E101: School Nurse [IEP Team BONUS Series]
School Nurses are an important member of the IEP Team, especially if you have a child with medical needs! In this episode of The IEP Team BONUS Series, we discover some context to what they do and what their qualifications are.
School Nurses are an important member of the IEP Team, especially if you have a child with medical needs! In this episode of The IEP Team BONUS Series, we discover some context to what they do and what their qualifications are.
In this episode we cover:
1) School Nurse qualifications using Colorado’s qualifications as an example
2) Nurses Aid’s and their qualifications
3) 1:1 Nurses for medically complex children
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E101: School Nurse
[00:00:00] One of my favorite professions to work with our school nurses. Now it’s interesting because there’s a lot of frustration around their position in the schools, especially for medically complex children. So we’re going to dive and hopefully bring some context to your advocacy around school nurses this is going to be a fun episode of the iep team bonus series so stick with me because we’re talking about school nurses today
You are listening to the parent IEP lab, the podcast that helps you get an effective IEP plan for your child so that you can get them supported and learning in school. I’m Beth LEAs and Feld occupational therapist, who started to notice trends in parents who got effective IEP for their kids without having to fight the school.
My mission is to help you turn insider knowledge from the school side into effective parent advocacy for your child. The parent IEP lab focuses on providing you knowledge about your parent role in the IEP and taking away the stress of an upcoming IEP meeting through the ultimate parent IEP prep course, but also in the podcast we highlight [00:01:00] commonly missed parent advocacy opportunities between iep meetings which is really how you avoid having a fight with a team so let’s dive into this topic and think about what we can change and tweak to get the right formula for success for your child to learn and grow at school welcome to the lab
I have a question for you. Have you ever been overwhelmed when you get a draft IEP or even look back at a finalized IEP? I mean, it made sense in the meeting, but now that you look at it, you may need a translator. Well, you can learn to be your own translator by coming to the IEP bootcamp. The last weekend in January, it’s three days of short and simple live trainings, and yes, you get the recording automatically to finally understand what you’re looking at and some tools to decode that IEP in front of you. Registration is [email protected] slash bootcamp, or the link below this podcast in your podcast player.
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Welcome to another IEP [00:02:00] team bonus series. If you are new to this series, we are focusing on one professional each week. That may be a part of your child’s IEP team, so that you can better understand what their qualifications are and what they actually do to support your child in school.
We have covered a lot of professions already. So if you want to scroll back in your podcast player, you can see that every Thursday for the last couple of months, now we have covered a different professional. So if you’re looking for a special education teacher or a speech language pathologist, or maybe a vision specialist, then you will find those in the Thursday episodes. If you want them all on one page, though, you can go to the website, www.TheIEPLab.com/podcast
and you will see on the right hand side of that website. There are menus and you can click the IEP team bonus series and there you can see them all on the same page. If it’s a little bit confusing to scroll. So this episode is about school nurses, who I feel particularly close to as
as they’re also medical professionals [00:03:00] who just happened to be able to also work in schools, just like occupational therapists, which is what I am. So we work closely with our friends in hospital settings and in home health settings. So nurses understand what OTs do, which is really rare, to be honest. And we understand what nurses do. So it’s a really nice partnership because we are both itinerant as well, go into a little bit later where we cover multiple schools so we can kind of have each other’s back.
And bring each other into situations where we’re like, oh, this is an OT thing. Or this is a school nurse thing. And so I’ve done this many, many times. Um, one example is that I used to be on the child find team. So the bird. So when somebody would go through the birth to three. Transition to school services at their third birthday, I would be on a lot of those evaluations. Not every single one. Speech was probably the most frequent one for that, but I was also on a lot of those. And I would look through [00:04:00] the paperwork that we got for the screening or for the evaluation. And I would see something like, you know, Uh, medical condition that was kind of rare, or I would see a tube feed or I would see something else that flagged it for me and I would turn to the preschool coordinator who was running these and I’d say, Hey, you have the nurse involved in this one. Right. And she would look at me and be like,
No, do I need her involved? And I’m like, yes. Yes. You need this nurse involved in this because this is, this is a medical case. Like they are going to have to write a health plan for this. And so I was kind of the screener in that position as well sometimes. So, um, first we’re going to talk about qualifications and then we’re going to talk about what they actually do.
And there is some conflict that I see from parents in understanding the role of the school nurse, because. Like I said, they’re itinerant. They’re not in the building all the time. And so we’re going to talk about a couple situations where that’s really concerning as a parent that they’re not present all the time. And so we’ll talk about some [00:05:00] different ways that the school covers needs. And if that’s okay with you or not, or what you need to advocate for. Right. So first qualification. So this comes from the Colorado state website. I am myself in Colorado. So I use these as an example, if you’re ever wondering about your own state’s regulations or qualifications,
Then, please jump into the Facebook group. The link to join the group is below this podcast in your podcast player. And I will be happy to help you find your state’s regulations for school nurses and see if they have nurse aids. And we’re going to talk about that in a second too. So just know that that resource is there, but I use, um, the color Colorado state website a lot because they just, they have a lot up there.
It’s actually a good one. So let’s talk about their qualification. So first thing is a bachelor’s or higher degree in nursing from a regionally accredited institution. Or three years or more of licensed practical experience as an RN with school aged children. The second thing is a valid R N issued by the Colorado [00:06:00] department of regulatory agencies.
Or an RN in a state that is participating in the nerd. In the nurse licensing compact agreement, which just means that they’re, they’re licensed in a different state, but Colorado has an agreement that they recognize each other’s licenses. And then the last one says successful completion of field experiences and a supervised practicum. As prescribed by the preparing institution, including experiences with school aged children in a community health or public health or school setting. So a lot of the RNs that I have worked with have actually been.
Nurses in the ER or a hospital setting of some kind and they transfer into schools. Many times because their children are now school-aged and they want the same schedule as their kids. Because they were working 12 hour shifts, they were working overnight shifts. And so they want to be with their kids more. So.
I would say the majority of the ones that I have specifically worked with have come from other settings into schools, because let’s be very [00:07:00] honest. They do not make a lot in schools compared to what they can make in other medical settings. So. Just to give you some context. I know when I was at the last district I worked at.
They were. Growing districts. So they hired another RN to come on and she was very, very, very, very competent. She came from the ER setting and she’s amazing. I really love her as a person as well. And so when she came in and she was like, oh, okay, like I know what I’m doing nurse wise, but I don’t know what I’m doing
iEP wise. And I don’t know, you know, so she had to get oriented to the system just like parents and just like I had to do my first year in schools too. So, um, just know that that they might be learning this particular system, but that doesn’t mean they’re incompetent. It just might mean that they need to ask them questions to clarify what their role is in this particular setting, because it is quite different.
So let’s go into talking about their role and what they actually do. So many of them, like I mentioned are itinerant, which means that they cover multiple schools [00:08:00] at the same time. So, you know, I was covering like 10 teams or like four buildings and then different case managers in those teams. And they would cover, I want to say like two or three schools.
But here’s the thing, us OTs. We cannot see anybody if they don’t have an IEP. So, you know, sometimes there’s exceptions for kids with 5 0 4, is that kind of thing. But for nurses. They cover the entire school body. Right. So any medical or health needs. And that entire school is really up to them.
Does that make sense? So, you know, that same nurse that I was talking about who joined? She said, oh my gosh. She said, I am so overwhelmed this year. This was like her second or third year in the schools. She sent him so overwhelmed this year because I have 16 kids with diabetes on my caseload. And these aren’t, these aren’t necessarily kids with IEP. I think one of them might’ve been one.
[00:09:00] But these aren’t necessarily just kids with IEP with special needs. Quote unquote, special needs. Um, but they have medical plans and those diabetics need to be monitored. So most of them would have an app that linked to each kid’s phone or whatever device was tracking their blood sugars. Sometimes they would have to manually take blood sugars. So.
There is a lot of responsibility put on our ENS. Um, more than the kids with IEP, if that makes sense.
So you might be thinking, okay, so the RN isn’t there in the school, but my kid has emergency meds for seizures, or my kid has a really serious allergy or my kid has a history of choking. And so they, they choke frequently or like it’s a chance that they will choke, right? How can they not have an RN there?
And that’s because they have nursing aids, at least in Colorado, we have nursing aides here. So they are a certified nursing aid. And they’re trained to give meds. They’re trained to [00:10:00] follow orders from an RN. Um, so they’re not actually writing any of the plans, which we’ll get to next in, in like the health plans.
There was actually an incident that I wasn’t present for, but was in one of the districts that I was in and somebody actually I stopped breathing and went into cardiac arrest and the nurse, they didn’t even think to call the nurse. And who was in a different building until EMS arrived. So it was the nurse aid who did CPR on this person. Um, and yes, they survived and they’re fine.
Um, but you know, you cannot underestimate somebody who is highly trained and there for a reason, like nurses, Aids are pretty amazing. Um, and they know their kids really, really well. Cause they’re managing them day by day by day. So I’m just letting you know that even if the RN isn’t there, there might be somebody like a nurses aid and you can ask questions, like, are they a certified nurses, aide, you know,
what is their experience like have they ever had somebody, in an uncontrolled seizure before you can ask those kinds of [00:11:00] questions? To just get an idea for who is going to be there and in charge of implementing the health plan. So are they a nurse? No, but are they competent in my experience? That’s a yes, for sure. So let’s talk about like the RN. So the.
The actual nurse will sit on IEP evaluations a lot. They don’t necessarily do a lot of like treatment. I would say they don’t necessarily spend a lot of time with each individual kid, but they know the medical precautions. They know how to assess caregiver needs. They know how to be in the loop for health plans.
They know how to write health plans. They’re in charge of keeping that information secure. Um, and they follow, you know, even, even though schools don’t follow HIPAA. They treat the medical records like HIPAA. So, you know, need to know information for people who are, um, with that individual. But those health plans aren’t necessarily part of that IEP for a good reason, right? Like they are separate,
’cause [00:12:00] that’s protected. Medical information, right. Um, if there are two feeds going on at school, if there’s medicine giving at school, then they need to be in the loop for that. There’s a lot of regulations around like how they keep that, you know, where’s the lock for that, those kinds of regulations.
Um, and then if there’s any serious allergy or any medical health need, they need to be involved.
So, again, just keep in mind, they cover the entire school body, not just kids with IEP. So they’re managing a lot. That we don’t even see in special education. A lot of times they would like pop into our weekly meetings, like maybe for 10 minutes and then they had to go do something. So they are, pretty busy. And I would say at least in my experience spread relatively thin because they’re covering a lot.
Um, but that does not mean they’re in competent because a lot of them were. You know, in the ER, they can certainly handle that. Um, but just know that they’re, they’re handling other things as well. So the other thing that I’ve seen in Colorado at least, and I’ve seen this posted in several, like support parent Facebook groups that [00:13:00] I’m in, that I try to support parents in is that it varies state by state if you’re trying to advocate for a one-on-one nurse.
So, you know, I’ve had people in schools that have like spinal muscle atrophy, or there was another person who had really, really rare disorder that needed 24 hour care. The way that it works here in Colorado is that that 24 hour nurse is paid for by insurance. Mostly by the disability side of Medicaid, Medicaid has kind of two branches in Colorado. One is a financial need, so you have to not make a lot to get qualified for Medicaid, but then there’s a second way to qualify for Medicaid in Colorado. And that is disability related. So.
A lot of those one-on-one 24 hour nursing care is paid for by Medicaid in Colorado. But I have seen people in these Facebook groups in other states that have to advocate for a one-on nurse while they are in school and that’s paid for by the school district. So it just really depends on what’s [00:14:00] happening in your
particular state for how that gets funded. So, um, you know, in our case, I’ve seen the nurse can be involved in transporting them to the school. So they meet them at home. They bring them to school they’re with them all school day. Some of them feel like they want to get more involved and they ended up being like a para for them.
And then some nurses are like strictly, no, I am here to be their nurse. And like, I’m not getting involved with any of the Paris stuff. So it really kind of depends even on that individual. Um, nurse that’s with that person. So that just depends, but. Not all states do that. Some states run this differently. So just know that we might have to do a little bit of research for your state to figure out if you need to advocate for this one-on-one nurse support, or if you need to go a different route, um, like the Medicaid situation in Colorado. So now of course, this is a super quick rundown of what nurses do, right?
I’m sure if I had a nurse on which [00:15:00] hopefully I will have one of my friends who are nurses on. Um, then they will be able to explain their role much, much deeper than that. But hopefully if you’re thinking about nursing or if you’re wanting to advocate for nursing, this definitely helps you get started with what kind of informed questions can you ask based off of this information? Right. So, um, you can start to ask, like, do you guys provide one-on-one nursing support?
Like are, is this nurse in the building all day? Because they might be like, you might have the funding for that in your district. And that might be different. They might not. B itinerant in your district. So hopefully that gives you some context for questions to ask if you’re concerned about nursing care. So remember to snag your free IEP process, step-by-step guide, you can do that in the link below this podcast in your podcast player, or it’s at the IEP lab.com/iep. And don’t forget to register for the IEP bootcamp.
It’s coming up in two weeks and I’m so excited to give you the tools that you need to read that IEP with confidence and ask good questions of the things that you [00:16:00] are an understanding from your IEP team and just. Just have some context for what the heck you’re looking at. So it’s going to be really fun. Don’t miss it.
The link to register is below this podcast in your podcast player. So thank you so much for tuning in this week and I’ll see you. Same time, same place next week. Thanks so much. Bye.