Who feeds the child with seizure disorder

[Nabberdo]

I do 1:1 in the school setting for a child with Dravets Syndrome.

The child was original oral aversion and required G tube feedings. Gradually (and with physician permission) I was able to get her back to eating all foods (pureed) and liquids orally (meds are still admin via G tube). I have been feeding this child orally for nearly one year as a contract nurse. Recently however, the Dept Of Education has informed my company that all oral feeding is to be done by DOE personnel in the classroom.

I'm curious to know if other School Nurses have the same "hands off oral feeds" in their schools?

I'm also interested in thoughts on untrained personnel feeding a child who has seizures throughout the day? I am shocked that given the potential for aspiration and liability this would be allowed. I monitor the entire feeding by the DOE personnel but still seems an odd assignment.

Thoughts?

[JustBeachyNurse, LPN]

I am permitted to feed my clients in school after I demonstrate competency to the SLP (just like in a hospital where you demonstrate competency during orientation and training). I must verbalize my plan, have a physician prescription and demonstrate technique with my client to child's or senior SLP.

One school I must demonstrate competency to OT for splinting and sensory therapy in school and demonstrate competency in lifting and transferring my clients as well as proper orthotic application and using equipment (stander, gait trainer, specialized seating, etc).

After seeing the random "technique" used by some PDN and one nearly causing harm by improperly placing the child in school equipment at another school, I can see why some of these schools insist on contracted staff demonstrating competency. Heck seeing what some school paraprofessionals misinterpret in my son's IEP I think all schools should mandate orientation and demonstration of competent skills for staff and contracted personnel!

[Nabberdo]

Thank you for the input. Unfortunately the staff at the school I speak if have no training on feeding a child with potential aspiration

[JustBeachyNurse, LPN]

Sounds like a recipe for disaster. What do the parents think? Parents can get policies changed much faster than others...

[Nabberdo]

You have hit the nail on the head. A recipe for disaster ! I wondered if other states / schools were allowing untrained personnel to perform procedures, feedings, and use equipment without proper training. I am going to contact the state board of nursing.

[JustBeachyNurse, LPN]

I'd consider also the state SLP board also as feeding evaluation and technique is under their scope also

[smartnurse1982]

this should be moved to the pdn forum.

[Flare, ASN, BSN]

Typically, I take a hands off approach for my 1:1 students except in the case of the student having an emergency. Then I get involved and make myself available to the nurse. I can't imagine telling a trained 1:1 nurse not to do the oral feedings and to expect an aide who has received no training or at best has read a pamphlet. Not only is this a recipe for disaster - but doesn't the BOE you work in wonder what they are paying for then if their staff has to do the feedings and you are just there to stand by? They should be contacting the DOE and challenging this.

[OldDude]

I might have missed this somewhere above, but are you not being utilized at all for this child now or are they saying you can't feed the child orally? In other words, are you still 1:1 with him/her?

[Wave Watcher]

Since I am the only nurse in our building I would not have the time to feed 1:1. I am being pulled in 10 different directions all day long due to other chronic issues. In most buildings they have a trained 1:1 assistant that feeds (except g tubes then it is a nurse) and takes care of daily needs.