School Nurse Wanna Be's

[Nerd13]

School Nurses have to assess for diabetic shock, concussions, internal bleeding, and heart attacks often. All of which happen at school, and are the EMT's always going to be there ? No.

What EMT's and Paramedics are not taught to assess for the exact same things in any and all settings? How is an RN going to assess for those things any better than an EMT or Paramedic? I'm done arguing now because neither side is going to agree because there are too many logical fallacies.

 

[Shishkabob]

School Nurses have to assess for diabetic shock, concussions, internal bleeding, and heart attacks often. All of which happen at school, and are the EMT's always going to be there ? No.

Guess what? So do Paramedics.


I run circles around most nurses I've met when it comes to cardiology, the exceptions usually being cardiac ICU nurses that's been doing it longer than I've been alive.




But hey, what do I know, I'm an ambulance driver with no education. A new grad nurse fresh out of ADN school is clearly more suited at dealing with cardiology than I am.

 

[Katy]

And you think an ADN knows everything they need to know about nursing / medicine after they graduate?

You DO understand that, as a rule, ADN is foundation of nursing, and the nurse is expected to choose a specialization after graduation and learn most of it OTJ. Look at 8jimi8 here on the forum. He's an RN, yet he''s just had to go through a crap load of stuff to get cleared to care for cardiac surgery patients. Not stuff they teach in AND school.



So, if a nurse is expected, and able to, learn more specialized stuff outside of school, after licensure and certifcation, why is a Paramedic unable to?

Paramedicine is a specialization in emergency medicine, trauma, cardiology and respiratory emergencies... but apparently you think they're completely incapable of learning anything beyond that?

No, I do not. I think they can, but you said so yourself, it is a specialization. You wouldn't see many Cardiac nurses saying they could be a Neuro Nurse if they wanted, which is basically what is happening here.

 

[rmabrey]

USAF can you PM me that law? I dont want to be a criminal

 

[silver]

School Nurses have to assess for diabetic shock, concussions, internal bleeding, and heart attacks often. All of which happen at school, and are the EMT's always going to be there ? No.

Excuse me?

 

[DESERTDOC]

I'm simply posting what I know of them him.

Self edit: I re-read your post and got it wrong the first time. But with that, I will bow out.

Sigh, good bye thread.

 

[Katy]

Excuse me?

Child obesity, very common sadly.

 

[rmabrey]

No, I do not. I think they can, but you said so yourself, it is a specialization. You wouldn't see many Cardiac nurses saying they could be a Neuro Nurse if they wanted, which is basically what is happening here.

Not sure where your from but a here a BSN is a BSN.

 

[Katy]

Guess what? So do Paramedics.


I run circles around most nurses I've met when it comes to cardiology, the exceptions usually being cardiac ICU nurses that's been doing it longer than I've been alive.




But hey, what do I know, I'm an ambulance driver with no education. A new grad nurse fresh out of ADN school is clearly more suited at dealing with cardiology than I am.

I never said that. I simply was saying that School Nurses do those things too, since some people here seem to think its band-aids and ointment all the time. A Paramedic is perfectly capable of all those things, it is the other less critical things that matter. In fact, a Paramedic is far better at assessing and helping the child, but do those things happen every day ? No. And the last paragraph I have never made such assumptions.

 

[ffemt8978]

And that is my entire point. This person is unqualified to make the statements that they are making.

NO...we just don't allow people to post a photocopy of their credentials simply because another member demands it.

 

[Akulahawk]

First off, School Nurses do the following that EMT's and Paramedics don't do on a regular basis;
- Teach Health classes and public speaking on health
- Patient education
- Hygiene and oral care
- Massive recording keeping
- Vaccinations
- Screenings
Now, are you seriously going to say that an EMT and possibly a Paramedic has the knowledge to do all of the above ? I'm to doubt.
And don't take it the wrong way, I'm all for them standing by, but when they,
1. Portray the role of a "School Nurse"
2. Don't have a higher medical authority or an actual School Nurse on hand
All these can have bad consequences. What if all of a sudden a student faints at a school even and an EMT can't figure out why they have ? The School Nurse may say, " Yes, Bobby Joe has hypoglycemia, we have to make sure he eats some at lunch and such, lets get a BLG over here. " The EMT that isn't there all the time with the students wouldn't have this knowledge on file or on their agenda of things to make sure of throughout the day. Same with a camp nurse.

Just a couple things... one is addressed below. The other is that when I'm on-duty as a Paramedic and I'm on a scene call, generally speaking, nurses function if I allow them to, and I can throw them off my scene or have them arrested if they interfere with the care I am providing.

Using the above example, how does the school nurse know that Bobby Joe has hypoglycemia if that nurse isn't familiar with Bobby Joe? This is not implausible in the large school setting. Making sure he eats some lunch and such presumes that the school nurse knows that Bobby Joe didn't eat Lunch. That's putting the cart before the horse. Getting a BGL is a great idea, but schools may not have that equipment on hand. So where you end up is essentially working up an unknown unconscious patient without many, if any, tools to assist in the assessment. In that instance, that school nurse would do what a school Paramedic would do: call for an emergency ambulance.

Now in a later post, you stated that one shouldn't limit the education: Great! Teaching health classes and speaking about health is something that Phys Ed teachers do on a regular basis. If a Phys Ed teacher isn't also a coach, they're commonly a health teacher. Teaching hygiene and Oral Care is well within their ken. Patient Education? Which subject? A Primary Care type Paramedic would have the necessary education to conduct vaccinations and provide general health education and screenings. Why? That's also part of their job. As to the massive record-keeping: for the majority of the students, that would be the parents filling out forms, reviewing them for completeness, flagging the records that have something special in their history, and filing all those records away. It doesn't take a rocket scientist to figure how to do that. Record-keeping and documentation is something that all healthcare providers should be thoroughly familiar with.

It is one thing to hold one-self out as a Nurse when one clearly does not hold the appropriate license. It is completely another to posit that a Nurse must hold Bachelor's Degree to be a "School Nurse"...

Incidentally, I would NOT want any school nurse assessing and caring for an injured student athlete. Their education doesn't cover the appropriate knowledge needed to prevent, evaluate, care, or rehab athletic injury.

In my role as an athletic trainer, I routinely interacted with all 300-500 (or more) athletes that I had a duty to. A School Nurse might have perchance to actually assess a couple hundred a year, of the entire school population. My role included gathering medical history, any current medications, allergies to food, medications, and other environmental substances, conducting most of the physical exam, deferring CV, Resp, and GI/GU exams for the MD.

In other words, by the time my athlete goes to their first team practice, I've met the athlete, gone over their history, established a baseline, and recorded my findings, and generally know more about that student-athlete than the school nurse does, who likely has only some written documentation from his/her parents about general health in the student's file. That school nurse probably won't personally know most of the student population that he or she owes a duty to. I know all my athletes by name.

Now then, I got that specialized education well before I got into EMS. Why do I bring up that? Because there's a world of difference in knowledge-base between what I did and school nursing. I'm not, by any stretch, minimizing the education that a nurse gets OR the specialized education that a school nurse gets. It's that a nurse gets 2 years (or so) of an education in a wide variety of healthcare settings and the school nurse gets specialized education for the school setting, but that doesn't equal 4 years of specialized education in sports injury management.

For running a first-aid booth or tent at a large event, Nurses, Paramedics, EMTs, Athletic Trainers all can do the basic job, certifications/licenses notwithstanding.

As to the "camp nursing" thing: That's basically remote medicine. Paramedics with the appropriate education can fill that role quite nicely... and in those places where they exist, they do quite well. Because of my specific background, in some ways, I'm quite well prepared for the camp provider role, however, I do recognize that I have some areas that I'd have to work on to fully take on such a role. As it is, I could safely muddle through.

The moral of this story: Do not make generalizations about non-nursing providers doing the role of a school/public healthcare resource.

I do, however, share your concern about non-nursing personnel advertising themselves as a nurse... and I'd have similar concerns about a nurse advertising themselves as any level of EMS provider if they're not appropriately licensed/certified to function in that role.

 

[Gray]

the moral of this story: Do not make generalizations about non-nursing providers doing the role of a school/public healthcare resource.

I do, however, share your concern about non-nursing personnel advertising themselves as a nurse... And i'd have similar concerns about a nurse advertising themselves as any level of ems provider if they're not appropriately licensed/certified to function in that role.

+1!

 

[Tigger]

Is anyone else looking at this argument and going "What the :censored::censored::censored::censored: does it matter?"?

There's a damn law in Indiana that says things I've done with a couple members of this forum in the confines of my apartment are illegal simply because we weren't married to each other. There are a lot of really asinine laws. Accept that fact, accept that nurses have a lobby, stop arguing with a CNA and move on to more important things. You know....like which light bar makes you look least like an overzealous Ricky Rescue with a fulminating case of micropenis.


NOTE: I'm a bottle and a half of wine into the night so I make no guarantee that anything above makes one damn bit of sense nor do I acknowledge any attempt to check my spelling or grammar. Thank you.

What more could possibly be added to this discussion following this beauty. Seriously, thank you for saying what I (and I imagine others) was thinking.

To the OP, I know the HS school I graduated from had no BSN, we had a ditzy ADN nurse who took some classes in public health. At no point was she involved in health education classes (not even healthcare career day), and most of the roles you speak of in regards to developmental abnormalities were handled by the district's doctor. I don't think I ever received a "dental exam" or was ever offered/made aware of mentoring programs run by the nurse during any of my 13 years if school. Just because a system is set up in your area in a certain way does not make it universal. The school nurse role here could easily be filled by an EMT, as the nurse's office was more of a first aid station.

Sent from my out of area communications device.

 

[Katy]

Just a couple things... one is addressed below. The other is that when I'm on-duty as a Paramedic and I'm on a scene call, generally speaking, nurses function if I allow them to, and I can throw them off my scene or have them arrested if they interfere with the care I am providing.

Using the above example, how does the school nurse know that Bobby Joe has hypoglycemia if that nurse isn't familiar with Bobby Joe? This is not implausible in the large school setting. Making sure he eats some lunch and such presumes that the school nurse knows that Bobby Joe didn't eat Lunch. That's putting the cart before the horse. Getting a BGL is a great idea, but schools may not have that equipment on hand. So where you end up is essentially working up an unknown unconscious patient without many, if any, tools to assist in the assessment. In that instance, that school nurse would do what a school Paramedic would do: call for an emergency ambulance.

Right, my only point here was that the Paramedic wouldn't be better suited to handle this situation if it came down to it. I totally agree with this.

Now in a later post, you stated that one shouldn't limit the education: Great! Teaching health classes and speaking about health is something that Phys Ed teachers do on a regular basis. If a Phys Ed teacher isn't also a coach, they're commonly a health teacher. Teaching hygiene and Oral Care is well within their ken. Patient Education? Which subject? A Primary Care type Paramedic would have the necessary education to conduct vaccinations and provide general health education and screenings. Why? That's also part of their job. As to the massive record-keeping: for the majority of the students, that would be the parents filling out forms, reviewing them for completeness, flagging the records that have something special in their history, and filing all those records away. It doesn't take a rocket scientist to figure how to do that. Record-keeping and documentation is something that all healthcare providers should be thoroughly familiar with.

Again, I was simply speaking in my experience. In my school, the School Nurse did rotations with the Phys. Ed teacher. And I understand that Paramedic education would equip them for this position, but my only point was the School Nurse position better prepares the provider.

It is one thing to hold one-self out as a Nurse when one clearly does not hold the appropriate license. It is completely another to posit that a Nurse must hold Bachelor's Degree to be a "School Nurse"...

Incidentally, I would NOT want any school nurse assessing and caring for an injured student athlete. Their education doesn't cover the appropriate knowledge needed to prevent, evaluate, care, or rehab athletic injury.

In my role as an athletic trainer, I routinely interacted with all 300-500 (or more) athletes that I had a duty to. A School Nurse might have perchance to actually assess a couple hundred a year, of the entire school population. My role included gathering medical history, any current medications, allergies to food, medications, and other environmental substances, conducting most of the physical exam, deferring CV, Resp, and GI/GU exams for the MD.

In other words, by the time my athlete goes to their first team practice, I've met the athlete, gone over their history, established a baseline, and recorded my findings, and generally know more about that student-athlete than the school nurse does, who likely has only some written documentation from his/her parents about general health in the student's file. That school nurse probably won't personally know most of the student population that he or she owes a duty to. I know all my athletes by name.

Now then, I got that specialized education well before I got into EMS. Why do I bring up that? Because there's a world of difference in knowledge-base between what I did and school nursing. I'm not, by any stretch, minimizing the education that a nurse gets OR the specialized education that a school nurse gets. It's that a nurse gets 2 years (or so) of an education in a wide variety of healthcare settings and the school nurse gets specialized education for the school setting, but that doesn't equal 4 years of specialized education in sports injury management.

No, it doesn't. It does, however, give the School Nurse a better preparation and knowledge of healthcare in the school setting.

For running a first-aid booth or tent at a large event, Nurses, Paramedics, EMTs, Athletic Trainers all can do the basic job, certifications/licenses notwithstanding.

As to the "camp nursing" thing: That's basically remote medicine. Paramedics with the appropriate education can fill that role quite nicely... and in those places where they exist, they do quite well. Because of my specific background, in some ways, I'm quite well prepared for the camp provider role, however, I do recognize that I have some areas that I'd have to work on to fully take on such a role. As it is, I could safely muddle through.

My only point with these was the misrepresentation. You cant' call yourself a nurse and not be one in my state. I know they are capable.

T

he moral of this story: Do not make generalizations about non-nursing providers doing the role of a school/public healthcare resource.

I do, however, share your concern about non-nursing personnel advertising themselves as a nurse... and I'd have similar concerns about a nurse advertising themselves as any level of EMS provider if they're not appropriately licensed/certified to function in that role.

I will only do so when they represent themselves as nurses and don't have the proper education to fulfill that role. Glad we agree on something : )

 

[fortsmithman]

Used to come into the classroom, show us how to brush our teeth, explain what plaque was, and other common gum diseases.



School Nurse is also protected, because it has nurse in it. And I'm surprised to find out that you would actually think a CNA could hold a School Nurse position, when they aren't even a nurse.

The school here uses a dental therapist and no school nurse.

 

[epipusher]

Speaking for my children's school district only; school nurses are not even allowed to give otc meds unless they are the childs own from home along with a note from a parent.

 

[Akulahawk]

Right, my only point here was that the Paramedic wouldn't be better suited to handle this situation if it came down to it. I totally agree with this.
Don't be so certain. A paramedic might actually be on better footing because the paramedic is more used to doing rapid exams and working from limited information and may come to a more rapid conclusion that additional help is emergently needed.

Again, I was simply speaking in my experience. In my school, the School Nurse did rotations with the Phys. Ed teacher. And I understand that Paramedic education would equip them for this position, but my only point was the School Nurse position better prepares the provider.
Nurses have to go through specific education to do school healthcare well. A paramedic would have to go through a similar specific education to fill that role. No difference.

No, it doesn't. It does, however, give the School Nurse a better preparation and knowledge of healthcare in the school setting.
See the above.

My only point with these was the misrepresentation. You cant' call yourself a nurse and not be one in my state. I know they are capable.

T
I will only do so when they represent themselves as nurses and don't have the proper education to fulfill that role. Glad we agree on something : )

True. We do agree on some things.

My responses above... in red for easier reading to what I'm responding to.

 

[Yarbo]

First off, School Nurses do the following that EMT's and Paramedics don't do on a regular basis;
- Teach Health classes and public speaking on health
- Patient education
- Hygiene and oral care
- Massive recording keeping
- Vaccinations
- Screenings
Now, are you seriously going to say that an EMT and possibly a Paramedic has the knowledge to do all of the above ? I'm to doubt.
And don't take it the wrong way, I'm all for them standing by, but when they,
1. Portray the role of a "School Nurse"
2. Don't have a higher medical authority or an actual School Nurse on hand
All these can have bad consequences. What if all of a sudden a student faints at a school even and an EMT can't figure out why they have ? The School Nurse may say, " Yes, Bobby Joe has hypoglycemia, we have to make sure he eats some at lunch and such, lets get a BLG over here. " The EMT that isn't there all the time with the students wouldn't have this knowledge on file or on their agenda of things to make sure of throughout the day. Same with a camp nurse.

Oh no! Bobby Joe.. it's so sad that since I'm an EMT I'm unable to treat you! I don't know if I can get a BLG, but i'll get a BGL.

 

[ffemt8978]

Play nice....

 

[systemet]

I'd like to point out that my Paramedic book (Brady) covered pretty much every single topic that this thread has argued that only RN's are taught.

That book is terrible. Absolutely terrible at everything.