School nurses are not nurses

[Anonymous]

I have been told that each elementary school no longer has a school nurse. Instead, the person who sits in the nurse's office is an "aide" without medical training. Anyone know if this is true?

[Anonymous]

Yes, and there is a floating RN supervising over a few schools.

[Anonymous]

They are not called school nurses. They are called Heath Technicians. I know ours quite well and she's always handled everything we needed plus more. For example, recently we had a problem with my child having bathroom accidents at school. We got the health tech involved to help develop strategies and work with my child. This being said, I don't have any kids with serious health issues, so I don't know how it works in that case.

[Anonymous]

My children's schools all have RNs working there. This is in Prince George's County. I'm not sure if all schools have RNs but at least 2 seem to, as far as I know.

[Anonymous]

This is absolutely true and a very alarming trend given the fact that the number of children with chronic illnesses in the school system is dramatically higher than in previous generations. Nurses have extensive knowledge and training on how to handle diabetic crisis, respiratory distress, anaphylactic shock, etc. Health techs do not---the only medical training that many of them have had is a CPR class! The teenage lifeguards at the pool are often more qualified! It's such a shame that the school systems do not place a higher priority on having actual RN's in the building. It's also a travesty that people are led to believe that these individuals are nurses----it's a discredit to the nursing profession!

[Anonymous]

Anonymous wrote:This is absolutely true and a very alarming trend given the fact that the number of children with chronic illnesses in the school system is dramatically higher than in previous generations. Nurses have extensive knowledge and training on how to handle diabetic crisis, respiratory distress, anaphylactic shock, etc. Health techs do not---the only medical training that many of them have had is a CPR class! The teenage lifeguards at the pool are often more qualified! It's such a shame that the school systems do not place a higher priority on having actual RN's in the building. It's also a travesty that people are led to believe that these individuals are nurses----it's a discredit to the nursing profession!

If they administer medication in the state of MD they are supposed to have Certified Medication Training -- a 20 hour training program, with recertification every 2 years requiring another 4 hours of review.

http://www.marylandpublicschools.org/MSDE/nonpublicschools/nplegal/annotated_code/Notice_MEDICATION_ASSISTANT_TRAINING.htm

The Code of Maryland Regulations (COMAR) 10.39.04.01.01 sets forth regulations for nursing assistants. This regulation requires persons who perform delegated nursing functions to be trained and certified by the Maryland Board of Nursing (MBON) as Certified Nursing Assistants (CNAs). If unlicensed (not a licensed practical nurse or a registered nurse) school staff perform only the delegated nursing function of medication administration, they must complete an approved 20-hour training course and be certified by the Maryland Board of Nursing as a Medication Technician. Re-certification will occur every two years for certified medication technicians. The training for re-certification can be completed up to 90 days prior to the expiration of the certification. Renewals will occur on the birth month of the certified medication technician. The initial cost of certification is $20. Renewal fees are $30 every two years.

The medication technician must have a registered nurse who delegates to him or her.


School employees in both public and nonpublic schools are affected by the requirement for Medication Technician training. School employees include all individuals, other than registered nurses (RNs) or licensed practical nurses (LPNs), who administer medication in schools on a routine basis.

[Anonymous]

Maybe if their pay was competitive with hospitals, clinics, etc then more nurses would actually be attracted to work in schools.

[Anonymous]

I don't think the problem is lack of nurses willing to work -- I think schools just aren't hiring or staffing the job with RNs period.

To save money, the school districts have cut back on RN positions and are making do with lower paid technicians.

[Anonymous]

While the health techs have nowhere near as much training as registered nurses, they do, in fact, go through rigorous training that includes far more than CPR. They are all Maryland state certified nursing assistants and they have to re-qualify every two years. In addition, they have immediate access to a supervising nurse. They are also trained in use of epi-pens and insulin administration.

Health techs have been the primary caretakers in MCPS elementary schools for over 15 years.

[Anonymous]

From the MD Board of Nursing website:

Certified nursing assistant is defined as an individual regardless of title, who routinely performs nursing tasks delegated by a registered nurse or a licensed practical nurse for compensation; and does not include a medication assistant or an individual who merely provides assistance with activities of daily living, unless the client's needs are such that adverse health consequences are predictable.


So if a student fall on the playground and gets a deep cut or hits her head, parents shoul feel reassured that there is a CNA on site who only needs to telephone the cluster's actual nurse for directions. I'd rather have an EMT at the school. Someone who legally can provide treatment without waiting for tasks to be delegated.

[Anonymous]

It is absurd to think that every school is going to have an EMT on site.
The school, if they have a serious accident, can also call 911.

Did the nursery school that your kids went to have EMT's on site?

[Anonymous]

What makes no sense is that there is huge pool of unemployed recent grad RNs out there looking for work. Hospitals invest alot of money in training RN's for specialities so even though you hear about a nursing shortage there are tons of recent grads with good scores that can't find jobs.

[Anonymous]

Anonymous wrote:It is absurd to think that every school is going to have an EMT on site.
The school, if they have a serious accident, can also call 911.

Did the nursery school that your kids went to have EMT's on site?

The point is that an EMT is cheaper than a registered nurse. If you are going to call 911 everytime there is an incident, why even have the CNA, train the teachers in basic first aid and CPR.

[Anonymous]

But are EMTs allowed to give out Rx medication? If not, they would never be allowed to work at a school since the school nurse does that BIG TIME!

[Anonymous]

I used to teach in Fairfax Co, and it was certainly true at my school. Bizarre. I'm from New York State and used to teach there. Our nurses were all RNs- people who actually had training and could administer insulin, etc.