Wheelchair use in high school

[peaceful2100, BSN, RN]

I had a student come to me today stating he wanted to use the wheelchair because he has a broken ankle and he is using crutches. He stated that he is having a hard time getting around with crutches. He wanted me to just allow him freedom to keep the wheelchair but I didn't feel comfortable with that. I am checking with my supervisor haven't heard back but just curious isn't that the right thing. Do you allow/would you allow students to have freedom of a wheelchair (If they are not normally using one for other health reasons). Doesn't that require a DR's note for the student the even use a wheelchair? For me to even push the student in the wheelchair?

[Tina, RN]

I think you would need a doctor's order for that. You need an order to allow for crutches, so I assume a wheelchair would need one, too?

[OldDude]

You'd need the MD order and the wheelchair would have to be provided by the patient/family.

[cayenne06, MSN, CNM]

Hmmmm. I'd imagine you'd need a doctor's order to allow that. But if I was in high school, I can see why I'd want a chair instead of crutches. I can't imagine trying to lug around all those books while hobbling on crutches. Seems reasonable to me.

[cayenne06, MSN, CNM]

You'd need the MD order and the wheelchair would have to be provided by the patient/family.

Now that I think about this more. . . my daughter has a progressive physical disability, and she used the school chair ad lib when she was transitioning from using a gait trainer to being in a chair full time at school, until we finally got her own chair to bring to and from school. No MD order, but maybe it was covered under her IEP, I can't remember.

[amoLucia]

This is partially related to your school environment but --- what would you use for an emergency if your whch is being loaned out??

In some of my LTC places, we had a whch near the front door that was used for visitors who became huffy-puffy walking in from our parking lots. And they were used for quick emergencies of visitors (somebody felt faint, or overcome with emotion/grief, etc).

Also you would be setting an example/standard that anybody could 'borrow' the whch for whatever ("oh, I stubbed my toe, my new shoes gave me blisters, I exercised hard and have thigh cramps, etc etc"). And this not only from students but staff.

In LTC/SNF rehab gym, pts are given a lesson on whch safety and evaluated for same. Could you just see your student doing wheelies in the hall, having unlocked brakes when transferring, bumping into others, other showing off, like speeding, etc ? Should NOT his ortho/rehab ensured the student could manage crutches?

FWIW, I'd say "DON'T DO IT! JMHO. You already have doubts of your own. If he needs a whch, let his ortho order it and I think they rent them from a surg supply.

I see safety, liability and other problems. And you do too.

By the way, what would happen IF you DIDN'T even have a whch to borrow? What would he do?

Let us know how this works out for you, please.

[Farawyn]

Yes to what everyone said!

I wouldn't without an order. How about crutches, and elevator pass (if applicable) and a pass to leave class 5 minutes early with a book buddy to help carry books if needed? That's what we do.

[ohiobobcat]

I have had kids ask if they can use my wheelchair for similar reasons. I have told them no, not without a doctor's order, and they would need to bring one from home as my wheelchair is for emergencies only. Plus I always worry about kids horsing around with a wheelchair and tipping it or otherwise getting hurt. Can you say lawsuit?

I agree with Farawyn about the elevator pass and leaving class a few minutes early with a buddy.

[fetch, BSN, RN]

Yes to everything amoLucia said!

[Flare, ASN, BSN]

so students are allowed to use A wheel chair with a MD order, but the parents need to rent one, borrow one (because i need mine for emergencies) or find one in grandma's attic.

That being said, Student's are expected to move themselves around as much as possible and a peer assistant can help them with books and doors. If there is an incline then a peer can assist in pushing. If a student can't push themselves, them a staff member is preferred but as an absolute last resort we will resort to a peer helper (only grades 4 and above - high schoolers should have the wisdom and maturity to not have races down the hall and try to plow people down... note i said should...)

[Farawyn]

I like "peer assistant" over "book buddy".

[peaceful2100, BSN, RN]

Thanks everyone for confirming what I felt. I do have 2 wheelchairs in my office but I still did not feel comfortable with it. This is my first year as a school nurse and I'm very cautious. Some things are more common sense, other things is I think this is right but let me check first. I feel like unless I'm giving a band aid, ice pack (in certain cases), spray deodorant, menstrual product everything else probably needs a Dr. order. Kids don't understand it because some stated their old school gave out Tylenol or Ibuprofen but I don't. Some tell me well, you can hardly do anything why are you here. Well, I'm here for emergencies mostly, followed by a few other things you probably won't quite understand, and I won't tell you because I don't have to.

I think his issue was more laziness than anything the more and more I thought about it. My supervisor told me we can do a temporary accommodation where he can leave class a few minutes earlier if necessary.