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Discussion

When School Nurses Are Required

At my charter school, we don't have a school nurse (just contract with one for hearing and vision screening) and I can't find what the requirements are for when a school would be required to have a nurse.

We're our own district (authorized by the California Department of Education) and receive public funding. We have fewer than 300 students but deal with all the issues any urban school with the majority of students living in families at or below (or just above) the federal poverty level sees regularly. I have minimal medical training (but am applying to nursing school now, which brought me to this site!) but unfortunately have only gotten as far as developing conservative policies for keeping kids in class as long as possible (especially frequent fliers). Then we have to consult with parents to pick up their kids or have them do what a nurse would otherwise have done, but we're not able to do (OTC meds, etc.).

Fortunately, we have doctors notes and inhalers/epipens for all our students that need them and (albeit rudimentary) training for 4-5 of us that would give these medicines.

I'm curious if anyone out there is a nurse in a tiny school (and/or has seen a situation like this) and if you can point me to somewhere in the ed code I can bring up with our principal.

Thanks!

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    It's usually a state statute. School nurses are not required by statute in Texas; whatever kind of school. The deciding factor has been associated with a few things. The campus principal is responsible for the health and safety of the students if there isn't a RN on staff - and they don't like that. Having said that I believe the biggest determining factor is the industry standard that compels school districts to staff school nurses which equates back to liability and legal/law suit issues. Most school districts, especially those of any size, employ school nurses. If a law suit is filed, for whatever reason associated with school health, and the district doesn't have a school nurse (RN) on staff, the district is exhibiting it has ignored the industry standard for school health and places them in somewhat of a "conscious negligence" role right off the bat. Say for instance I sell rattlesnakes and most of the rattlesnake retail businesses provide their snake collectors with snakeproof leggings and snake collection hooks. I don't supply any safety equipment to my snake collectors. If one of my snake collectors gets bitten and sues me it will be shown that I have not complied with the industry standard and I might as well just write the check.

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    Agree with OldDude. It's in your state statute. Each state is different. In NJ public schools, registered nurses with a bachelors are required and one certified nurse per district (although we all are) is required as well. Totally different ballgame with charter and private.

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    I'm in a small charter school with a similar demographic. Luckily, my state simply requires that every public school have a full-time BSN on staff (minimally).

    Like OldDude said, it's state specific, and I don't believe there are any general "requirements" that mandate a school nurse on staff.

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    You can Google CA ed code, but the short version is a nurse ( or parent) must be available for insulin administration/supervision and other injections. Epi pen and oral medication may be given by trained staff with appropriate order...if you do not have a nurse overseeing your district I would wonder who is responsible for the training though..maybe a public health nurse? :)

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    • Author
    You can Google CA ed code, but the short version is a nurse ( or parent) must be available for insulin administration/supervision and other injections. Epi pen and oral medication may be given by trained staff with appropriate order...if you do not have a nurse overseeing your district I would wonder who is responsible for the training though..maybe a public health nurse? :)

    That's a good question. I'd have to find someone to train us. No insulin, but two kids have their epipens in the office. I'll have to pour over the ed code since that's the only way I'd be able to justify the expense. :(

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    So who has delegated the meds to your staff for use? Or who has done the training for using your epi's?

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    • Author

    No formal training, just dr. notes for meds we give (usually just inhalers).

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    No formal training, just dr. notes for meds we give (usually just inhalers).

    Look into that requirement for having a school nurse for training. In my state a school nurse HAS to sign off on staff medication administration and then that gets delegated by a nurse.

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    • Author
    Look into that requirement for having a school nurse for training. In my state a school nurse HAS to sign off on staff medication administration and then that gets delegated by a nurse.

    All I can find is that any "designated person" can do it as long as the parent signs a form to not hold the school liable. I think we're just barely following the law, but would benefit from more comprehensive training. Perhaps this summer.

    From California Ed. Code:

    49423. (a) Notwithstanding Section 49422, any pupil who is requiredto take, during the regular schoolday, medication prescribed for himor her by a physician and surgeon or ordered for him or her by aphysician assistant practicing in compliance with Chapter 7.7(commencing with Section 3500) of Division 2 of the Business andProfessions Code, may be assisted by the school nurse or otherdesignated school personnel or may carry and self-administerprescription auto-injectable epinephrine if the school districtreceives the appropriate written statements identified in subdivision(b).

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