school file and the nurses file. But really I would approach the head school administrator about this issue so you will know what needs to be done in case this situation comes up again.

Angie

For any medically fragile child you need an emergency plan. How will you be contacted for CPR, calling 911, alert the EMS (with a release) that you have a child that will likely intitate a 911. Get releases to talk to the physicians about where to send the child with what information etc etc etc.

I would go to the school administrator. But Iwould say that yes there should be something in the file (Legal) school lawyer or personal lawyer as long as it is legal and there is a copy in his school file and the nurses file. But really I would approach the head school administrator about this issue so you will know what needs to be done in case this situation comes up again.

Angie

My first thought is this child would have had a 504 in place. This could have been the forum to address these issues. As a school nurse, I would have also asked the question. If the parent did want CPR, I would have worked to coordinate this through the other providers. For instance, was this child on hospice or has the private physician discussed this with the parent? It may be legal documents have been drawn up and you just need to have a copy on file.

Resources for the schools vary greatly. Do you have a designated Medical Director over school health? Also most states have a State Nurse Consultant to offer some guidance. Hope this helps!

We were in the process of receiving a terminally-ill child at our school. Today I found out he died. Since his condition was fatal, I asked the mom in a prior meeting if she wanted us to perform CPR or to let him go. She wanted all measures performed to save his life. To all of you school nurses out there with experience in this area, do you ask for advanced directives to be drawn up by the school lawyer or what? I'm so lost in this type of situation that I'm not sure what questions to even ask you. I feel there must be some kind of legal documentation on file for these kinds of situations, but I'm just not sure what is needed. We have no head nurse in our district, so I can't turn to her/him for guidance. Any ideas?

Thank you all for your advice. I writing it down. You have suggested some things that I would have never thought of. I hope a situation like this never comes up again, but just in case it does, it's good to be prepared.

are you in a public school? all of my medically fragile children have individual health care plans with a dedicated emergency procedure. (Project School Care at Childrens hospital in Boston puts out an excellent book regardiing same.)All of that is covered by a physician order, which we follow. the IHCP is updated prn, its like a care plan in the hospital.

We just wrote up our District's DNR policy this year! Definiitely add a 504 and Emergency Health Care Plan for this student. Make sure it can be easily located in case you are out. All of the things mentioned in the above postings should be included in your plan.