What to do at school

[Not_A_Hat_Person, RN]

I work private duty, and I go to school with my client, who is in high school. The client has a trach, which means he has to have a nurse instead of an aide (agency policy, not the school district's). He goes to a few classes and some therapy. I thought it was odd that my client didn't have an individual classroom aide, like some of the less disabled students I've seen. Today, I found out why.

I finally got a look at my client's IEP (Individiual Education Plan), and realized that I'm expected to provide instruction! I'm supposed to do a few things every day and see how my client responds. I had no idea. I'm a nurse, not a teacher. I've read books to my client, asked questions (the client uses a switch to communicate, though not well), and put on music, but I'm not sure what else I'm expected to do.

Is this the norm for Private Duty nurses in school? I like the job otherwise, but I'm wondering if I'm being taken advantage of.

[tothepointeLVN, LVN]

When I was going to school with one of my preschool patients I also found that a lot of the assigned activies I was expected to participate with such asdo the patients walking therapy, the craft projects , the reading. Only circle time did the teacher do. I kind of felt this wasn't right because what benefit was the child getting from school if I was doing all the interaction which I would have done at home.

[caliotter3]

If the nurse is doing all of these activities with the patient, they should occur at home. In the school setting you are doing what the teacher is being paid to do.

[nursel56]

Oops! They forgot to mention that little detail to you when they had the IEP meeting? Sorry, but having personal experience with these things it's very easy for them to allow a child to fall through the cracks while the school gets the Special Ed bucks for not doing jack. :-/

I would request a meeting with the Principal of the school, who is required to either be at, or send a qualified representative to the IEP meeting. If you are being asked to tutor the child 1:1 while he is in school you should have been a participant at the planning stage and I would say that unless they spell out exactly what you are expected to do and exactly what they are expected to do they can lump it.

These things are so detailed with intervention/goal analysis from every department and the butcher the baker and the candlestick maker they can't possibly mean to say " just go teach the kid ummm. . . something-- you make it up! We will have no clue how to evaluate the effectiveness of your intervention but oh well!"

I would also run it by your agency to see if they have a policy regarding that - and if so - maybe taking a look at some age-appropriate homeschool curriculums would give you some ideas assuming he does not have a delay there, too.

[joprasklpn]

kids I have gone to school with do get the benefit of being around other children. I do agree that some teachers seem to think they have no obligation to actually teach special needs children or even interact with them when they have a nurse. I personally enjoy helping with the arts and craft projects and trying to help the kids get the most out of the school day. I have never went to school with a high school student so I really can't say much about that, but I do know younger kids like to be included in a group and not cooped up at home.

[WI_home_RN]

I would request a meeting with the Principal of the school, who is required to either be at, or send a qualified representative to the IEP meeting. If you are being asked to tutor the child 1:1 while he is in school you should have been a participant at the planning stage and I would say that unless they spell out exactly what you are expected to do and exactly what they are expected to do they can lump it.

I don't go to school with the kids i care for but i can ask the RNs who do attend school what they do. As a Mom of a special needs son, I can attest to Nurse's comments about the importance of the IEP. Since you are part of the student's/patient's school day, you should definitely be included in the IEP (individualized educational program). The IEP spells out EXACTLY what goes on, who does what, goals achieved, etc.....IEP is for teachers as to what the Care Plan is to RNs. It should spell out exactly what is expected of you at school just as your plan of care spells out what is expected of you at home. Be sure to ask for a copy of the child's IEP report and review it and have it in your files as well.

[PediLove2147, BSN, RN]

I go to school with my patient (he is in the 2nd grade) but he has a 1:1 teacher. I am only there to attend to his medical needs. I read otherwise. I don't think I would feel comfortable doing school work as I didn't go to school to teach and honestly have no idea how to go about it, especially with a developmentally delayed child.

[liveyourlife747]

this situation frustrates me so bad. there has been only one class ive been to (out of 4 special ed) that the teachers actually work with the kids and the nurses did only the nursing stuff. We even have a school that requests the nurses do not do instructional things with the kids at school, but when you go to school with him the teacher and aides do nothing and they expect the nurse to do it all. i always feel bad when i see our client not being able to participate because the teachers are being lazy, so i feel like i need to give that child the opportunity to feel somewhat normal and be involved with his/her peers, thats why i step in and get the child involved, hoping to show the teachers how much the kid loves it. but hasn't helped too much yet.

in my opinion the nurse is there to tend to the medical needs of the child in the school setting and the teachers should do the teaching like they are trained to do.