Toileting pre-k a nursing function?

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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?

I was just about to ask a question similar to this. How many of you help with toileting with special ed students or students who are 504?

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Specializes in School Nursing.
56 minutes ago, pennyeary said:

I was just about to ask a question similar to this. How many of you help with toileting with special ed students or students who are 504?

Since I have multiple buildings/schools, this would not be a nurse/health aid responsibility. If a student has toileting assistance as an accommodation on their IEP/504, it is the school's responsibility to train a staff member to perform this care. I will say it is uncommon for a student to require toileting assistance who is not already receiving heavy assistance in other areas.

Also to clarify further, not being "potty trained" at a Pre-K, KG, or even 1st grade level can be age appropriate. My district is very strict that potty training is NOT part of any curriculum and is not an expectation of the school staff. If we have a student who is aging up and is still not potty trained, the social worker/school psychologists usually get involved and communicate with parents about potty training at home and connect them with resources.

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Specializes in School Nurse, past Med Surge.

I have/will help in a pinch, but my thoughts are that it's not my issue. We don't have PreK in my building, but even kinders I will send into the bathroom & talk them through it if necessary. It's an important skill to learn, it should absolutely be the teacher or TA's job to help then learn to take care of their toileting needs & changing clothes, buttoning, zipping, etc.

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Specializes in School Nursing.
On 1/8/2020 at 12:30 PM, ihavealltheice said:

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.

In all the school divisions I know, it is not a nursing responsibility, as it is not a medical task. Toileting is the responsibility of the TA. The nurse can train the TA, but it is not a nursing function.

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Just now, beachynurse said:

In all the school divisions I know, it is not a nursing responsibility, as it is not a medical task. Toileting is the responsibility of the TA. The nurse can train the TA, but it is not a nursing function.

My health aid though is not a nurse. So I think that's where the barriers for her exist. She's mainly seen as a catchall secretary, unfortunately.

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Specializes in School Nursing.
6 minutes ago, ihavealltheice said:

My health aid though is not a nurse. So I think that's where the barriers for her exist. She's mainly seen as a catchall secretary, unfortunately.

Neither was mine, and she was not pulled from the clinic to assist with toileting. She was considered clinic staff, and part of nursing, so therefore not a TA. It got bounced right back to the TA.

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Specializes in Med-surg, school nursing..

In hearing how your principal responded I would approach it this way:

How often is this happening? Once in a blue moon, okay, I'll help.

Every single day? I would talk with the principal and make sure to word it something like "While I am trained to take care of toileting issues, I am worried about the liability that the school might have should an actual emergency arise while I am assisting with an issue that could easily have been handled by other staff.

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Specializes in School nursing.
On 1/9/2020 at 12:32 PM, pennyeary said:

I was just about to ask a question similar to this. How many of you help with toileting with special ed students or students who are 504?

If this is the case, I'm betting there may be a strong chance this student needs a 1:1 para or nurse and that person would be the one assigned with this task. At least with my older MS/HS population :).

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