Toileting pre-k a nursing function?

[UpliftingRN, BSN, RN]

Hi all,

Just polling how many school nurses assist/toilet students when they have accidents in school. I am the only nurse in my school and I had a huge back and forth about this with a pre-k teaching assistant (who adamantly defended they were not "trained" to do this citing something along the lines of using proper precautions to do this) and later with the principal. I had to defend my view on why I should not be leaving the office to toilet an accident in pre-k as I feel I should be available in the nurse’s office to take care of students who have actual medical needs. Thoughts?

[tining, BSN, RN]

Duties as assigned should be on the TA's contract.

Lazy, just lazy.

[UpliftingRN, BSN, RN]

Oh, they used that excuse as well! This is a private school and apparently unless you have a "contract" perhaps everything falls on you. Where's my contract?! It's really a shame.

[ihavealltheice]

In most schools, it's seen as a nurse's responsibility and is a losing battle. I don't work in the health office of the elementary school I am in charge of, but my health aid has told me stories. There are some teachers aids that deliver the child to the health office, while the health aid help clean up the PreKer, the teachers aid will just stand there and watch.

Makes me mad, but I have much bigger fish to fry.

[BrisketRN, BSN, RN]

Our preschool teaching assistants and teachers deal with potty accidents. I will help in circumstances where no one is available and it's either I clean a poopy kid or I watch 15 preschoolers while teacher cleans a poopy kid. Can you offer to do a training session with teaching assistants? Make a really nice power point about wearing gloves, wiping from front to back, washing hands properly. Maybe even throw in some freebie tips--wear multiple pairs of gloves for BIG poopy messes then strip one off at a time to keep the booty clean. It really would be a shame if a real medical emergency...ya know...the thing you're here for...was to occur and you were in a bathroom cleaning up a toilet mess. It truly is best that you're in your office aside from lunch break and emergencies.

[SandIsMyGlitterRN, BSN, RN]

In our district the school nurse is not responsible for toileting in PK. My school has several PK classes and that is solely the responsibility of the teacher and TA. It is actually part of their state compliance rules.

[UpliftingRN, BSN, RN]

It's so interesting to hear how this is handled so differently depending on the school. I did actually volunteer to do a training which the principal replied "yes that would have to be a whole other thing but in the meantime this is how we are going to handle it". I just hated the feeling that it was just a passing the buck thing. I mean of course no one WANTS to clean up after toileting accidents but in the interest of the safety of the children/rest of the school, I was hoping the logic would be to keep the school nurse available for actual medical situations/issues.

[BrisketRN, BSN, RN]

37 minutes ago, UpliftingRN said:

It's so interesting to hear how this is handled so differently depending on the school. I did actually volunteer to do a training which the principal replied "yes that would have to be a whole other thing but in the meantime this is how we are going to handle it". I just hated the feeling that it was just a passing the buck thing. I mean of course no one WANTS to clean up after toileting accidents but in the interest of the safety of the children/rest of the school, I was hoping the logic would be to keep the school nurse available for actual medical situations/issues.

That is so frustrating. Training would take 15 minutes. I'm sorry your principal isn't seeing the need to utilize the nurse correctly.

[mainecoonRN92, BSN, RN]

1 hour ago, Nurse Jen said:

In our district the school nurse is not responsible for toileting in PK. My school has several PK classes and that is solely the responsibility of the teacher and TA. It is actually part of their state compliance rules.

This is the same in my state. You cannot run a public preschool without the teachers and their assistants receiving an annual training on diapering, standard precautions, etc. It's part of the child care licensing agreement.

[Jedrnurse, BSN, RN]

If a pre-K TA doesn't know how to handle toileting, they are in the wrong business...

[UpliftingRN, BSN, RN]

17 hours ago, mainecoonRN92 said:

This is the same in my state. You cannot run a public preschool without the teachers and their assistants receiving an annual training on diapering, standard precautions, etc. It's part of the child care licensing agreement.

Unfortunately since my school is a private school we do not have the child care licensing requirement like the public schools do apparently. But we SHOULD.

[MrNurse(x2), ADN]

I work private. There was no nurse 5 years ago, and then when I came, it continued to be a teacher issue. Being male probably helped in this instance. In a school with a counselor, I would try the behavioral angle that this needs counseling more than a medical intervention.