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Peanut Free Store

Posted on: Sat, 08/07/2004 - 1:02am
MommaBear's picture
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Joined: 09/23/2002 - 09:00

Quote:Originally posted by MQriley2:
[b]
I will make it shorter, but my 504 states: If the school nurse is absent or leaves as well as his teacher, I have the right to pull my DS from school and keep him home until they return without penalization for his absences.
Now, at the time this made sense to me. The subs for the nurse are just subs..teachers..no different than you and me. They may not have ANY knowlege of allergys or epi-pen. But, my teacher is trained and many of the school staff that is associated with my DS is trained about his allergy and his epi-pen. I asked the teacher if SHE felt comfortable having my DS there without a nurse and she said..well, it is the epi and then 911 right?
[/b]
Couple of questions and observations............
"subbing". The parallel in *my mind* is about a "standard of care". Is the standard of care in your school an RN [i]every day, all day, in the school building[/i]?
I mean, not as advice in any manner or form, but only regarding my *own, unique, highly individual and personal situation*: I'm an RN. I work in a hospital critical care unit. Only familiar with the particular limitations and practices surrounding where *I* work. There are always [b]2[/b] RN's in the unit. There must always be [b]2[/b] RN's. This is just part of [i]The Standard of Care[/i] in *the unit* [b]I work in[/b]. Just building a foundation for my explanation. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
So. 2 RN's, at least, always. In *the critical care unit*. Even tho there may be *many* RN's in the unit, If I leave the unit, I [b]must[/b] formally ask [b]another RN[/b] to monitor my team. An RN who is not monitoring more than their own team already. I must recieve some confirmation of this. Verbal, most likely. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Of course, this is only if *all is well* in the unit. Judgement type of thing.
Rambling.........back to my point. Another RN must "substitute" for me. If I leave without having requested an [i]equal substitution of care[/i] for my [i]assignment[/i], even if only temporary........I *believe* I might be disciplined for "patient abandonment". But, again, this is [i]the particular environment/location [b]I[/b] work in.[/i] Don't know specifically, but I've heard sometimes, laws and requirements may differ..............
I mean, only a similiarly trained, [b]experienced[/b], and licensed individual can [b]substitute[/b] for me. Should I dare say a similiarly trained, experienced, licensed [b]and oriented[/b] individual?
I mean, again,..............[i]if I were unable to attend a scheduled work day[/i] for whatever reason, and my presence was needed..................another RN would have to [b]substitute[/b].
Now this is kind of a tangent.............but.........part of the "Standard of Care" in the environment I work in is a "Staffing Ratio" or "Nurse to Patient Ratio". Timely, but I've heard regards to this in legislation recently related to the same. Don't remember it being about schools, but the particular blip I heard of related to acute care settings.
Question: Does the presence of the RN in the building, or just "being on duty" influence those who are have been "delegated" to administer the epi-pen?
I mean, as I don't know myself in your situation....... does [b]the RN[/b]..........[b]an[/b] RN[/b] have to "be on duty" in order that those who have been "delegated" to administer have the authority to do so? If so, again, as I don't know myself in your situation, do you think this would this influence the presence of an RN?
Disclaimer: I am not offering advice in any manner or form.

Posted on: Sat, 08/07/2004 - 1:57am
saknjmom's picture
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Joined: 04/02/2003 - 09:00

I finally had to make the arrangement that if the school nurse is absent, I keep my son home from school.
There are no backups allowed because of a quirk in NJ law about benedryl being given first.
Anyway, the nurse was absent three times last year, 2 times a sub was in the building.
I just won't take a chance!

Posted on: Tue, 08/10/2004 - 1:04am
MQriley2's picture
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Joined: 05/25/2004 - 09:00

" Is the standard of care in your school an RN [i]every day, all day, in the school building[/i]? "
I am not sure. I do know that at both of our elementary schools we have an RN on duty. I do know that they are not required to have an RN on duty in order to administer the epi pen, or at least that is what they told me. But, the sub for the nurse would not be an RN.
I do not think that they can give meds though, like Benadryll, which my DS can only have during a mild attack (says doctor).
The sub for the teacher as well may not be trained in using the epi pen. They said that they will train a few subs specifically for my teacher's room, but I don't know if that will happen. We will have to wait and see. I do know that I will not allow him in school the day there is a sub for the teacher if the sub is not WELL aware of his accommodations to the room and him.
I just haven't decided about the nurse and I guess I better get deciding because school has already started.
Renee

Posted on: Tue, 08/10/2004 - 2:43pm
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Joined: 06/15/2004 - 09:00

Quote:I finally had to make the arrangement that if the school nurse is absent, I keep my son home from school.
There are no backups allowed because of a quirk in NJ law about benedryl being given first.
Saknjmom, can you elaborate? I'm in NJ too, but I'm not sure what you mean. My son's school has a part time nurse, and a part time "relief nurse"; but I was assured by the principal that there were additional staff members who were trained to administer the Epi and would do so if needed. I recall someone else posting that only the nurse, not a lay person, was allowed to administer Benadryl, is that what you mean? Just curious, because that wasn't mentioned to me as a problem last year...just wondering if I should bring it up when I meet with the school this month.

Posted on: Wed, 08/11/2004 - 11:52pm
saknjmom's picture
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Joined: 04/02/2003 - 09:00

MCMOM
The deal is that NJ school nurses interpretation of the law allowing backups excempts backups if the dr order states to administer benadryl at first sign of hives, swelling, epi if symptoms persist.
So, we are not allowed a backup person. if i have the dr take off the benadryl order, he will get the epi pen at the first sign of hives. Plus backups have to be CPR trained and some other rules apply.
It is really frustrating. Their current procedure is to have a nurse from another school "on call" if the nurse is absent or out of the building. This isn't good enough for me because it could take 10 minutes or more for another nurse to arrive at my son's school.
The paramedics in our town do not currently carry epi pens in their supplies, although they are allowed to. The school would not release my son's epi to them if they arrived before the backup.
feel free to email me offline if you want to chat.
I live in Bergen county and another PA.com member has organized a group meeting in Ridgewood if you are nearby, join us.

Posted on: Tue, 08/17/2004 - 8:41am
sueqtpie's picture
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Joined: 03/03/2003 - 09:00

I , like yourself have a child with a peanut allergy. We moved from another state last year and the school we choose has a NURSE. Now when he goes to middle school and changes classes and has a larger population to be exposed to...oh I will wonder what I would need for him to attend. Can we require a nurse? Such a scary thought. As school starts, today is the second day, I too get nervous. Is is hard to live in fear.
Sue

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