# School Nurse Wanna Be's



## Katy (Sep 12, 2011)

Okay, so why when I am at a local camp or school function, and I look to see the First-Aid tent and clinic center. I start to talk to the person giving care, and come to find out they are an EMT-B! :glare: I'm sorry, but there is something very wrong with an EMT-B functioning as a School Nurse or Camp Nurse, I wouldn't even put a Paramedic in this job because they aren't a "nurse" first of all, and second, I'm all for EMS being techs and assistants in the clinics, but to be the primary care giver in a education setting ?h34r: What do you all think ? Any experience with this ?


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## MedicBender (Sep 12, 2011)

What exactly do you find "very wrong" with an EMT-B or Paramedic providing medical stand-by at a camp or school function?

What life saving treatment is the nurse going to deliver that the EMT or Paramedic can't?


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## usalsfyre (Sep 12, 2011)

Right, because all a paramedic is good for is providing less than nursing care .

First off you mention first-aid tents. What is it exactly you think an EMT class consist of? Secondly, success in these roles depends entirely on the person. The oil and gas and industrial settings have been using paramedics in clinic roles for decades with satisfactory results. Sure I can think of a lot of paramedics I don't want in this role, but I can think of a whole lit of nurses to. Finally, how do you reconcile the fact that my initial education and continuing education since graduation have both been longer and far more in depth than what the typical LVN receives, yet they draw no ire from you? 

I agree, EMT-Basic is a little light to be used in a "school nurse" role. But I fail to see why an appropriately educated paramedic couldn't function as or more successfully as an RN or LVN in this role.


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## Katy (Sep 12, 2011)

MedicBender said:


> What exactly do you find "very wrong" with an EMT-B or Paramedic providing medical stand-by at a camp or school function?
> 
> What life saving treatment is the nurse going to deliver that the EMT or Paramedic can't?


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.


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## Shishkabob (Sep 12, 2011)

Happy said:


> but to be the primary care giver in a education setting



You're new to EMS, so I'll give you a pass on this one.  You're neither an EMT nor a Paramedic, let alone an RN, and you think you know what they are capable of, what they know, and what they can do?


Look up Community Paramedicine.  That is precisely what Paramedics do, and in all the places that do it, it's a resounding success.  Eagle County, Colorado does it.  Fort Worth does it.  Plenty of places do it and it's shown to work, and work damn well.





Happy said:


> 2. Don't have a higher medical authority or an actual School Nurse on hand.



And nurses don't have a higher medical authority than a Paramedic.


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## usafmedic45 (Sep 12, 2011)

Linuss said:


> You're new to EMS, so I'll give you a pass on this one.  You're neither an EMT nor a Paramedic, let alone an RN, and you think you know what they are capable of, what the know, and what they can do?
> 
> 
> Look up Community Paramedicine.  That is precisely what Paramedics do, and in all the places that do it, it's a resounding success.  Eagle County, Colorado does it.  Fort Worth does it.  Plenty of places do it and it's shown to work, and work damn well.


I was about to point out the irony of a first responder criticizing someone with more training, not a lot more, but still a higher level of provider.


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## Katy (Sep 12, 2011)

usalsfyre said:


> Right, because all a paramedic is good for is providing less than nursing care .
> 
> First off you mention first-aid tents. What is it exactly you think an EMT class consist of? Secondly, success in these roles depends entirely on the person. The oil and gas and industrial settings have been using paramedics in clinic roles for decades with satisfactory results. Sure I can think of a lot of paramedics I don't want in this role, but I can think of a whole lit of nurses to. Finally, how do you reconcile the fact that my initial education and continuing education since graduation have both been longer and far more in depth than what the typical LVN receives, yet they draw no ire from you?
> 
> I agree, EMT-Basic is a little light to be used in a "school nurse" role. But I fail to see why an appropriately educated paramedic couldn't function as or more successfully as an RN or LVN in this role.


I didn't actually mean a "first-aid" tent, these tents are the area for medical attention in the facility. They have capabilities far more than first-aid, my apologies. And I have never seen a LPN in the school systems that functions solely without RN supervision. Because they don't have the proper certification and education. School Nurses in my area have to take special courses in order to be available for the job.


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## JPINFV (Sep 12, 2011)

Linuss said:


> Look up Community Paramedicine.  That is precisely what Paramedics do, and in all the places that do it, it's a resounding success.  Eagle County, Colorado does it.  Fort Worth does it.  Plenty of places do it and it's shown to work, and work damn well.




...and it's not something that your average paramedic is going to be doing. If they're taking the first paramedic that applies to a situation that requires more than emergency medical care, then it is inappropriate.


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## Katy (Sep 12, 2011)

Linuss said:


> You're new to EMS, so I'll give you a pass on this one.  You're neither an EMT nor a Paramedic, let alone an RN, and you think you know what they are capable of, what they know, and what they can do?
> 
> 
> Look up Community Paramedicine.  That is precisely what Paramedics do, and in all the places that do it, it's a resounding success.  Eagle County, Colorado does it.  Fort Worth does it.  Plenty of places do it and it's shown to work, and work damn well.
> ...


Never said I claimed to know any of that, I am simply pointing out my opinion, and why I have a problem with it. Like I said, my main concern is a medic or EMT calling themselves a "School Nurse", which is illegal in my area I know of. And again, I am talking of in an actual school, school-related even, and camp.


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## BEorP (Sep 12, 2011)

Happy said:


> 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
> ...



If you have a problem with an EMT who presents themselves as a nurse, I can understand. In terms of the public health type stuff, you are correct that a nurse is probably better suited. 

What I cannot agree with though is that somehow Bobby Joe is going to be at risk because he is treated by an EMS provider rather than a nurse. EMS providers treat unconscious patients everyday without having a clue what their history is and any competent provider would quickly discover and treat the hypoglycemia.

Asking questions is always good. We need more people willing to question things in EMS in North America, but I think you will see with time that there is no risk to the patient here as you suggest.


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## LucidResq (Sep 12, 2011)

Funding comes to mind. Unfortunately there are schools here that can't even provide desks for all students. They literally have kids sitting on the floor. If they can't hire a full-time RN... that's ok. I'd rather they invest any available money in providing a quality education. Although it's a great resource to have at a school, an RN is not necessary by any means. If they can't afford that, I suppose a good EMT or medic is better than nothing.


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## DESERTDOC (Sep 12, 2011)

Happy said:


> Okay, so why when I am at a local camp or school function, and I look to see the First-Aid tent and clinic center. I start to talk to the person giving care, and come to find out they are an EMT-B! :glare: I'm sorry, but there is something very wrong with an EMT-B functioning as a School Nurse or Camp Nurse, I wouldn't even put a Paramedic in this job because they aren't a "nurse" first of all, and second, I'm all for EMS being techs and assistants in the clinics, but to be the primary care giver in a education setting ?h34r: What do you all think ? Any experience with this ?



School nurse wanna be's.  The title to your thread says it all.

Perhaps you need to seek out more information about what it is that EMT's and Paramedics do.  Perhaps you should learn about Remote Medicine and what EMT's and Paramedics do.  Perhaps, you should find out why Bechtel, KBR etc all use Paramedics for their remote operations.  By remote, I mean Siberia, the Arctic etc.

Explain to me why Paramedics should not be functioning as the primary care provider?  Chapter and verse please.


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## Katy (Sep 12, 2011)

BEorP said:


> If you have a problem with an EMT who presents themselves as a nurse, I can understand. In terms of the public health type stuff, you are correct that a nurse is probably better suited.
> 
> What I cannot agree with though is that somehow Bobby Joe is going to be at risk because he is treated by an EMS provider rather than a nurse. EMS providers treat unconscious patients everyday without having a clue what their history is and any competent provider would quickly discover and treat the hypoglycemia.
> 
> Asking questions is always good. We need more people willing to question things in EMS in North America, but I think you will see with time that there is no risk to the patient here as you suggest.


Yes, I understand all of this as well. All I was pointing out there was that the Nurse that is constantly documenting and watching that patient throughout the day would be a step ahead of the EMS who have no clue about that patient with a medical illness. Could save time, which is crucial. Again, I'm all for them being there and at a scene, but when they claim to be Nurses and don't go through the day-to-day work of a School Nurse.


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## DESERTDOC (Sep 12, 2011)

Happy said:


> 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
> ...



You really do not know what you are talking about.

A nurse works at my discretion and under my direction.  Period, end story.


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## fast65 (Sep 12, 2011)

Happy said:


> 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
> ...



I don't know what kind of school nurses you had, but at my school we had these people called "health teachers", they covered health and such. The school nurse just consisted of band aids and Neosporin, they weren't a dentist or accountant. 

Vaccinations are not a hard thing to do, they're simply an injection, I've given plenty of them. Screenings? Well, I suppose that could just be an ASSESSMENT. 

As far as the hypoglycemia thing is concerned, what makes syncope on the playground any different than a 911 call for syncope? The EMT would approach it the same way, they would do the same assessment, and I highly, highly doubt they would miss something as simple as hypoglycemia.


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## Katy (Sep 12, 2011)

LucidResq said:


> Funding comes to mind. Unfortunately there are schools here that can't even provide desks for all students. They literally have kids sitting on the floor. If they can't hire a full-time RN... that's ok. I'd rather they invest any available money in providing a quality education. Although it's a great resource to have at a school, an RN is not necessary by any means. If they can't afford that, I suppose a good EMT or medic is better than nothing.


I totally agree, and I never really looked at it from that point. I suppose money could be a major issue as far as getting an RN trained School Nurse goes.


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## Shishkabob (Sep 12, 2011)

JPINFV said:


> ...and it's not something that your average paramedic is going to be doing. If they're taking the first paramedic that applies to a situation that requires more than emergency medical care, then it is inappropriate.



Somewhat agreed, but that's not the issue that was brought up.  The issue that was brought up was that Paramedics are not, and cannot be, as capable as an RN in 'primary care', which is a fallacy, let alone a fallacy portrayed by member who isn't educated at either of the 2 levels in question.


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## DESERTDOC (Sep 12, 2011)

As a CNA Student I find it interesting that you walked into my home, Emtlife, and :censored::censored::censored::censored: on my table.


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## Katy (Sep 12, 2011)

Linuss said:


> Somewhat agreed, but that's not the issue that was brought up.  The issue that was brought up was that Paramedics are not, and cannot be, as capable as an RN in 'primary care', which is a fallacy, let alone a fallacy portrayed by member who isn't educated at either of the 2 levels in question.


Not primary care in general, but an education primary care. School Nurses in my area must have an x amount of experience and various certifications before becoming available for the position at hand. And are you educated in the RN level considering you are not one ? Again, this was simply my opinion and views, I wanted to express them. No need to get so serious about it, it was a simple view. Would you want an RN walking around saying they are a Paramedic when they are not ? Same applies in this case.


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## JPINFV (Sep 12, 2011)

DESERTDOC said:


> As a CNA Student



Umm, CNA or CRNA?


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## fast65 (Sep 12, 2011)

Happy said:


> Yes, I understand all of this as well. All I was pointing out there was that the Nurse that is constantly documenting and watching that patient throughout the day would be a step ahead of the EMS who have no clue about that patient with a medical illness. Could save time, which is crucial. Again, I'm all for them being there and at a scene, but when they claim to be Nurses and don't go through the day-to-day work of a School Nurse.



This is something that has confused me about your post. You make it seem as though a paramedic acting in the role of a school nurse would be off-site, whereas an RN, LPN, or what have you, would be on-site while functioning in the same role. Your post makes it seem as though the level of provider dictates the amount of time they spend with their patients.


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## Shishkabob (Sep 12, 2011)

Happy said:


> Not primary care in general, but an education primary care. School Nurses in my area must have an x amount of experience and various certifications before becoming available for the position at hand.



So tell me, what makes someone good at 'primary care', not competent at 'educational primary care'?  What's the difference between an 80 year old at home, and a 22 year old at college?  One possesses a TI-83 calculator?


Why do you think Paramedics are incapable of providing competent medical care just because it's a school?








> And are you educated in the RN level considering you are not one ?


There are nurses I run laps around when it comes to 'nursing material'.  There are nurses who know more than me in 'Paramedic stuff'.

Quit limiting it to just someones original education... and education you have not obtained yourself.


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## DESERTDOC (Sep 12, 2011)

JPINFV said:


> Umm, CNA or CRNA?



It says CNA, what did I miss?


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## fast65 (Sep 12, 2011)

Linuss said:


> So tell me, what makes someone good at 'primary care', not competent at 'educational primary care'?  What's the difference between an 80 year old at home, and a 22 year old at college?  One possesses a TI-83 calculator?



Oh the good old days of playing Phoenix on my TI-83


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## Katy (Sep 12, 2011)

fast65 said:


> I don't know what kind of school nurses you had, but at my school we had these people called "health teachers", they covered health and such. The school nurse just consisted of band aids and Neosporin, they weren't a dentist or accountant.
> 
> Vaccinations are not a hard thing to do, they're simply an injection, I've given plenty of them. Screenings? Well, I suppose that could just be an ASSESSMENT.
> 
> As far as the hypoglycemia thing is concerned, what makes syncope on the playground any different than a 911 call for syncope? The EMT would approach it the same way, they would do the same assessment, and I highly, highly doubt they would miss something as simple as hypoglycemia.


We did have those, but often we would have the School Nurse do health education and puberty education as well. I'm sorry, but School Nurses do far more than that. 
No they are not, but experience and extra training nurses go through here further ensure what you just said. Screenings aren't just assessments, they include assessing vision, hearing, and consulting with parents for any abnormal findings and suggesting a Physician for a consultation. 
And it doesn't, but for someone who knows a patients health history, would you not think they are better and faster to respond to this persons illness ? I would think so.


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## JPINFV (Sep 12, 2011)

Linuss said:


> Somewhat agreed, but that's not the issue that was brought up.


You can't take an outlier group and use that as a counter. Otherwise any time a "should we arm EMS providers" comes up, the concept of armed tactical medics can be extrapolated to mean that all EMS providers can be safely armed. 




> The issue that was brought up was that Paramedics are not, and cannot be, as capable as an RN in 'primary care', which is a fallacy, let alone a fallacy portrayed by member who isn't educated at either of the 2 levels in question.


How much education does the average paramedic have regarding non-emergent medications (including administration) and primary care situations? Sorry, but I can completely picture an EMT running as a "school nurse" sending the first "neck pain" patient to the ER to "rule out" spinal injury. 

This isn't to say that EMS providers are incapable of being educated and trained to fill that role, but the question regarding the current education standards and how they match up with the demands of a primary/pediatric  care clinic style job is pertinent.


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## JPINFV (Sep 12, 2011)

DESERTDOC said:


> It says CNA, what did I miss?



Just wanted to make sure that I read it as certified nursing assistant correctly.


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## JPINFV (Sep 12, 2011)

Linuss said:


> Why do you think Paramedics are incapable of providing competent medical care just because it's a school?


What other standard should we go off of if not average education level?


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## Katy (Sep 12, 2011)

Linuss said:


> So tell me, what makes someone good at 'primary care', not competent at 'educational primary care'?  What's the difference between an 80 year old at home, and a 22 year old at college?  One possesses a TI-83 calculator?
> 
> 
> Why do you think Paramedics are incapable of providing competent medical care just because it's a school?
> ...


- Public speaking
- Being the only medical provider in the building
- Health education 
- Sometimes Psych at this level

You are the one limiting to ones original education, you say because I don't possess a RN degree, I know nothing about it. Then you waltz in like you know everything about RN's, please, don't make that assumption.


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## Shishkabob (Sep 12, 2011)

JPINFV said:


> What other standard should we go off of if not average education level?



You're one to oft quote studies... so how about a study about primary, non-emergent, care handled by Paramedics?


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## DESERTDOC (Sep 12, 2011)

JPINFV said:


> Just wanted to make sure that I read it as certified nursing assistant correctly.



No worries, you got right.

I wanted to know why, as a CNA student this guest felt it was ok to walk in the door and tells us all about our jobs.


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## fast65 (Sep 12, 2011)

Happy said:


> We did have those, but often we would have the School Nurse do health education and puberty education as well. I'm sorry, but School Nurses do far more than that.



I'm speaking of school nurses from my experience. What they do in your area is beyond me.



Happy said:


> No they are not, but experience and extra training nurses go through here further ensure what you just said. Screenings aren't just assessments, they include assessing vision, hearing, and consulting with parents for any abnormal findings and suggesting a Physician for a consultation.



So I'm guessing the assessment you were taught didn't include those? Because mine did, among other things.




Happy said:


> And it doesn't, but for someone who knows a patients health history, would you not think they are better and faster to respond to this persons illness ? I would think so.



See below



fast65 said:


> This is something that has confused me about your  post. You make it seem as though a paramedic acting in the role of a  school nurse would be off-site, whereas an RN, LPN, or what have you,  would be on-site while functioning in the same role. Your post makes it  seem as though the level of provider dictates the amount of time they  spend with their patients.


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## JPINFV (Sep 12, 2011)

Linuss said:


> You're one to oft quote studies... so how about a study about primary, non-emergent, care handled by Paramedics?




By your average paramedic? Why would I need a study to discuss a situation where the education doesn't cover it. Going to the extreme, you'd require a study to show that a paramedic can't safely do open heart surgery.


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## JPINFV (Sep 12, 2011)

DESERTDOC said:


> No worries, you got right.
> 
> I wanted to know why, as a CNA student this guest felt it was ok to walk in the door and tells us all about our jobs.



Ah, with how you wrote that post, I interpreted it as you talking about yourself being a CNA student, not the OP.


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## Shishkabob (Sep 12, 2011)

Happy said:


> - Public speaking


  Because being an RN instantly makes someone a good public speaker, while being a Paramedic means they never interact with the public?



> - Being the only medical provider in the building


  Remote Paramedcine?

Hell, the vast majority of EMS calls, the Paramedic is the only person in the back with the patient, so they are essentially the 'only medical provider' there.    I do rural EMS... I have atleast an hour of just myself with the patient.  A school worker can often have EMS there in a matter of minutes if poop hits the fan, and a school health worker often has the luxury of already knowing a students medical history prior to a situation popping up.



> - Health education


  And we go back, yet again, to the 'why limit to original education', that you yourself used to defend your view in this very post.


> You are the one limiting to ones original education, you say because I don't possess a RN degree, I know nothing about it. Then you waltz in like you know everything about RN's, please, don't make that assumption.


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## Katy (Sep 12, 2011)

DESERTDOC said:


> No worries, you got right.
> 
> I wanted to know why, as a CNA student this guest felt it was ok to walk in the door and tells us all about our jobs.



Stop trying to tell me how I felt, when you don't know. I wasn't trying to tell you about your jobs, I was simply saying that EMT's can't say they are RN's. Simple and plain as that. Also, they don't have the education to provide the best care in that setting. Nothing more, nothing less. I don't know what being a CNA student has to do with it, but if that is trying to be a "low blow", considered it nothing.


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## fast65 (Sep 12, 2011)

Happy said:


> Stop trying to tell me how I felt, when you don't know. I wasn't trying to tell you about your jobs, I was simply saying that EMT's can't say they are RN's. Simple and plain as that. Also, they don't have the education to provide the best care in that setting. Nothing more, nothing less. I don't know what being a CNA student has to do with it, but if that is trying to be a "low blow", considered it nothing.



I see, but how does that make you feel?


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## DESERTDOC (Sep 12, 2011)

Happy said:


> Stop trying to tell me how I felt, when you don't know. I wasn't trying to tell you about your jobs, I was simply saying that EMT's can't say they are RN's. Simple and plain as that. Also, they don't have the education to provide the best care in that setting. Nothing more, nothing less. I don't know what being a CNA student has to do with it, but if that is trying to be a "low blow", considered it nothing.



I do not care how you feel.  You are insulting, degrading, uneducated and do not know what you are talking about.

You are not even a quarter to being right.

Care to address my questions and posts?


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## Katy (Sep 12, 2011)

Linuss said:


> Because being an RN instantly makes someone a good public speaker, while being a Paramedic means they never interact with the public?
> 
> Remote Paramedcine?
> 
> ...


- Nope, because it is law that a RN have a Bachelor's to be a School Nurse in most cases, and in those early years, that education usually consists of communication and public speaking classes.
- But is the Paramedic responsible for up to over a thousand people at one time ? Not to mention the Nurse has little to none of the equipment used for interventions on the rig, so that again would put the Paramedic out of their comfort zone.
- Again we go back to it was just an opinion, stop trying to tell me I can't form one when I don't have the degree.


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## Shishkabob (Sep 12, 2011)

Happy said:


> Stop trying to tell me how I felt, when you don't know. I wasn't trying to tell you about your jobs, I was simply saying that EMT's can't say they are RN's. Simple and plain as that. Also, they don't have the education to provide the best care in that setting. Nothing more, nothing less. I don't know what being a CNA student has to do with it, but if that is trying to be a "low blow", considered it nothing.



No, your original post questions an EMS provider functioning in the same capacity that a 'school nurse' does, and acting in a 'primary care' type of way. 


Not a single mention about calling themselves something they are not.


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## Shishkabob (Sep 12, 2011)

Happy said:


> - Nope, because it is law that a RN have a Bachelor's to be a School Nurse in most cases, and in those early years, that education usually consists of communication and public speaking classes.



Please please please provide me with that law.





> - But is the Paramedic responsible for up to over a thousand people at one time ?


  I have.  I worked a rave where another Paramedic and I were the highest medical providers on scene.  


But let's be honest here, what's the difference between being responsible for 1000 students in a college, and 100,000 people in a county?  




> - Again we go back to it was just an opinion, stop trying to tell me I can't form one when I don't have the degree.



Not questioning your right to have an opinion...but don't be shocked that people with the education you're dismissing come and question the basis of your opinion.


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## DESERTDOC (Sep 12, 2011)

Happy said:


> - Nope, because it is law that a RN have a Bachelor's to be a School Nurse in most cases



Wrong.


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## Katy (Sep 12, 2011)

Linuss said:


> No, your original post questions an EMS provider functioning in the same capacity that a 'school nurse' does, and acting in a 'primary care' type of way.
> 
> 
> Not a single mention about calling themselves something they are not.



_something very wrong with an EMT-B functioning as a School Nurse or Camp Nurse, I wouldn't even put a Paramedic in this job because they aren't a "nurse"_
My full intention, when they function as a School Nurse, when they should as a School Medic. Do you really think primary care is where EMS belongs ? Hence the  "E" ?


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## fast65 (Sep 12, 2011)

Happy said:


> - Nope, because it is law that a RN have a Bachelor's to be a School Nurse in most cases, and in those early years, that education usually consists of communication and public speaking classes.
> - But is the Paramedic responsible for up to over a thousand people at one time ? Not to mention the Nurse has little to none of the equipment used for interventions on the rig, so that again would put the Paramedic out of their comfort zone.
> - Again we go back to it was just an opinion, stop trying to tell me I can't form one when I don't have the degree.



My degree in EMS included public speaking classes...

No, they have a duty to 1,000 people, they are not responsible for them, the school administration is. The nurse will mostly be dealing with one student at a time, ergo cutting their responsibility down to 1. However, if they are responsible for 1,000 people at a time because that's how many are in the school, then by that measure I would be responsible for about 18,750 people every time I head to shift. 

So are you saying that as a paramedic I am completely useless without my equipment?


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## Shishkabob (Sep 12, 2011)

Happy said:


> Do you really think primary care is where EMS belongs ? Hence the  "E" ?



Honestly?   I wish people weren't stupid and used 911 for what it was intended:  Life threatening emergencies.  However, that's not the case.


EMS is filling in a gap by doing exactly what the public has been using it as for decades, as primary care outside of a doctor.  We're just now progressing education to match that need. I see no issues with EMS going that route, "E" or not.


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## Katy (Sep 12, 2011)

fast65 said:


> My degree in EMS consisted of public speaking classes...
> 
> No, they have a duty to 1,000 people, they are not responsible for them, the school administration is. The nurse will mostly be dealing with one student at a time.
> 
> So are you saying that as a paramedic I am completely useless without my equipment?


But I bet they didn't focus on it in the pre-medical studies ? Besides, there are again those certificates out there where they get little to none. 
- They are certainly responsible along with the administration for the health of the students, thats why they were hired.
- No, but, you are going to be out of your element. The school nurse already has the certificate and specialized training for the job.


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## NomadicMedic (Sep 12, 2011)

Happy said:


> Stop trying to tell me how I felt, when you don't know. I wasn't trying to tell you about your jobs, I was simply saying that EMT's can't say they are RN's. Simple and plain as that. Also, they don't have the education to provide the best care in that setting. Nothing more, nothing less. I don't know what being a CNA student has to do with it, but if that is trying to be a "low blow", considered it nothing.



I'm curious. Did the person providing care, at any point, say 'I'm a nurse"? You say: 



			
				Happy said:
			
		

> Okay, so why when I am at a local camp or school function, and I look to see the First-Aid tent and clinic center. I start to talk to the person giving care, and come to find out they are an EMT-B!



It seems like the provider identified themselves as an EMT-B, not a nurse. Why is this a big deal? You're talking about 'first aid tents', these are locations where a person might require a band-aid or some form of basic life support, a skill that most EMT-Bs are uniquely qualified to perform. Seems like a no brainer to me. 

Of course, if that EMT is wearing a lapel pin that says "RN" or is walking around with an orange vest emblazoned with "SCHOOL NURSE", I might have a problem.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> - No, but, you are going to be out of your element. The school nurse already has the certificate and specialized training for the job.



Says who?


----------



## DESERTDOC (Sep 12, 2011)

For the OP:

Are you aware that not all EMS personnel who post here work soley on an ambulance?  That was rhetorical and meant to get you to think about where you are and who posts here.

Ask some of the aussie medics about snake bite care, it is the best in the world that I have seen.

Ask me about Cholera and wound care.

Got any South Africans running around?  They are Independant Practitioners.

Talk to some of the Paramedics who work in the North Sea.


----------



## fast65 (Sep 12, 2011)

Happy said:


> But I bet they didn't focus on it in the pre-medical studies ? Besides, there are again those certificates out there where they get little to none.
> - They are certainly responsible along with the administration for the health of the students, thats why they were hired.
> - No, but, you are going to be out of your element. The school nurse already has the certificate and specialized training for the job.



Care to define what you mean by "pre-medical studies"? If you're talking math, writing, psych, and so on...then yes, they did focus on that.

So then by that measure I'm responsible for 18,750 people when I'm on shift.

I am failing to see how a paramedic who is trained to assess someone with diagnostic equipment would be out of their element anymore than an RN who is trained to use that same equipment (and then some) would be out of theirs. They are both taught to assess someone and care for them without that fancy equipment prior to learning how to do so with all the gadgets and doodads, so what's the difference?


----------



## JPINFV (Sep 12, 2011)

Linuss said:


> We're just now progressing education to match that need.


Hence, I believe, the crux of the issue.


----------



## Katy (Sep 12, 2011)

n7lxi said:


> I'm curious. Did the person providing care, at any point, say 'I'm a nurse"? You say:
> 
> 
> 
> ...



The underlined is exactly what happened. I began talking to them because I have goals to get an RN degree, so I was going to converse with them about their route. Then they said, "Nope, I'm an EMT-B."  They had a pin that said School Nurse, which I am pretty sure is illegal in my state.


----------



## Chimpie (Sep 12, 2011)

*Keep it polite and on topic or it's getting closed.*


----------



## ffemt8978 (Sep 12, 2011)

Happy said:


> They had a pin that said School Nurse, which I am pretty sure is illegal in my state.


Care to cite which law that is?  A link would be helpful.


----------



## fast65 (Sep 12, 2011)

ffemt8978 said:


> Care to cite which law that is?  A link would be helpful.



Agreed, I would appreciate a link as well


----------



## Shishkabob (Sep 12, 2011)

I'm still waiting on this one;





Happy said:


> - Nope, because it is law that a RN have a Bachelor's to be a School Nurse


----------



## DESERTDOC (Sep 12, 2011)

I would like all of my questions addressed by the OP.  I would like links to mainstream websites to back up the OP's claims and statements.


----------



## Katy (Sep 12, 2011)

ffemt8978 said:


> Care to cite which law that is?  A link would be helpful.


http://www.nursingworld.org/MainMen...tate/StateLegislativeAgenda/TitleNurse_1.aspx
Here, many states find it illegal. You'll find the law in typing below.


----------



## JPINFV (Sep 12, 2011)

ffemt8978 said:


> Care to cite which law that is?  A link would be helpful.



For California, Business and Professions code contains the following:


> 2795.  Except as provided in this chapter, it is unlawful for any person to do any of the following:    (a) To practice or to offer to practice nursing in this state unless the person holds a license in an active status.    *(b) To use any title, sign, card, or device to indicate that he or she is qualified to practice or is practicing nursing, unless the person has been duly licensed or certified under this chapter.
> *


Emphasis added. 
http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=02001-03000&file=2795-2800


----------



## Katy (Sep 12, 2011)

Linuss said:


> I'm still waiting on this one;


The first link is to show that Nurses must go through a certification to become a School Nurse to further their education. Now, when going to school to get certified, it clearly states the program is intended for BSN nurses only. So if you must have the certificate, and you must have a BSN to do the program and get a certificate, you must be a BSN to be a School Nurse. 
http://wvasn.com/certification.cfm
http://www.ab.edu/academics/nursing


----------



## Cup of Joe (Sep 12, 2011)

Ok, Let me throw this question in the discussion:

What would a school nurse have access to that a Paramedic would not be trained in or not be able to use?  Schools have budgets, and I doubt that a school would have enough money to pay for a nurse and all the equipment that nurse wants.  

My grammar school had an RN nurse with a first aid kit, some OTC medications (i.e. acetaminophen, benedryl, etc.), a scale, and an exam table.

In high school, they had the same thing, but no nurse.  They trusted us enough to put on our own band-aids.  Had a headache, here's two tylenol.  If the child needed to go home, the parents were called to take the child to their primary care physician.  If the child needed medical attention urgently, they called an ambulance.

If I was a parent or school administrator, I would have no problem with a paramedic in that role.

Also, what about colleges that have their own student run EMS organizations.  Those are EMT-Bs who will most likely encounter more than a school nurse would (drunks, sports injuries, possibly drug overdoses).


----------



## JPINFV (Sep 12, 2011)

You know, we haven't even established the scope of practice for the school nurse yet. Here it is for California. It should also be noted that your average plain Jane RN isn't qualified to be a school nurse in California either. 



> School nurses may perform, if authorized by the local governing board, the following services:
> 
> (a) Conduct immunization programs pursuant to Section 49403 and assure that every pupil's immunization status is in compliance with the law, including parental or guardian consent, and good health practice.
> 
> ...


http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=49001-50000&file=49422-49427


...and the education requirement



> 44877.  The qualifications for a nurse shall be a valid certificate of registration issued by the Board of Nurse Examiners of the State of California or the California Board of Nursing Education and Nurse Registration and a health and development credential, a standard designated services credential with a specialization in health, or a services credential with a specialization in health.    The services credential with a specialization in health authorizing service as a school nurse shall not authorize teaching services unless the holder also completes the requirements for a special class authorization in health in a program that is approved by the commission.    On and after January 1, 1981, the qualifications for a nurse shall also include proof satisfactory to the school district that the nurse has acquired training in child abuse and neglect detection. This requirement may be satisfied through participation by the nurse in continuing education activities relating to child abuse and neglect detection and treatment.


http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=44001-45000&file=44830-44929


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> The first link is to show that Nurses must go through a certification to become a School Nurse to further their education. Now, when going to school to get certified, it clearly states the program is intended for BSN nurses only. So if you must have the certificate, and you must have a BSN to do the program and get a certificate, you must be a BSN to be a School Nurse.
> http://wvasn.com/certification.cfm
> http://www.ab.edu/academics/nursing



And yet, no mention of it being a "law" as you claimed.


----------



## Katy (Sep 12, 2011)

JPINFV said:


> You know, we haven't even established the scope of practice for the school nurse yet. Here it is for California. It should also be noted that your average plain Jane RN isn't qualified to be a school nurse in California either.
> 
> http://www.leginfo.ca.gov/cgi-bin/displaycode?section=edc&group=49001-50000&file=49422-49427
> 
> ...


Agreed, in WV, you must be certified as well, and hold a BSN. The certificate holds educational training and medical training specialized in School Nursing, making it a specialty like any other.


----------



## Katy (Sep 12, 2011)

Linuss said:


> And yet, no mention of it being a "law" as you claimed.


It says, and I quote, "The West Virginia Board of Education requires all nurses to become certified." And, in every school there, the certificate is only offered in the BSN program or a bridge program to the Bachelor's level, so yes, you have to be a Bachelor's Nurse.


----------



## JPINFV (Sep 12, 2011)

So, remind me, how much education and experience does the average paramedic have in developing, implementing, and monitoring individual health maintenance and providing assistance with education plans due to health issues?

How much education do paramedics have in dental hygiene? 

How about subsection (i)?


----------



## JPINFV (Sep 12, 2011)

Happy said:


> Agreed, in WV, you must be certified as well, and hold a BSN. The certificate holds educational training and *nurse* training specialized in School Nursing, making it a specialty like any other.




Fixed that for you. Nurses aren't educated in medicine.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> It says, and I quote, "The West Virginia Board of Education requires all nurses to become certified." And, in every school there, the certificate is only offered in the BSN program or a bridge program to the Bachelor's level, so yes, you have to be a Bachelor's Nurse.



Requirement for a private educational program =/= state law.


----------



## Katy (Sep 12, 2011)

JPINFV said:


> Fixed that for you. Nurses aren't educated in medicine.


Thanks, I know they aren't, we all make mistakes. 
Also, would someone like to point out how much education Paramedics get in Nutrition ? A huge part of School Nurses.


----------



## Katy (Sep 12, 2011)

Linuss said:


> Requirement for a private educational program =/= state law.


Those are the only ones that give the certificate, they all require and even Fairmont states " The program is designed for BSN students ". There isn't any way around it, sorry, but thats how it is. An ADN can't be a School Nurse in my state.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> Those are the only ones that give the certificate, they all require and even Fairmont states " The program is designed for BSN students ". There isn't any way around it, sorry, but thats how it is. An ADN can't be a School Nurse in my state.



And I go back, for the 3rd time:  There is no state law, that you've provided, that says you have to hold a BSN.



Say you want an MBA for a job the state states you need an MBA in.  The school may require you to hold a bachelors in business to do their program, but there is no state law requiring you to hold a BB to do MBA school.


----------



## fast65 (Sep 12, 2011)

Happy said:


> Thanks, I know they aren't, we all make mistakes.
> Also, would someone like to point out how much education Paramedics get in Nutrition ? A huge part of School Nurses.



I got 3 credits of it, maybe not a lot, but still, a decent amount


----------



## Katy (Sep 12, 2011)

Linuss said:


> And I go back, for the 3rd time:  There is no state law, that you've provided, that says you have to hold a BSN.
> 
> 
> 
> Say you want an MBA for a job the state states you need an MBA in.  The school may require you to hold a bachelors in business to do their program, but there is no state law requiring you to hold a BB to do MBA school.



You have to hold a BSN before you can get a certificate. If you can't get a certificate, you can't be a school nurse. Put two and two together, I'm sure there is a law.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> You have to hold a BSN before you can get a certificate. If you can't get a certificate, you can't be a school nurse. Put two and two together, I'm sure there is a law.



I asked for the law.  You haven't provided the law.  'Put two and two together.'  Just because a private institution requires something doesn't mean it's law.


----------



## ffemt8978 (Sep 12, 2011)

Happy said:


> You have to hold a BSN before you can get a certificate. If you can't get a certificate, you can't be a school nurse. Put two and two together, I'm sure there is a law.


That's the type of thinking that can get you into trouble.  If you can't find the law, then it doesn't exist.


----------



## JPINFV (Sep 12, 2011)

So, no one wants to discuss the training that paramedics have in counseling students and staff about genetic disorders or contributing to individualized educational plans?


----------



## DESERTDOC (Sep 12, 2011)

JPINFV said:


> So, remind me, how much education and experience does the average paramedic have in developing, implementing, and monitoring individual health maintenance and providing assistance with education plans due to health issues?
> 
> How much education do paramedics have in dental hygiene?
> 
> How about subsection (i)?



I do not speak for all Paramedics, but I will speak for my self. 

I have extensive training and direct clinical practice.

Not all Paramedics are equal in training or experience.


----------



## Katy (Sep 12, 2011)

ffemt8978 said:


> That's the type of thinking that can get you into trouble.  If you can't find the law, then it doesn't exist.


]
The law says that a School Nurse must have the certificate, and in order to get the certificate one must have a Bachelor's degree at the least. The Certification's site is below and says it in plain detail.
http://www.nbcsn.com/examdefault.htm


----------



## Shishkabob (Sep 12, 2011)

This


DESERTDOC said:


> Not all Paramedics (or nurses) are equal in training or experience.




And this


Because fresh out of school your average ADN is proficient in those abilities, but your average APS is unable to obtain the same level of proficiency?


----------



## JPINFV (Sep 12, 2011)

Ok, how much does the average paramedic have in those things?

After all, I know a fair number of EMTs who can interpret 12 leads, so should EMTs be interpreting 12 leads?

(On a side note, legally speaking paramedics in California can't do 12 leads right now. It's actually kinda of funny).


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> ]
> The law says that a School Nurse must have the certificate, and in order to get the certificate one must have a Bachelor's degree at the least. The Certification's site is below and says it in plain detail.
> http://www.nbcsn.com/examdefault.htm



Certification requirements for a private certification are NOT law.


Example:  Let's say the states requires you to hold an ZERA card for a job.  Let's say ZERA requires you to be a Paramedic.  There is NO law at the state level requiring you to be a Paramedic, just to hold an ZERA card.  The only requirement is by a private institution that teaches ZERA, requiring you to be a Paramedic.


----------



## fast65 (Sep 12, 2011)

JPINFV said:


> Ok, how much does the average paramedic have in those things?
> 
> After all, I know a fair number of EMTs who can interpret 12 leads, so should EMTs be interpreting 12 leads?
> 
> *(On a side note, legally speaking paramedics in California can't do 12 leads right now. It's actually kinda of funny*).



Really?


----------



## Shishkabob (Sep 12, 2011)

JPINFV said:


> (On a side note, legally speaking paramedics in California can't do 12 leads right now. It's actually kinda of funny).



It's just not fair to use California as ANY sort of educational baseline when talking about EMS


----------



## ffemt8978 (Sep 12, 2011)

Happy said:


> ]
> The law says that a School Nurse must have the certificate, and in order to get the certificate one must have a Bachelor's degree at the least. The Certification's site is below and says it in plain detail.
> http://www.nbcsn.com/examdefault.htm



And from the page you linked to...



> a.      Attainment of bachelor's degree or higher, in nursing or health related field, or the equivalent in other countries.
> OR
> b.      Current certification by NBCSN as an NCSN.


I see a BSN as one of the requirements, but there are other ways to meet the qualifications.  

And the site you linked to is not a legislative agency that actually writes the laws, it is simply their own requirements.  So unless you can provide a link to the actual law that says you must have a BSN (and only a BSN), then your argument doesn't hold water.


----------



## DESERTDOC (Sep 12, 2011)

Linuss said:


> It's just not fair to use California as ANY sort of educational baseline when talking about EMS



Ahem, do some searching about EMS in the north part of the State.


----------



## JPINFV (Sep 12, 2011)

fast65 said:


> Really?



It used to be a part of the EMT-II level. Paramedic scope is "Everything in EMT-II level plus _____." When EMT-II went to AEMT, the monitor component was removed, but never added to the paramedic scope. 

http://www.emsa.ca.gov/about/files/ParaDraftParamedic_Regulations.pdf
Page 7. Everything underlined is being proposed as being added to the statute authorizing paramedics.


----------



## BandageBrigade (Sep 12, 2011)

JPINFV said:


> It used to be a part of the EMT-II level. Paramedic scope is "Everything in EMT-II level plus _____." When EMT-II went to AEMT, the monitor component was removed, but never added to the paramedic scope.
> 
> http://www.emsa.ca.gov/about/files/ParaDraftParamedic_Regulations.pdf
> Page 7. Everything underlined is being proposed as being added to the statute authorizing paramedics.



Yet another reason why california just needs to sink into the ocean already.  



Not a slight at any of you cali peeps, I would be more than happy for you to move inland and settle down where your practice and education would not be limited so. ;p


----------



## Katy (Sep 12, 2011)

ffemt8978 said:


> And from the page you linked to...
> 
> 
> I see a BSN as one of the requirements, but there are other ways to meet the qualifications.
> ...


Right, but every single one of those schools required a BSN for the certificate, and it was said several times it was for the BSN course. Tell me how there are other ways to meet the qualifications ?


----------



## ffemt8978 (Sep 12, 2011)

For all those interested, here is the ACTUAL law in WV covering licensing of Nurses.

http://www.legis.state.wv.us/WVCODE/Code.cfm?chap=30&art=7#07

In a quick scan, I did not see having a BSN as a requirement for anything.

In addition, from this link
http://www.wvasn.com/certification.cfm
it states, 





> The West Virginia Department of Education requires that all school nurses become certified. The process of School Nurse Certification must be initiated within the first year of employment. There are various programs offered in the state of West Virginia for this certification.


, so it is a Department of Education requirement for the certificate...not a law.


----------



## DESERTDOC (Sep 12, 2011)

JPINFV said:


> It used to be a part of the EMT-II level. Paramedic scope is "Everything in EMT-II level plus _____." When EMT-II went to AEMT, the monitor component was removed, but never added to the paramedic scope.
> 
> http://www.emsa.ca.gov/about/files/ParaDraftParamedic_Regulations.pdf
> Page 7. Everything underlined is being proposed as being added to the statute authorizing paramedics.



It is not in the state scope as defined by Title 22, but numerous LEMSA's use 12-lead.  Also, SSV-EMS just says EKG, it does not say can only use 3 leads.  Hence, 12 lead is utilized.


----------



## ffemt8978 (Sep 12, 2011)

Happy said:


> Right, but every single one of those schools required a BSN for the certificate, and it was said several times it was for the BSN course. Tell me how there are other ways to meet the qualifications ?



I understand it is a requirement to have a BSN...my issue is that you keep claiming it is the LAW.  There is a huge difference between a requirement and a law.


----------



## JPINFV (Sep 12, 2011)

DESERTDOC said:


> It is not in the state scope as defined by Title 22, but numerous LEMSA's use 12-lead.  Also, SSV-EMS just says EKG, it does not say can only use 3 leads.  Hence, 12 lead is utilized.




I think it's an oversight and no one is going to care if a paramedic uses a monitor until that bill gets passed. After all, how many LEMSAs have gone through the wavier process in order to add it?


----------



## Shishkabob (Sep 12, 2011)

JPINFV said:


> no one is going to care if a paramedic uses a monitor



Then again, White Castle is being sued because some fat guy hits his knees on the table...


----------



## Katy (Sep 12, 2011)

ffemt8978 said:


> For all those interested, here is the ACTUAL law in WV covering licensing of Nurses.
> 
> http://www.legis.state.wv.us/WVCODE/Code.cfm?chap=30&art=7#07
> 
> ...


I was just at that site, I'm surfing through it now, but there may still be a law.


----------



## DESERTDOC (Sep 12, 2011)

JPINFV said:


> I think it's an oversight and no one is going to care if a paramedic uses a monitor until that bill gets passed. After all, how many LEMSAs have gone through the wavier process in order to add it?



Perhaps it is, but the the California EMSA leaves much of the scope of practice issues to local medical directors.


----------



## Nerd13 (Sep 12, 2011)

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. I still fail to understand why I would have any less knowledge of the school population I would be working with than an RN if I was working in the same exact capacity. There are just so many logical issues here. I can honestly tell you that even without my paramedic education and just as an EMT-B I would still feel completely comfortable working in the capacity of a 'school nurse' even if I couldn't legally identify myself as one. It's just not that big of a deal to change from dealing with the entire population of a county to the population of a school. The issues are only different if you try to make them that way. 

I will agree that it would be wrong to identify yourself as an RN if you aren't one. However the title of 'school nurse' isn't a degree or a license so there is technically no reason why an EMT, Paramedic, LVN or CNA couldn't be one. Excluding, apparently, some states who have some sort of certification for school nurse.


----------



## JPINFV (Sep 12, 2011)

Nerd13 said:


> 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. I still fail to understand why I would have any less knowledge of the school population I would be working with than an RN if I was working in the same exact capacity. There are just so many logical issues here. I can honestly tell you that even without my paramedic education and just as an EMT-B I would still feel completely comfortable working in the capacity of a 'school nurse' even if I couldn't legally identify myself as one. It's just not that big of a deal to change from dealing with the entire population of a county to the population of a school. The issues are only different if you try to make them that way.



So, again, how much health maintenance and dental education was in your paramedic, and especially your EMT course? 



> I will agree that it would be wrong to identify yourself as an RN if you aren't one. However the title of 'school nurse' isn't a degree or a license so there is technically no reason why an EMT, Paramedic, LVN or CNA couldn't be one. Excluding, apparently, some states who have some sort of certification for school nurse.



The term "nurse" is a protected term in most states. Would you have an issue with a non-paramedic calling themselves a paramedic?


----------



## Katy (Sep 12, 2011)

Nerd13 said:


> 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. I still fail to understand why I would have any less knowledge of the school population I would be working with than an RN if I was working in the same exact capacity. There are just so many logical issues here. I can honestly tell you that even without my paramedic education and just as an EMT-B I would still feel completely comfortable working in the capacity of a 'school nurse' even if I couldn't legally identify myself as one. It's just not that big of a deal to change from dealing with the entire population of a county to the population of a school. The issues are only different if you try to make them that way.
> 
> I will agree that it would be wrong to identify yourself as an RN if you aren't one. However the title of 'school nurse' isn't a degree or a license so there is technically no reason why an EMT, Paramedic, LVN or CNA couldn't be one. Excluding, apparently, some states who have some sort of certification for school nurse.



Do you really think EMT training would make you feel comfortable in giving injections, health education, nutrition, educational plans, teaching, public speaking, and much much more ? No.  It is a certification though. And you would have less knowledge because you learned nothing or very little of teaching, dental hygiene, counseling, and mentoring.


----------



## Nerd13 (Sep 12, 2011)

JPINFV said:


> So, again, how much health maintenance and dental education was in your paramedic, and especially your EMT course?



Some actually. When was the last time you had a dental exam in the school nurses office beyond checking to see if you have all of your teeth and what kind of condition they were in. 




JPINFV said:


> The term "nurse" is a protected term in most states. Would you have an issue with a non-paramedic calling themselves a paramedic?


Yes, but I did not say "nurse" I said "school nurse". I don't think there is any technical requirement for what kind of 'nurse' a school nurse must be. Can they be an LVN? CNA? If there is no steadfast rule I don't think it can be argued that they have to be one particular level of care provider. Just my two cents though. That one is open to interpretation.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> Do you really think EMT training would make you feel comfortable in giving injections, health education, nutrition, educational plans, teaching, public speaking, and much much more ?



EMT?  No.  Paramedic?  Yes.  Community / Advanced Practice Paramedic?  Most definitely.  


What do you think most 911 calls are, except for primary care situations?


----------



## Katy (Sep 12, 2011)

Nerd13 said:


> Some actually. When was the last time you had a dental exam in the school nurses office beyond checking to see if you have all of your teeth and what kind of condition they were in.


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




Nerd13 said:


> Yes, but I did not say "nurse" I said "school nurse". I don't think there is any technical requirement for what kind of 'nurse' a school nurse must be. Can they be an LVN? CNA? If there is no steadfast rule I don't think it can be argued that they have to be one particular level of care provider. Just my two cents though. That one is open to interpretation.


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.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


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


  And a Paramedic is unable to do just as well?



If you're worried about the "more educated" person doing it, then we just need to have dental hygienist come and do it.


----------



## JPINFV (Sep 12, 2011)

Nerd13 said:


> Yes, but I did not say "nurse" I said "school nurse". I don't think there is any technical requirement for what kind of 'nurse' a school nurse must be. Can they be an LVN? CNA? If there is no steadfast rule I don't think it can be argued that they have to be one particular level of care provider. Just my two cents though. That one is open to interpretation.




Again...



> 2795.  Except as provided in this chapter, it is unlawful for any  person to do any of the following:    (a) To practice or to offer to  practice nursing in this state unless the person holds a license in an  active status.    *(b) To use any title, sign, card, or device to  indicate that he or she is qualified to practice or is practicing  nursing, unless the person has been duly licensed or certified under  this chapter.*


*

*Using a title with the term "nurse" is going to indicate that that provider is qualified to practice or is practicing nursing. Paramedics are not licensed under the chapter of the Business and Professions code in California regarding nursing. 

http://www.leginfo.ca.gov/cgi-bin/displaycode?section=bpc&group=02001-03000&file=2795-2800


So, again, if someone used the term "specialty care paramedic" who isn't licensed as a paramedic, little less any level of EMS, you wouldn't care because of the "specialty care" part of the title?


----------



## Nerd13 (Sep 12, 2011)

Happy said:


> Do you really think EMT training would make you feel comfortable in giving injections, health education, nutrition, educational plans, teaching, public speaking, and much much more ? No.  It is a certification though. And you would have less knowledge because you learned nothing or very little of teaching, dental hygiene, counseling, and mentoring.



Giving injections is no big huge miracle thing. If you're shown how to do it once, it's pretty much the same thing over and over again. You could argue that you would need to be a medic for this and that would be fine. I can FOR SURE tell you I would be able to do all of the above as a paramedic. You're arguing that school nurses have some crazy in depth job of dental hygiene. They aren't dental hygienists, they make sure you have your teeth and you're taking care of them. Mentoring is done by paramedics very frequently by coworkers but I don't know what kind of mentoring school nurses are doing either. That job is usually done by actual mentors. So much of this stuff is done mostly by other educational providers and school nurses have a hand in it. I'm not arguing that every single paramedic is completely qualified to be a school nurse but there are a lot of nurses that aren't qualified either. It goes both ways. Many medics and many nurses will be qualified for the same position. It's not the impossible task you're making it out to be. Most nurse stations I've seen in schools are primarily general health and well being and very minor first aid. Everything else gets an ambulance called for anyway.


----------



## Katy (Sep 12, 2011)

Linuss said:


> EMT?  No.  Paramedic?  Yes.  Community / Advanced Practice Paramedic?  Most definitely.
> 
> 
> What do you think most 911 calls are, except for primary care situations?


Please show me where most Paramedic programs educate their students how to properly 
-teach children
-fundamentals of education
-assess behavorial status 
-  assess growing milestones 
-  teach educational programs 
-  eat and advanced nutrition
The Paramedic wouldn't' get the education knowledge that is a must for a School Nurse, and would weakly touch on behavior, nutrition, and dental hygiene.


----------



## Nerd13 (Sep 12, 2011)

JPINFV said:


> So, again, if someone used the term "specialty care paramedic" who isn't licensed as a paramedic, little less any level of EMS, you wouldn't care because of the "specialty care" part of the title?



Actually, I see that every day because 'specialty care' as well as 'critical care' denote a wide variety of programs and certifications with a wide variety of educational requirements so no, I wouldn't care. I see your point I just don't think it's the huge deal that it's being made out to be as long as an EMT/Paramedic doesn't specifically say "I'm a nurse".


----------



## Katy (Sep 12, 2011)

Linuss said:


> And a Paramedic is unable to do just as well?


If they don't know how, then how are they able ? 

I





Linuss said:


> f you're worried about the "more educated" person doing it, then we just need to have dental hygienist come and do it.


Often not the case, hence why I said they were the sole provider of medical care in most cases.


----------



## DESERTDOC (Sep 12, 2011)

JPINFV said:


> Again...
> 
> 
> 
> ...



Well, when it comes to titles, I see your point.  Paramedic is a protected title in the U.S. in other countries it is not.

Registered Nurses, Licensed Vocational Nurses and Paramedics all have their own little titles and they are all protected.

For me, this is not about titles.


----------



## CAOX3 (Sep 12, 2011)

Nerd13 said:


> 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.



Oh well then by all means pick your medical profession.

You cant even guarentee a paramedic has had a traditional anatomy class.

Training isnt the same as education, sorry but it isnt. This isnt a personal attack it just isnt the same.

And why do paramedics get their panties in a bunch all the time when compared with the nursing profession?

If you want to be a school nurse go to nursing school.


----------



## usafmedic45 (Sep 12, 2011)

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.


----------



## DESERTDOC (Sep 12, 2011)

Happy said:


> The Paramedic wouldn't' get the education knowledge that is a must for a School Nurse, and would weakly touch on behavior, nutrition, and dental hygiene.



Please scan and post your Paramedic diploma, certificate of completion etc,  that allows you to make this statement.


----------



## Nerd13 (Sep 12, 2011)

CAOX3 said:


> Oh well then by all means pick your medical profession.
> 
> You cant even guarentee a paramedic has had a traditional anatomy class.
> 
> ...



I agree, just pointing out that at least some paramedics are going to be taught these things. You can't assume that NO paramedics could possibly be qualified to take care of kids in a school setting. That would be like assuming that NO nurses have the capability to function in an EMS transport setting. Neither are true.


----------



## Katy (Sep 12, 2011)

Nerd13 said:


> Giving injections is no big huge miracle thing. If you're shown how to do it once, it's pretty much the same thing over and over again. You could argue that you would need to be a medic for this and that would be fine. I can FOR SURE tell you I would be able to do all of the above as a paramedic. You're arguing that school nurses have some crazy in depth job of dental hygiene. They aren't dental hygienists, they make sure you have your teeth and you're taking care of them. Mentoring is done by paramedics very frequently by coworkers but I don't know what kind of mentoring school nurses are doing either. That job is usually done by actual mentors. So much of this stuff is done mostly by other educational providers and school nurses have a hand in it. I'm not arguing that every single paramedic is completely qualified to be a school nurse but there are a lot of nurses that aren't qualified either. It goes both ways. Many medics and many nurses will be qualified for the same position. It's not the impossible task you're making it out to be. Most nurse stations I've seen in schools are primarily general health and well being and very minor first aid. Everything else gets an ambulance called for anyway.


Yes, and the reactions are the same every time too ? 
You wouldn't be able to do it if you seriously don't know how School Nurses mentor. 
I know they are not, but they do receive additional training in dental hygiene over average Nurses. 
Just because and ambulance is called, doesn't mean that time freezes till it gets there. 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.


----------



## Shishkabob (Sep 12, 2011)

Happy said:


> If they don't know how, then how are they able ?



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?




> Often not the case, hence why I said they were the sole provider of medical care in most cases.


What do you think rural Paramedics do?


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## usafmedic45 (Sep 12, 2011)

> would weakly touch on behavior, nutrition, and dental hygiene.



Hey Slappy....you do realize that _most_ nurses can't hold an intelligent conversation about any of those topics right?


----------



## rmabrey (Sep 12, 2011)

I dont know about anyone else, but but when I went to the nurses office, no matter what level of education I was in, I either got to lay down, or they called my parents. If SHTF the ambulance was called. The most work I saw the nurse do in high school was at the ticket booth for football games.


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## ffemt8978 (Sep 12, 2011)

desertdoc said:


> please scan and post your paramedic diploma, certificate of completion etc,  that allows you to make this statement.



no.


----------



## Katy (Sep 12, 2011)

DESERTDOC said:


> Please scan and post your Paramedic diploma, certificate of completion etc,  that allows you to make this statement.


I'm making the statement based on many things I can assure, while I don't have the completion of the program, I can freely make assumption based on what I have gotten from talking to many many medics. They have told me about the weak links in their programs, I'm simply posting what I know of them him.


----------



## DESERTDOC (Sep 12, 2011)

ffemt8978 said:


> no.



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


----------



## BandageBrigade (Sep 12, 2011)

usafmedic45 said:


> 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.
> 
> ...



This gets my vote for post of the year. How this thread got this many replies is beyond me.
   Although you made need to explain which Indiana law you've be violating..


----------



## Nerd13 (Sep 12, 2011)

Happy said:


> 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 (Sep 12, 2011)

Happy said:


> 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 (Sep 12, 2011)

Linuss said:


> 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.
> 
> ...


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 (Sep 12, 2011)

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


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## silver (Sep 12, 2011)

Happy said:


> 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 (Sep 12, 2011)

Happy said:


> 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 (Sep 12, 2011)

silver said:


> Excuse me?


Child obesity, very common sadly.


----------



## rmabrey (Sep 13, 2011)

Happy said:


> 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 (Sep 13, 2011)

Linuss said:


> 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.
> ...


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 (Sep 13, 2011)

DESERTDOC said:


> 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 (Sep 13, 2011)

Happy said:


> 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
> ...



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 (Sep 13, 2011)

akulahawk said:


> 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 (Sep 13, 2011)

usafmedic45 said:


> 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.
> 
> ...



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 (Sep 13, 2011)

Akulahawk said:


> 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. 



Akulahawk said:


> 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. 



Akulahawk said:


> 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.
> 
> ...


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



Akulahawk said:


> 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





Akulahawk said:


> 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 (Sep 13, 2011)

Happy said:


> 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.


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## epipusher (Sep 13, 2011)

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.


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## Akulahawk (Sep 13, 2011)

Happy said:


> 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.
> ...


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


----------



## Yarbo (Sep 13, 2011)

Happy said:


> 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
> ...



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 (Sep 13, 2011)

Play nice....


----------



## systemet (Sep 13, 2011)

Nerd13 said:


> 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.


----------



## systemet (Sep 13, 2011)

I think Happy deserves some respect for continuing to argue a position that the majority of posters on this thread disagree with.  And continuing to do so in a professional manner.  



Happy said:


> Just because and ambulance is called, doesn't mean that time freezes till it gets there. 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.



It's good to have someone with first aid background present at the school.  I would hope that many (all?) of the teachers would have CPR / standard first aid.  

There is very very little that a school nurse is going to be able to do in any of the situations mentioned.

Concussion : - has there been a loss of consciousness with a period of confusion that's resolved? First aid.

Diabetic shock:- Do they even have a blood glucometer, or are they just going based on hx and the presentation of a child with diaphoresis / confusion?  Are they equipped to give glucagon or D50W?  Or is it just a case, of hey, Billy has DM, and he's acting funny, let's give him a Mars Bar? First aid.

Internal bleeding: First aid.

MI: Presumably amongst staff members?  Do they have a 12-lead?  At best they're going to give an ASA, and call 911.  Maybe counsel someone to take their previously prescribed NTG?  First aid.

Just as you're arguing that paramedics are not school nurses, school nurses are not paramedics.  Emergency care is going to be almost completely confined to calling 911 and performing basic first aid.  An EMT-B could easily fulfill the emergency part of the school nurse's role, in my opinion.

Now where it gets trickier is the other stuff:



> Please show me where most Paramedic programs educate their students how to properly
> -teach children
> -fundamentals of education
> -assess behavorial status
> ...



Unfortunately most paramedic programs don't.  I think that general nursing programs (e.g. BScN, diploma RN), are probably better than paramedic programs at providing instruction in patient education.

I think all levels of medical care are terrible at teaching nutrition.  This may be because nutrition is only barely a scientific discipline, every second person thinks they're an expert, and it's riddled with pseudoscience.  Exactly what is advanced about the nutrition a school nurse is teaching?  Are they placing transgenic mice in calorimetry chambers and measuring the RQ?

I would explain that basic RN training would cover a little more about childhood development.

A point that I think is important to make, is that most of the training specific to the "school nurse" position occurs post-grad.  If a nurse is unsuited for this position until they have post-graduate training, then, of course, a paramedic is also unsuited, until they get similar education.

If we're really honest with ourselves, a paramedic is basically an RN who has taken a cut-down entry-to-practice training, and a vastly expanded speciality training.  You probably could take a medic, put them through the post-graduate training for a school nurse position, and cover whatever material is missing from basic nursing education and put them into a "school nurse" position.

I just don't know why you'd want to.  The way I see it, community / advanced practice paramedicine shouldn't be able re-inventing currently existing systems like home care / palliative care / occupational health nursing (*some exception for remote and dangerous work sites), but about placing the patient in better contact with these services, and using the unique position of being in a mobile clinic to provide some added value.



> Often not the case, hence why I said they were the sole provider of medical care in most cases.



I feel compelled to point out that a paramedic is often the only "advanced" provider present at a complex medical or traumatic emergency, has substantially more autonomy than a "school nurse", and is well-prepared to provide care in an environment with minimal resources.



> 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.



Actually, I bet you would.  I think if you went to a cardiac ICU and asking them if they could do neuro, most of the nurses would think they could.  They'd probably be willing to admit they'd need some training (re-training?) in techniques they don't commonly use in the CCU, like ICP monitoring.  But they'd probably tell you that this is an intensive / critical care discipline, and they're training in intensive care.  

I wouldn't expect to walk into a fixed wing flight job tomorrow and be as competent as the guys doing it for 10+ years, even if we took the same basic training when we initially got our licences.  But I would expect that I could train and be mentoring into doing that role relatively well within a year or two.  Because it is just another area of specialisation.


----------



## clibb (Sep 13, 2011)

Happy said:


> 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
> ...



You would make an unconscious patient eat something? 
EMTs and Paramedics treat signs and symptoms. There are a lot of times we don't know the medical history of someone. Frankly, most of the time we'll find out the medical history is from the nurse at the nursing home who hasn't done ANYTHING to the patient. 



Happy said:


> - Nope, because it is law that a RN have a Bachelor's to be a School Nurse in most cases, and in those early years, that education usually consists of communication and public speaking classes.
> - But is the Paramedic responsible for up to over a thousand people at one time ? Not to mention the Nurse has little to none of the equipment used for interventions on the rig, so that again would put the Paramedic out of their comfort zone.
> - Again we go back to it was just an opinion, stop trying to tell me I can't form one when I don't have the degree.



What equipment do nurses not have that Paramedics have? Have you ever been in an ambulance? Yeah, they are responsible for a thousands of people at a time. 6 ambulances who can respond to anyone who has a medical emergency in a city of 200,000 people and anyone can be their responsibility, I'd say so. 
I know A LOT of Paramedics who teach class to nurses such as ACLS, PALS, PHTLS, etc. Paramedics have to read an EKG right away and make a decision from there, while a nurse can call a doc or talk to a doc and see what she should do.


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## Aidey (Sep 13, 2011)

Happy said:


> We did have those, but often we would have the School Nurse do health education and puberty education as well. I'm sorry, but School Nurses do far more than that.
> No they are not, but experience and extra training nurses go through here further ensure what you just said. *Screenings aren't just assessments, they include assessing vision, hearing, and consulting with parents for any abnormal findings and suggesting a Physician for a consultation. *
> And it doesn't, but for someone who knows a patients health history, would you not think they are better and faster to respond to this persons illness ? I would think so.



So yeah, that is EXACTLY what an assessment is. Screening = assessment. Believe it or not, we do more than the ABCD assessments on people. It is also not unusual for me to consult with family members and advise on what treatment options are available. I think assuming schools nurses know their patient's health history is also a false assumption in a lot of circumstances. 

In small schools the nurse probably does know a majority of the students, but they may not be full time at one school. Where I grew up we shared one school nurse between 3 different schools.* In a large school the staff probably only know the students with complicated problems who are in the office daily for medications or things like blood sugar checks. 


*And for the record she did not do any education/teaching. 



DESERTDOC said:


> I do not care how you feel.  You are insulting, degrading, uneducated and do not know what you are talking about.



As a former remote paramedic I'm feeling pretty damn insulted also. 



Happy said:


> Please show me where most Paramedic programs educate their students how to properly
> -teach children
> -fundamentals of education
> -assess behavorial status
> ...



As has been said before, this stuff isn't covered in a 2 year nursing degree, and you will not get most of it in a 4 year degree unless you take the classes as an elective. 



usafmedic45 said:


> 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.
> 
> ...




:blink::blink::blink::blink: I'm going to regret asking this...but did all at this law breaking happen at the same time?


Edit: I want to add that for the record I do not think that paramedics should be replacing school nurses. I just don't like the attitude that it is ludicrous for a paramedic to provide care in a clinic setting.


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## johnrsemt (Sep 13, 2011)

In many states the school district needs to have a RN as 'the' school nurse.  the individual schools do not need nurses; and many of the schools have EMT-B's or P's as the medical Provider in the school. 
  They are trained for what they need to do in the school; just as the RN is trained for what they need to know to do for the district.

  I went to many school injuries as a 911 provider where the 'school nurse' had primary medical care.  Student fell off monkey bars, landing on back of his head; and the RN had his head in her lap; "Because he was complaining of head and neck pain".   
   Sure glad there was a RN on scene first, to provide first aid, and not a EMT:   He was paralyzed for approx 2 weeks till the swelling went down.  He got lucky.   

  Nurses are not trained in pre hospital medical care;  but they can be.  
  EMT's are not trained in as much documentation  but they can be also.


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## Shishkabob (Sep 13, 2011)

Or that we're unable to assess patients and do a treatment plan based off that assessment.

Or that we're unable to be the sole medical provider for a patient.

Or that 'having responsibility for a thousand people' is harder than having responsibility for a whole county, INCLUDING those thousand people.

Or that we are unable to operate just as effectively, if not more so, on limited resources, when that's what we do, day in and day out.




Happy;  How many times have you been inside an ambulance for a shift?


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## abckidsmom (Sep 13, 2011)

Happy said:


> 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.



Are you familiar with nursing?  In her 12 year career, my mom has worked in a Medical/Respiratory ICU, a urology clinic, a radiation oncology clinic, a pediatric imaging clinic, a hospice floor, in home-hospice, and now as an administrator in a nursing home.

The best part of nursing is that you aren't locked into one specialty.

I'm a paramedic and a nurse, in 2 years in nursing, I worked in a Surgery-Trauma ICU and on a cardiology floor.  If I went back to nursing, ironically, I'd either want to do school nursing or work in a PICU.  You know how I'd get that knowledge?  By studying those specific specialties.

Most of the valuable knowledge in life and career is gained ON THE JOB.

I can't believe I was drawn into this thread, but there ya go.


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## Anjel (Sep 13, 2011)

abckidsmom said:


> Most of the valuable knowledge in life and career is gained ON THE JOB.



I really didn't feel like this thread was worth getting sucked into. 

But that statement right there pretty much sums it up. 

Every time a nurse switched specialties they don't have to go back for another degree. 

I really don't see why if a paramedic wanted to perform functions of a school nurse, why they couldn't get the specific training or certifications they needed, and/or study what they need to know.


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## Gray (Sep 13, 2011)

Happy said:


> Please show me where most Paramedic programs educate their students how to properly
> -teach children - Do you feel that a Nurse would be the right person to teach someone without being a certified Teacher?
> -fundamentals of education -
> -assess behavorial status -Do you feel a Nurse would be the right person rather than say a Psychologist or Psychiatrist?
> ...



The Nurse wouldn't get the education knowledge that is a must for a; Teacher, Psychologist, Nutritionist, Pediatrician, Dentist/Dental Hygienist. 

In the State of West Virginia you need these criteria meet in order to be hired as a Teacher:

 (1)Completion of WVBE approved educational 
 personnel preparation program through a  
 West Virginia institution of higher education. 
 (2) Completion of an approved educational  
 personnel preparation program through a  
 regionally accredited out-of-state institution. 
 (3) Possession of a valid license issued by a  
 state other than West Virginia based upon  
 completion of a teacher education program 
 through a regionally accredited institution of 
 higher education.

Source: http://wvde.state.wv.us/certification/forms/Form20T.pdf

In West Virginia to call your self a Dietitian you need to: 

A Registered Dietitian (RD) is a highly qualified health care professional educated in nutrition and foods. An RD has a Bachelor of Science or a Master of Science degree in human nutrition or dietetics and has successfully completed a dietetic internship and passed the registration examination administered by the American Dietetic Association. An RD receives specific education and training to provide medical nutrition therapy and nutrition counseling to promote optimal nutrition, health and well-being.

Source: http://www.wvda.org/rd/

In west Virginia you need these credentials to be a Dental Hygienist:

Attend and pass a Dental Hygienist School and pass State Certification by taking and passing State and National Boards. 

Source: http://www.wvdentalboard.org/DH APP - NEW.pdf

In the State of West Virginia you need to meet these requirements to call yourself a Psychologist: 

1. Master:censored::censored::censored:8217;s Degree Applicants must possess a MA (Master:censored::censored::censored:8217;s of Arts) or MS (Master:censored::censored::censored:8217;s of 
Science) degree granted by an  accredited institution of higher learning, such degree must 
have been completed in a department of psychology, a department of educational psychology, 
a department of education and psychology, or in a university department with the official 
designation containing the words :censored::censored::censored:8220;psychology:censored::censored::censored:8221; or :censored::censored::censored:8220;psychological.:censored::censored::censored:8221; 
2. Accredited Graduate Degree Granting Institutions must be accredited by one of the six 
nationally recognized regional accrediting agencies which include: North Central Association of 
Colleges and Schools, Western Association of Schools and Colleges, Southern Association of 
Colleges and Schools, New England Association of Schools and Colleges, Northwest 
Association of Schools and Colleges, Middle States Association of Schools and Colleges.  
3. Fifty (50) Hours of graduate level psychology course work must be completed for a Master:censored::censored::censored:8217;s 
degree to meet Board standards. 
4. On Campus Graduate Programs:  Master:censored::censored::censored:8217;s degrees must include at least 80% course work 
earned from on campus classes.  Thus, Master:censored::censored::censored:8217;s degrees from distance learning institutions do 
not meet educational requirements for licensure.    
5. Required Core Graduate Level Course work includes, but is not limited to, all of the following 
areas: clinical interviewing, diagnosis and treatment planning, psychopathology, biological 
bases of behavior, ethics, assessment of children and adults, individual psychotherapy, clinical 
practicum, clinical internship, and tests and measures. 

Source: http://www.wvpsychbd.org/Licensure Info 2010.pdf

So how can you say you are properly trained as a Dental Hygienist, Teacher, Dietitian, Psychologist, Pediatrician being a school Nurse? The facts I have unequivocally shown say that you are not properly trained in such matters as such said professionals.


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## abckidsmom (Sep 13, 2011)

Anjel1030 said:


> I really didn't feel like this thread was worth getting sucked into.
> 
> But that statement right there pretty much sums it up.
> 
> ...





It's like a train wreck...you don't want to get involved, but you have to step in to stop the carnage.


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## Nerd13 (Sep 13, 2011)

systemet said:


> That book is terrible.  Absolutely terrible at everything.



That was kind of my point. If even BRADY covers most of those topics I can only assume most other paramedic books do too. It was just a stab at the point that most paramedic courses cover more than just the absolute emergency topics. Is it in depth education? No. It is a start though and it does show that paramedics can be educated even at the initial education level above helping with that which kills us emergently.


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## Martyn (Sep 13, 2011)

abckidsmom said:


> It's like a train wreck...you don't want to get involved, but you have to step in to stop the carnage.


...or add to it...lol


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## Katy (Sep 13, 2011)

abckidsmom said:


> Are you familiar with nursing?  In her 12 year career, my mom has worked in a Medical/Respiratory ICU, a urology clinic, a radiation oncology clinic, a pediatric imaging clinic, a hospice floor, in home-hospice, and now as an administrator in a nursing home.
> 
> The best part of nursing is that you aren't locked into one specialty.
> 
> ...


I understand they can switch, and that flexibility is one of the reasons a lot of people go into nursing. But I would hope that some orientation and brush up on skills would occur every time.


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## abckidsmom (Sep 13, 2011)

Happy said:


> I understand they can switch, and that flexibility is one of the reasons a lot of people go into nursing. But I would hope that some orientation and brush up on skills would occur every time.



Yes, of course, but get this: the knowledge base developed in nursing school is enough to cover many, many specialties.  Intelligent people just pick up the needed skills in their daily lives in their jobs.  

You are making the mistake of boxing in the world into neat little squares of job responsibilities, when in fact nursing and EMS both stretch far and wide into many, many areas.  It's very easy for nurses to become jacks of all trades, and still master a few too.

The persistence with which you are approaching this thread and its limited topic range shows me that you are not giving people enough credit for their ability to learn jobs that are set before them.  ANY PERSON can learn the paperwork required of school nurses, can learn to teach children how to brush their teeth, can screen people well enough to know when to call an ambulance.  ANY PERSON can learn to care for children who come to the nurse's office with a fever and a stomach ache. 

All the job really requires is a brain and the will to care and learn.

Licensure is secondary.


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## Katy (Sep 13, 2011)

systemet said:


> I think Happy deserves some respect for continuing to argue a position that the majority of posters on this thread disagree with.  And continuing to do so in a professional manner.


My only point with this entire thread was that another provider was presenting themselves as a Nurse, which as we saw earlier, is illegal in some states.
The only reason I argue education is that, I'm not talking about why nurses are better than Paramedics when they are not. I'm talking about the National Certification and Exam the Nurses must go through  before they take the role as the School Nurse, and I hate it when Paramedics call themselves as such and don't have the proper education to best provide for the kids. [/QUOTE]  




systemet said:


> It's good to have someone with first aid background present at the school.  I would hope that many (all?) of the teachers would have CPR / standard first aid.


Totally agree, hence why I said I support techs and other persons assisting the School Nurse in the clinic. I have only heard of teachers getting first aid to add to there list, CPR also. Said really, but true. 


systemet said:


> There is very very little that a school nurse is going to be able to do in any of the situations mentioned.


Agreed, my concern was assessing if a child did have a concussion, or was suffering from internal bleeding. Everyone here seems to think I think the nurse could do it better, no she couldn't, the Paramedic would do it far better in trauma assessment. Again, I simply through these scenarios out there to show that the School Nurse does more than first aid, and is trained far beyond first aid. 



systemet said:


> Concussion : - has there been a loss of consciousness with a period of confusion that's resolved? First aid.
> 
> Diabetic shock:- Do they even have a blood glucometer, or are they just going based on hx and the presentation of a child with diaphoresis / confusion?  Are they equipped to give glucagon or D50W?  Or is it just a case, of hey, Billy has DM, and he's acting funny, let's give him a Mars Bar? First aid.
> 
> ...





systemet said:


> Now where it gets trickier is the other stuff:
> 
> 
> 
> ...


If the School Nurse is teaching Health classes which are common, then they would be teaching about various minerals and vitamins that are essential to the human body, and how they affect the human body. In my thinking, its one  thing to explain that you need something, but a totally different one of why and how it affects you. 



systemet said:


> I would explain that basic RN training would cover a little more about childhood development.
> 
> A point that I think is important to make, is that most of the training specific to the "school nurse" position occurs post-grad.  If a nurse is unsuited for this position until they have post-graduate training, then, of course, a paramedic is also unsuited, until they get similar education.


Agreed, totally, hence why I am still here arguing with the few who have said nothing about pursuing such a certificate before getting into the field or when they are still new. No one has, because I suppose no one thinks they need too. If it is essential for someone who has generally better patient education skills as you just said, why wouldn't it be for someone who has weaker skills in that area ? It should be, but no one here seems to be telling me that they would. 



systemet said:


> If we're really honest with ourselves, a paramedic is basically an RN who has taken a cut-down entry-to-practice training, and a vastly expanded speciality training.  You probably could take a medic, put them through the post-graduate training for a school nurse position, and cover whatever material is missing from basic nursing education and put them into a "school nurse" position.


Exactly what I am saying, they don't have that nursing education and don't have that post-graduate experience and certificate either. Other than that, I wouldn't have any trouble. But you can't go around saying your a nurse when your not, and attempt to fill a role that is specialized enough for post-graduate testing and certification. 



systemet said:


> I just don't know why you'd want to.  The way I see it, community / advanced practice paramedicine shouldn't be able re-inventing currently existing systems like home care / palliative care / occupational health nursing (*some exception for remote and dangerous work sites), but about placing the patient in better contact with these services, and using the unique position of being in a mobile clinic to provide some added value.


Totally agree. Hence why I was surprised to find a EMT-B acting as a "School Nurse."





systemet said:


> I feel compelled to point out that a paramedic is often the only "advanced" provider present at a complex medical or traumatic emergency, has substantially more autonomy than a "school nurse", and is well-prepared to provide care in an environment with minimal resources.


- Yes, they are, but sometimes, they have another ALS provider with them.
- Yes, they do have more autonomy, but, that doesn't make them any less of a provider
- Yes, they are, again I simply said it would be harder to work without more resources. 




systemet said:


> Actually, I bet you would.  I think if you went to a cardiac ICU and asking them if they could do neuro, most of the nurses would think they could.  They'd probably be willing to admit they'd need some training (re-training?) in techniques they don't commonly use in the CCU, like ICP monitoring.  But they'd probably tell you that this is an intensive / critical care discipline, and they're training in intensive care.


I agree some extra training among other things, but that was my point, one cannot simply jump to another field without some type of preparation. And neuro was a bad example, as both are intensive care areas, paramedicine and school nursing are much more vastly different. 



systemet said:


> I wouldn't expect to walk into a fixed wing flight job tomorrow and be as competent as the guys doing it for 10+ years, even if we took the same basic training when we initially got our licences.  But I would expect that I could train and be mentoring into doing that role relatively well within a year or two.  Because it is just another area of specialisation.


Agreed, but the extra training and education needed is what I am stressing here. Otherwise, I think Paramedics would make good school nurses.


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## Katy (Sep 13, 2011)

abckidsmom said:


> Yes, of course, but get this: the knowledge base developed in nursing school is enough to cover many, many specialties.  Intelligent people just pick up the needed skills in their daily lives in their jobs.
> 
> You are making the mistake of boxing in the world into neat little squares of job responsibilities, when in fact nursing and EMS both stretch far and wide into many, many areas.  It's very easy for nurses to become jacks of all trades, and still master a few too.
> 
> ...


I will give people credit where it is deserved, but I am being persistant because of what I believe, and what I know many others believe. 
- You can't be a School Nurse and not actually be one
- It is scary that people with little training are operating as School Nurses, when they have little to no knowledge on major concepts covered in the job. 
- Yes, any person can, but does that mean they should or they are capable of without proper education ? NO.


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## Katy (Sep 13, 2011)

EMT 34 said:


> 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.


But did you know that he had hypoglycemia when walking up ? 
Did you know that he has a severe case and needs to be monitored daily ? 
Did you know that he may have other health issues that could have caused this ? 
Nope, you didn't. But the School Nurse does, because she deals with the direct care of this patient at school every day.


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## abckidsmom (Sep 13, 2011)

Happy said:


> I will give people credit where it is deserved, but I am being persistant because of what I believe, and what I know many others believe.
> - You can't be a School Nurse and not actually be one
> - It is scary that people with little training are operating as School Nurses, when they have little to no knowledge on major concepts covered in the job.
> - Yes, any person can, but does that mean they should or they are capable of without proper education ? NO.



^^^

A product of our nation's public school system.  Industrialized, group-scheduled, non-individuated, creative-thought killing education has lead our youth to become excellent factory workers, to go from one thing to another beleiving that the subjects have nothing to do with one another, you learn to respond to bells and meaningless spans of time spent on task because of crowd control, not because of a topic to be mastered.

You, Happy, have been socialized to believe some falsehoods about the world that are not true.  

Let your mind move beyond what you have been taught to believe because you are showing your limited thought capability here.


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## Katy (Sep 13, 2011)

Gray said:


> The Nurse wouldn't get the education knowledge that is a must for a; Teacher, Psychologist, Nutritionist, Pediatrician, Dentist/Dental Hygienist.
> 
> In the State of West Virginia you need these criteria meet in order to be hired as a Teacher:
> 
> ...


None of the above laws matter, because I never claimed the school nurse to be any of the above.
- Yes, because they have the additional certification that teaches them about education and patient education in the School environment. 
- Often, when the child's direct health is affected by such mental illnesses as anxiety or depression, yes the School Nurse gets involved. They often talk to the student about how this is giving them hypertension or causing fatigue, and that for the better of their health they could come talk to them or if the school has a counselor they should go see him/her. 
- I'm not even going to answer this one. Of course a MD or DO is far better at assessing anything than a Nurse or Paramedic, but is the MD or DO at the school all the time ? Do they get a note from the teacher talking of disruptive behavior in class, which are clear signs of ADHD or other issues ? No, they don't. The medical provider at the school does. Then maybe a meeting with the teacher, parents, and Nurse would occur where they would decide if the said student needed medical assistance for the problem or not. 
- Yes, I do, when it comes to teaching health and nutrition. Which the teacher is likely to know little to nothing about. 
- Nope, but how many schools have those on hand ? Not many if any. The Nurse will be assessing nutrition and eating habits of the children, not a nutritionist. Never said they were better, just said they have the education to be the best, without each one of those providers being present.


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## emt11 (Sep 13, 2011)

Im sorry, but I fail to see your point here. School nurses where I'm from(GA) don't do much of anything. They keep records of medical conditions on students(on a computer) and give students their medications(if they even bother to get them). School nurses here dont do much of anything else, they dont even have an oxygen bottle in their office. What purposeful good are they going to do for a student other than give meds, and maybe some crackers if they so choose to give them to a student. 

Last time that I ran a call at a school, the nurse had a print out of the students info(medical conditions etc), and that was it. She was just sitting their with a I dont know what to do look on her face.


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## JPINFV (Sep 13, 2011)

emt11 said:


> School nurses here dont do much of anything else, they dont even have an oxygen bottle in their office.



What? They don't even have the magical cure all drug oxygen?


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## Katy (Sep 13, 2011)

abckidsmom said:


> ^^^
> 
> A product of our nation's public school system.  Industrialized, group-scheduled, non-individuated, creative-thought killing education has lead our youth to become excellent factory workers, to go from one thing to another beleiving that the subjects have nothing to do with one another, you learn to respond to bells and meaningless spans of time spent on task because of crowd control, not because of a topic to be mastered.
> 
> ...


Think what you want, because you are entitled to it. And so am I. I am simply expressing it here. But please, don't attempt to think I have been ruined by the public school system, when they have nothing to do with this.


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## abckidsmom (Sep 13, 2011)

Happy said:


> Think what you want, because you are entitled to it. And so am I. I am simply expressing it here. But please, don't attempt to think I have been ruined by the public school system, when they have nothing to do with this.



It's successful brainwashing when you're totally unaware.


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## Katy (Sep 13, 2011)

emt11 said:


> Im sorry, but I fail to see your point here. School nurses where I'm from(GA) don't do much of anything. They keep records of medical conditions on students(on a computer) and give students their medications(if they even bother to get them). School nurses here dont do much of anything else, they dont even have an oxygen bottle in their office. What purposeful good are they going to do for a student other than give meds, and maybe some crackers if they so choose to give them to a student.
> 
> Last time that I ran a call at a school, the nurse had a print out of the students info(medical conditions etc), and that was it. She was just sitting their with a I dont know what to do look on her face.


Don't make assumptions on what you think they do. If this is all you really think they do, then you aren't really educated in the subject of what they do. What good are they doing besides giving medicine ? This, right here, is exactly why I persist with this thread. Because people make such comments as these.


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## ArcticKat (Sep 13, 2011)

The difficulty I really have with this thread is just being able to comprehend why an EMS professional would demean themselves by misrepresenting themselves as a nurse.  They should be proud of who they are and claim that title with pride.  Not diminish themselves to the perception of being a school nurse....ick.

It`s just embarassing.  There`s no reason an EMS professional can`t be a school, camp, or worksite medical professional....just don`t claim to be what you aren`t.  I`d be embarassed to call myself a school nurse.....or any sort of nurse for that matter.


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## fast65 (Sep 13, 2011)

Happy said:


> But did you know that he had hypoglycemia when walking up ?
> Did you know that he has a severe case and needs to be monitored daily ?
> Did you know that he may have other health issues that could have caused this ?
> Nope, you didn't. But the School Nurse does, because she deals with the direct care of this patient at school every day.



Again, this depends on how large the school is. If it's a smaller school then yeah, she might know; but if it's a larger school, chances are she won't know. The thing is that if a paramedic is acting as a "school nurse" then they would have the same probability of knowing about a single students health problems as an RN acting in the role of a "school nurse" would. The level of provider does not dictate whether or not they will be onsite or offsite.

Either way, in this case 911 will more than likely be called and that will all be part of the history taking.


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## Katy (Sep 13, 2011)

fast65 said:


> Again, this depends on how large the school is. If it's a smaller school then yeah, she might know; but if it's a larger school, chances are she won't know. The thing is that if a paramedic is acting as a "school nurse" then they would have the same probability of knowing about a single students health problems as an RN acting in the role of a "school nurse" would. The level of provider does not dictate whether or not they will be onsite or offsite.
> 
> Either way, in this case 911 will more than likely be called and that will all be part of the history taking.


Highly doubtful, I know of some school nurses who operate on a large school base, and even do multiple schools at once, and still know there kids who have serious health issues that need monitoring. There are only so many kids with life or death health problems, keeping track of their problems isn't that hard. 
I know, if they were acting as a School Nurse on a regular basis. The person in the OP was just there that one time, and had no history with student interaction.
Agreed, 911 should be called.


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## fast65 (Sep 13, 2011)

Happy said:


> Highly doubtful, I know of some school nurses who operate on a large school base, and even do multiple schools at once, and still know there kids who have serious health issues that need monitoring. There are only so many kids with life or death health problems, keeping track of their problems isn't that hard.
> I know, if they were acting as a School Nurse on a regular basis. The person in the OP was just there that one time, and had no history with student interaction.
> Agreed, 911 should be called.



Agreed, that person should not have been misrepresenting themselves, however, that no longer seems to be the issue. 

And I know of some school nurses who operate in multiple schools and can maybe point out 10 students total who have "life-threatening" illnesses.

I do have an additional question, regarding the teaching of health classes by a school nurse. Wouldn't they require some sort of teaching degree in order to teach those classes? Thereby misrepresenting themselves as teachers...


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## Katy (Sep 13, 2011)

fast65 said:


> Agreed, that person should not have been misrepresenting themselves, however, that no longer seems to be the issue.
> 
> And I know of some school nurses who operate in multiple schools and can maybe point out 10 students total who have "life-threatening" illnesses.
> 
> I do have an additional question, regarding the teaching of health classes by a school nurse. Wouldn't they require some sort of teaching degree in order to teach those classes? Thereby misrepresenting themselves as teachers...


Agreed, and it was the issue the whole time. The other part of my issue was they don't have the proper certification for the job. And teaching the basics of health and nutrition would fall into patient education I would assume. Also, there certification includes education and teaching credits.


----------



## Shishkabob (Sep 13, 2011)

Except, the way you originally worded your thread was that you didn't agree with EMTs / Paramedics working in the capacity as a primary care provider, not that they were misrepresenting a title.  


That may be what you meant, but that's not what you wrote, and that's why this thread turned out this way.



Especially saying Paramedics should only work as 'techs'.  Sorry, I'm not a technician.


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## fast65 (Sep 13, 2011)

Happy said:


> Agreed, and it was the issue the whole time. The other part of my issue was they don't have the proper certification for the job. And teaching the basics of health and nutrition would fall into patient education I would assume. Also, there certification includes education and teaching credits.



I didn't say it was never the issue, I'm saying it has been addressed and we've moved onto bigger things. As far as certification goes, an RN representing a school nurse wouldn't be certified either, she doesn't have that certification yet. Should an EMTB have been wearing a shirt that says "School Nurse"? I guess not. Will I lose sleep over it? Absolutely, it's one of the many problems that plagues my thoughts on a daily basis.

Ah, but does that qualify them as a teacher? I think not. Am I going to continue carrying on an entire Q&A with myself? Totally.


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## Katy (Sep 13, 2011)

Linuss said:


> Except, the way you originally worded your thread was that you didn't agree with EMTs / Paramedics working in the capacity as a primary care provider, not that they were misrepresenting a title.
> 
> 
> That may be what you meant, but that's not what you wrote, and that's why this thread turned out this way.
> ...


I don't agree with them being the primary care provider in an educational setting without the proper education, as should any good citizen. They were misrepresenting there title, when I said "function", I meant a tag that said "School Nurse."  
Are you not a Emergency Medical Technician ? And I'm sorry, but you also don't have the proper certification or education to function at the best level in educational setting. Now, if you had some additional training, then it would be different.


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## BandageBrigade (Sep 13, 2011)

Happy said:


> Agreed, and it was the issue the whole time. The other part of my issue was they don't have the proper certification for the job. And teaching the basics of health and nutrition would fall into patient education I would assume. Also, there certification includes education and teaching credits.



Except to teach a class in a school on a regular basis you need a teaching license from that state. Which can be obtained either by getting a degree in education, or having a bachelors and obtaining a teaching endorsement (you take several courses for this after obtaining your initial degree, a teaching class during nursing school does not suffice).


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## fast65 (Sep 13, 2011)

Happy said:


> I don't agree with them being the primary care provider in an educational setting without the proper education, as should any good citizen. They were misrepresenting there title, when I said "function", I meant a tag that said "School Nurse."
> Are you not a Emergency Medical Technician ?* And I'm sorry, but you also don't have the proper certification or education to function at the best level in educational setting.* Now, if you had some additional training, then it would be different.




Neither does an RN...


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## Katy (Sep 13, 2011)

fast65 said:


> Neither does an RN...


An RN does most certainly they have completed the certificate exam and passed the exam. I never said any plain RN is a School Nurse, they too would have to have a certificate.


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## Katy (Sep 13, 2011)

BandageBrigade said:


> Except to teach a class in a school on a regular basis you need a teaching license from that state. Which can be obtained either by getting a degree in education, or having a bachelors and obtaining a teaching endorsement (you take several courses for this after obtaining your initial degree, a teaching class during nursing school does not suffice).


So why do School Nurses teach students about health, puberty, hygiene, and nutrition all the time and not get into legal trouble ? It is one thing to actually teach a class on a regular basis, and another to have a meeting with the students regarding the topics in the health room. Which is what I am talking about. As I said, the School Nurse didn't teach it all the time, he came in only to go over the above topics in more detail, and the Health Educator did the rest.


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## BandageBrigade (Sep 13, 2011)

G





Happy said:


> So why do School Nurses teach students about health, puberty, hygiene, and nutrition all the time and not get into legal trouble ? It is one thing to actually teach a class on a regular basis, and another to have a meeting with the students regarding the topics in the health room. Which is what I am talking about. As I said, the School Nurse didn't teach it all the time, he came in only to go over the above topics in more detail, and the Health Educator did the rest.



Please read my post. Notice I said on a regular basis. You made it sound in previous posts that the nurse or school health care provider (see what I did there? That could be a paramedic or nurse) was teaching a health course completely.


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## fast65 (Sep 13, 2011)

Happy said:


> *An RN does most certainly* they have completed the certificate exam and passed the exam. *I never said any plain RN* is a School Nurse, they too would have to have a certificate.



Maybe my reading comprehension isn't what it used to be?

So by that measure an RN and a paramedic are both perfectly capable of performing as a school nurse with just a little extra knowledge and a piece of paper.


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## Shishkabob (Sep 13, 2011)

Happy said:


> Are you not a Emergency Medical Technician ?


  Nope, I'm a Paramedic.



> And I'm sorry, but you also don't have the proper certification or education to function at the best level in educational setting. Now, if you had some additional training, then it would be different.



So... I am unable to care for 1,000 students effectively, but I am more than capable of dealing with a population of 100,000 in an entire county as the only advanced provider on scene, including those 1,000 students when the nurse needs help?

That make sense to anyone else?


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## Katy (Sep 13, 2011)

BandageBrigade said:


> G
> 
> Please read my post. Notice I said on a regular basis. You made it sound in previous posts that the nurse or school health care provider (see what I did there? That could be a paramedic or nurse) was teaching a health course completely.


The Health Educator was a teacher, and did not hold an RN or Paramedic degree. No, I said that in my case they switched in and out, and that in some places I know of School Nurses do teach health classes.


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## fast65 (Sep 13, 2011)

Happy said:


> The Health Educator was a teacher, and did not hold an RN or Paramedic degree. No, I said that in my case they switched in and out, *and that in some places I know of School Nurses do teach health classes.*



Then they are unqualified and misrepresenting themselves as a teacher.


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## BandageBrigade (Sep 13, 2011)

Happy said:


> The Health Educator was a teacher, and did not hold an RN or Paramedic degree. No, I said that in my case they switched in and out, and that in some places I know of School Nurses do teach health classes.



Except they cannot be the primary teacher.


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## Katy (Sep 13, 2011)

fast65 said:


> Then they are unqualified and misrepresenting themselves as a teacher.


They are not teachers, teachers are present in the classroom to deal with the kids while the School Nurse talks about a healthy lifestyle. And they are not unqualified, they are teaching about health-related topics, when you deal with patient education, are you misrepresenting yourself ? No, so why is this Nurse ? And if it is so wide-spread, why are there not legal cases taking place for all these nurses ?


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## Katy (Sep 13, 2011)

BandageBrigade said:


> Except they cannot be the primary teacher.


They were not the primary teacher, I just told you they came in to discuss nutrition, puberty, hygiene among other things in more detail. A teacher was always present in the classroom.


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## fast65 (Sep 13, 2011)

Happy said:


> They are not teachers, teachers are present in the classroom to deal with the kids while the School Nurse talks about a healthy lifestyle. And they are not unqualified, they are teaching about health-related topics, when you deal with patient education, are you misrepresenting yourself ? No, so why is this Nurse ? And if it is so wide-spread, why are there not legal cases taking place for all these nurses ?



The way you worded it, it sounded like they were the primary teacher. If that's not the case then I am wrong. If that is the case, then I am right.


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## BandageBrigade (Sep 13, 2011)

Happy said:


> They were not the primary teacher, I just told you they came in to discuss nutrition, puberty, hygiene among other things in more detail. A teacher was always present in the classroom.


 But you are saying a nurse comes in for most of the topics? Do you feel a nurse is more qualified than someone who in most cases went to school for four years to teach those subjects?


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## ffemt8978 (Sep 13, 2011)

Thread reopened.


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## fortsmithman (Sep 14, 2011)

I hope this thread can be civil.  Otherwise it will be closed permanently by the CLs.


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## Anjel (Sep 14, 2011)

fortsmithman said:


> I hope this thread can be civil.  Otherwise it will be closed permanently by the CLs.



Good. Its everyone against happy.

She isn't changing her mind and we've said everything there is.


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## sdennislee (Sep 14, 2011)

Can't believe the topic went as far as it did.

I quit lending any credit to it when Candy said the school nurse would be a better choice to deal with Lil Johnny when he fainted as she would know he was hypoglycemic. No medical training required here, only the ability to read a school record. Now what if it was another reason for fainting, I'm betting on the EMT for emergency issues not contained in a file cabinet.

I thought the responses to her post were very mild and to some point considerate. After reading her initial post I thought for sure she would be flamed.

Damn can't believe I just added to this thread, shame on me.


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## Sasha (Sep 14, 2011)

Anjel1030 said:


> Good. Its everyone against happy.
> 
> She isn't changing her mind and we've said everything there is.



Cant force a horse to learn tricks

Sent from LuLu using Tapatalk


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## IRIDEZX6R (Sep 14, 2011)

WOW.... <-- My comments on the stupidity contained within this thread. 

Maybe Happy should do some ride along with a good ALS crew...


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## sdennislee (Sep 14, 2011)

Should clarify, I thought it was the term Wanna Be's that would get her flamed.


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## 18G (Sep 14, 2011)

Happy.. you are ignorant to the capability of a Paramedic and the roles they can fulfill. It's a given some are less than desirable with their knowledge base and approach but guess what, there are just as many nurses that don't possess the level of knowledge and clinical care they should. 

An RN that worked in a nursing home for 20yrs and that's all they did isn't going to be as up-to-date and fast acting in an emergency as a Paramedic. And that is my opinion based on exposure to hundreds of different RN's in A LOT of nursing homes over an almost 20yr period. 

Your telling me that a Paramedic can't handle a fracture or laceration on the playground, a seizure, asthma attack, diabetes issue, syncope, or number of other issues that arise in a school? 

I can't speak for other states but Paramedic's in PA are authorized to administer vaccines. And how hard is it to teach a Paramedic how to maintain records the way the school want's them maintained? Patient care documentation is an art and one I take very seriously and have received numerous compliments on from different EMS organizations. And most EMS providers take pride in their documentation.  

And Paramedic's teach all the time! So why couldn't they teach certain segments of a school program such as CPR, injury prevention, and other related programs? In fact Paramedics would be the more ideal in most cases since they have the actual experience. 

I think were all aware of the reports of young people killing over on the sports field and playground. A Paramedic would be the preferred person to initiate care and respond to that situation. 

Not sure where your animosity is coming from but its way off base.


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## JPINFV (Sep 14, 2011)

Sasha said:


> Cant force a horse to learn tricks
> 
> Sent from LuLu using Tapatalk










It's just a matter of voltage.


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## Gray (Sep 14, 2011)

18G said:


> Happy.. you are ignorant to the capability of a Paramedic and the roles they can fulfill. It's a given some are less than desirable with their knowledge base and approach but guess what, there are just as many nurses that don't possess the level of knowledge and clinical care they should.
> 
> An RN that worked in a nursing home for 20yrs and that's all they did isn't going to be as up-to-date and fast acting in an emergency as a Paramedic. And that is my opinion based on exposure to hundreds of different RN's in A LOT of nursing homes over an almost 20yr period.
> 
> ...



You sir, placed all the words I could not into light. +1


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## JPINFV (Sep 14, 2011)

18G said:


> Your telling me that a Paramedic can't handle a fracture or laceration on the playground, a seizure, asthma attack, diabetes issue, syncope, or number of other issues that arise in a school?



Is that all a school nurse does, or all that you think a school nurse does?


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## Katy (Sep 14, 2011)

18G said:


> Happy.. you are ignorant to the capability of a Paramedic and the roles they can fulfill. It's a given some are less than desirable with their knowledge base and approach but guess what, there are just as many nurses that don't possess the level of knowledge and clinical care they should.


I understand some nurses don't possess proper skills and clinical knowledge. Don't make assumptions I am here to slaughter all the Paramedics I have ever faced, because that is simply not the case. 



18G said:


> An RN that worked in a nursing home for 20yrs and that's all they did isn't going to be as up-to-date and fast acting in an emergency as a Paramedic. And that is my opinion based on exposure to hundreds of different RN's in A LOT of nursing homes over an almost 20yr period.


I agree, there skills are most likely to be somewhat diminished, but this has really nothing to do with this thread. Your attempting to make it that I think Paramedic's and EMT's cannot handle medical emergencies, not the case, again.



18G said:


> Your telling me that a Paramedic can't handle a fracture or laceration on the playground, a seizure, asthma attack, diabetes issue, syncope, or number of other issues that arise in a school?


No, I am not. I even said multiple times that the Paramedic would most likely be more educated in dealing with those types of illnesses, but when it comes to the day-to-day patient education and the understanding of fundamental education is where Paramedics lack and so do RN's, until the certificate is awarded. You haven't read the thread obviously. 



18G said:


> I can't speak for other states but Paramedic's in PA are authorized to administer vaccines. And how hard is it to teach a Paramedic how to maintain records the way the school want's them maintained? Patient care documentation is an art and one I take very seriously and have received numerous compliments on from different EMS organizations. And most EMS providers take pride in their documentation.


Here, your making assumptions. Do you really know most of EMS ? No, you do not. So for you to make generalized statements as such aren't truly conceivable, I will agree that teaching it is not a skill that is difficult. But again, the School Nurse has more training and experience with such documentation. I never once said a Paramedic couldn't be a school health provider, they would just need the correct certification to do so and not take the title "nurse."



18G said:


> And Paramedic's teach all the time! So why couldn't they teach certain segments of a school program such as CPR, injury prevention, and other related programs? In fact Paramedics would be the more ideal in most cases since they have the actual experience.


This is true, but do they teach in a specialized environment such as schools and are trained to do so and even required to pass an exam on such subjects ? No, they do not. They certainly could, but I know very few Paramedics who would be comfortable with such situations, it simply isn't in their specialty to make public speeches on such topics. Not saying it isn't possible, but further education must be pursued. 



18G said:


> I think were all aware of the reports of young people killing over on the sports field and playground. A Paramedic would be the preferred person to initiate care and respond to that situation.
> 
> Not sure where your animosity is coming from but its way off base.


Again, I never said the Paramedic would be incapable and less capable than the School Nurse, it is the other more prominent job requirements that concern me. 
And since you came in her with the wrong thoughts and and not even reading what I have said or had to say, I don't believe your in the position to critique my opinions on unauthorized persons calling themselves nurses when they are not, and not having the proper education to fulfill the role fresh out of their program.


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## JPINFV (Sep 14, 2011)

They should just end the squabbling and have a physician do the job.

/thread.


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## 18G (Sep 14, 2011)

Happy... no I didnt read the entire 20 page thread on the silly subject. But I did read enough of your posts to see where you were coming from. The core of the position a Paramedic could do just fine. And so what if they would need an additional 2 or 3 week orientation to go over certain things for the job. Why is that a problem?

Most states do allow Paramedics to administer vaccinations in case of pandemics and other scenarios. Its a simple injection! And the vaccine itself can be learned in no time at all. 

Im not wanting to engage in a debate with you just wanted to give my opinion. I worked my 12.5/hr shift today and am tired and have to get up at 530am and do it all over. It's hard work being a Paramedic and roaming around with a patient on a cardiac monitor, multiple drip medications, a vent, and other things going on without knowing my *** from the hole in the ground. Imagine the stress my dear


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## Katy (Sep 14, 2011)

18G said:


> Happy... no I didnt read the entire 20 page thread on the silly subject. But I did read enough of your posts to see where you were coming from. The core of the position a Paramedic could do just fine. And so what if they would need an additional 2 or 3 week orientation to go over certain things for the job. Why is that a problem?
> 
> Most states do allow Paramedics to administer vaccinations in case of pandemics and other scenarios. Its a simple injection! And the vaccine itself can be learned in no time at all.
> 
> Im not wanting to engage in a debate with you just wanted to give my opinion. I worked my 12.5/hr shift today and am tired and have to get up at 530am and do it all over. It's hard work being a Paramedic and roaming around with a patient on a cardiac monitor, multiple drip medications, a vent, and other things going on without knowing my *** from the hole in the ground. Imagine the stress my dear


No, no, no. Here is what your not seeing, when you said if an orientation or a little more training was needed for the job, it is certainly not a problem, that is what I am stressing in this entire thread! And the vaccines I was more speaking in the states they couldn't, for that could bring up issues. 
Wow, sounds like an interesting shift! I totally respect your opinion, and I'm glad you chimed in.


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## squrt29batt12 (Sep 14, 2011)

usafmedic45 said:


> I was about to point out the irony of a first responder criticizing someone with more training, not a lot more, but still a higher level of provider.




not a lot more?
lol correct me if i am wrong, but i thought Paramedics, NREMT Paramedics at that, were more than just a little more advanced than a First Responder. ionno...RT


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## DrParasite (Sep 14, 2011)

After going through all 20 pages, I want to say I agree with happy that no one should claim to be an nurse when not one.  this includes paramedics, EMTs, furniture mover, lunch ladies, and custodians.  If you are not an RN, don't claim to be one.  that ends where I agree with happy


Happy said:


> But did you know that he had hypoglycemia when walking up ?
> Did you know that he has a severe case and needs to be monitored daily ?
> Did you know that he may have other health issues that could have caused this ?
> Nope, you didn't. But the School Nurse does, because she deals with the direct care of this patient at school every day.


and here is one example of where you are wrong.  grossly wrong.

the nurse doesn't know all that information because he or she is the a nurse; the nurse knows that information because he or she works in the nurses office full time.  I guarantee you that if a paramedic was there in place of the nurse, in the office 5 days a week, just like the nurse, they would know everything you just said about the patient.

similarly, if another school nurse was visiting the school (to cover a vacation day), i bet he or she would have no idea what was going on with the hypoglycemic person, despite being a bonafide school nurse, at least no more than any skilled provider with no history of the patient.

Happy, the biggest advantage a school nurse has is she knows the patient's history based on prior contact.  but if you put a paramedic in the office, with access to all that information, they will probably just as well, probably better when it comes to emergency situations.


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## Katy (Sep 14, 2011)

DrParasite said:


> After going through all 20 pages, I want to say I agree with happy that no one should claim to be an nurse when not one.  this includes paramedics, EMTs, furniture mover, lunch ladies, and custodians.  If you are not an RN, don't claim to be one.  that ends where I agree with happy
> and here is one example of where you are wrong.  grossly wrong.
> 
> the nurse doesn't know all that information because he or she is the a nurse; the nurse knows that information because he or she works in the nurses office full time.  I guarantee you that if a paramedic was there in place of the nurse, in the office 5 days a week, just like the nurse, they would know everything you just said about the patient.
> ...


I never said she knew it because she was a nurse, but she does because she is a "School Nurse" and has the access to that information. My point with that entire argument over the hypoglycemic patient was that an EMT that has no knowledge of that patient's health history is going to be at least one step behind the School Nurse that does. My only point. Which was what happened to me, a Basic without any sort of experience with the students simply "showing up." I agree that is the Paramedic had access, it would be of the same use. But the fact is they do not, hence why I use it in this argument. 
And no, that provider would likely not know, but that isn't the case I put forth was it ? 
Agreed, that is her/his biggest advantage when it comes to the emergency medicine aspect, without that, then a Paramedic would overwhelm them. And yes, emergency situations, but I have doubts that they would prove to be any better in the other vital aspects.


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## Katy (Sep 14, 2011)

IRIDEZX6R said:


> WOW.... <-- My comments on the stupidity contained within this thread.
> 
> Maybe Happy should do some ride along with a good ALS crew...


Perhaps you should learn more on the roles of the School Nurse, which has nothing to do with what I've done, so don't try and drag it into this discussion. Thanks.


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## abckidsmom (Sep 14, 2011)

Happy said:


> I never said she knew it because she was a nurse, but she does because she is a "School Nurse" and has the access to that information. My point with that entire argument over the hypoglycemic patient was that an EMT that has no knowledge of that patient's health history is going to be at least one step behind the School Nurse that does. My only point. Which was what happened to me, a Basic without any sort of experience with the students simply "showing up." I agree that is the Paramedic had access, it would be of the same use. But the fact is they do not, hence why I use it in this argument.
> And no, that provider would likely not know, but that isn't the case I put forth was it ?
> Agreed, that is her/his biggest advantage when it comes to the emergency medicine aspect, without that, then a Paramedic would overwhelm them. And yes, emergency situations, but I have doubts that they would prove to be any better in the other vital aspects.



You are again showing your inflexibility of thought.  There is a guy at one of our senior apartment complexes that always takes his insulin and doesn't eat.  We get dispatched and know from the address that it's going to be a hypoglycemic patient.  Then we arrive and find a guy with an altered mental status, pale, cool, sweaty skin, tachycardia, and snoring respirations, and low blood glucose.  We start an IV and give him D50 because we are clinically astute, and recognize his problem, not only because he's got low blood sugar.  

One of these times we're going to go for him and he's going to have a head bleed, and you know what?  We'll recognize that for what it is, too.  

Have you had a good class in physical exam, or pathophysiology?  When you get that education, it's super easy to recognize a problem when you see all the pieces to a puzzle fall into place in front of you.  It has nothing to do with your history with the patient, and everything to do with clinical assessment.


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## Katy (Sep 14, 2011)

abckidsmom said:


> You are again showing your inflexibility of thought.  There is a guy at one of our senior apartment complexes that always takes his insulin and doesn't eat.  We get dispatched and know from the address that it's going to be a hypoglycemic patient.  Then we arrive and find a guy with an altered mental status, pale, cool, sweaty skin, tachycardia, and snoring respirations, and low blood glucose.  We start an IV and give him D50 because we are clinically astute, and recognize his problem, not only because he's got low blood sugar.
> 
> One of these times we're going to go for him and he's going to have a head bleed, and you know what?  We'll recognize that for what it is, too.
> 
> Have you had a good class in physical exam, or pathophysiology?  When you get that education, it's super easy to recognize a problem when you see all the pieces to a puzzle fall into place in front of you.  It has nothing to do with your history with the patient, and everything to do with clinical assessment.


To the first two paragraphs, your making it seems so cut and dry. This is not always the case, and you know this. I never said that the EMT/Paramedic wouldn't ever figure it out, but I'm just saying that's one of the pros as far as having the School Nurse. 
I'm currently getting close to finishing my Anatomy and Physiology class, I took Biology and Basic Chemistry before as well. It does have to do partly with history, for you to even say it has nothing to do with it is a bit startling to me. Is clinical assessment important ? Yes, but the history is just going to further justify your diagnosis, which can be very helpful.


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## luke_31 (Sep 14, 2011)

Happy said:


> To the first two paragraphs, your making it seems so cut and dry. This is not always the case, and you know this. I never said that the EMT/Paramedic wouldn't ever figure it out, but I'm just saying that's one of the pros as far as having the School Nurse.
> I'm currently getting close to finishing my Anatomy and Physiology class, I took Biology and Basic Chemistry before as well. It does have to do partly with history, for you to even say it has nothing to do with it is a bit startling to me. Is clinical assessment important ? Yes, but the history is just going to further justify your diagnosis, which can be very helpful.



Out in the field we don't always have the luxury of knowing the history and have to go based on our clinical assesments.


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## abckidsmom (Sep 14, 2011)

Happy said:


> To the first two paragraphs, your making it seems so cut and dry. This is not always the case, and you know this. I never said that the EMT/Paramedic wouldn't ever figure it out, but I'm just saying that's one of the pros as far as having the School Nurse.
> I'm currently getting close to finishing my Anatomy and Physiology class, I took Biology and Basic Chemistry before as well. It does have to do partly with history, for you to even say it has nothing to do with it is a bit startling to me. Is clinical assessment important ? Yes, but the history is just going to further justify your diagnosis, which can be very helpful.




Whether you know the history or not...pale, sweaty unconscious people with low blood glucose are hypoglycemic.

There is no other way around that.

Knowing their history just lets you know whether it's because of poorly managed diabetes, insulinoma, sepsis, starvation, overdose, adrenal dysfunction, or one of the more complicated pathophysiologies I haven't thought of yet.

Be startled.  The more you know, the more you know you don't know.  Put your seatbelt on, seems like it's going to be quite a ride for you.


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## Katy (Sep 14, 2011)

luke_31 said:


> Out in the field we don't always have the luxury of knowing the history and have to go based on our clinical assesments.


I know that, never claimed I didn't. Don't know where your getting I didn't know this.


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## DrParasite (Sep 14, 2011)

Happy said:


> I never said she knew it because she was a nurse, but she does because she is a "School Nurse" and has the access to that information. My point with that entire argument over the hypoglycemic patient was that an EMT that has no knowledge of that patient's health history is going to be at least one step behind the School Nurse that does. My only point. Which was what happened to me, a Basic without any sort of experience with the students simply "showing up." I agree that is the Paramedic had access, it would be of the same use. But the fact is they do not, hence why I use it in this argument.


Your right Happy, I should have rephrased what I said.  A School Paramedic or a School EMT would know as much about the patient as the School Nurse.  Of course, if you have a random EMT showing up they won't know your history, but that has nothing to do with the fact that they are an EMT, but rather that they are a random person.  Heck I would wager if your best friend of 20 years was a construction worker, but knew you for 20 years, they would have an advantage of knowing your medical history than a chief of medicine at a hospital.  The individuals training has very little to do with how well they know your personal medical history (in the initial few minutes anyway it gets much more important later on).  





Happy said:


> And no, that provider would likely not know, but that isn't the case I put forth was it ?
> Agreed, that is her/his biggest advantage when it comes to the emergency medicine aspect, without that, then a Paramedic would overwhelm them. And yes, emergency situations, but I have doubts that they would prove to be any better in the other vital aspects.


The point I was trying to make, which you obviously missed, was it's not important that the person is a nurse, or a school nurse, or a school EMT, or the vice principle with a masters in education; during a medical emergency, anyone who works full time in the nurses office, and has access to a student's medical history, regardless of individual training, would have a distinct advantage over a non-full time employee.  and that can be applied to an individuals PCP vs an ER doctor too.

oh, and your lack of knowledge of what a school nurse's job is pretty apparent.  and as abckidsmom's said, having the history DOES make your job easier, but many of us in EMS have treated a patient without having a full access to their history.  that's where a good assessment, good tools, and knowing what to look for come into play; having a patient's history can point you to where to look, but it can also point you in the wrong direction.

I would also wager that I'm a better public speaker than most school nurses, many paramedics, and most EMTs; especially about topics I am very knowledgeable about.  And I'm not a school nurse.  but I did stay at a holiday in last night...


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## Katy (Sep 14, 2011)

abckidsmom said:


> Whether you know the history or not...pale, sweaty unconscious people with low blood glucose are hypoglycemic.
> 
> There is no other way around that.
> 
> ...


True, my point being before you even assess for the BGL, you would already know that it is a likely cause. My main point is it would take more time ruling out other things, when the School Nurse has a decent health history all ready. 
Agreed. Good, I like a nice ride.


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## Nerd13 (Sep 14, 2011)

Happy said:


> True, my point being before you even assess for the BGL, you would already know that it is a likely cause. My main point is it would take more time ruling out other things, when the School Nurse has a decent health history all ready.
> Agreed. Good, I like a nice ride.



Just as a minor point, this very thinking often gets providers at any level into trouble. Just because a patient/student is a regular for something in their history doesn't mean that's the only thing the provider will ever be called for. In fact, sometimes knowing someone's indepth history can cloud your judgement. Just as abckidsmom said clinical assessment is the only thing you can truly count on when dealing with any patients whether you've seen them 100 times or 1.


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## ffemt8978 (Sep 15, 2011)

Happy said:


> And since you came in her with the wrong thoughts and and not even reading what I have said or had to say, I don't believe your in the position to critique my opinions on unauthorized persons calling themselves nurses when they are not, and not having the proper education to fulfill the role fresh out of their program.



This is the type of attitude that will get this thread deleted from here...so this is the last warning to everyone in this thread.

PLAY NICE or become the focus of my complete and undivided attention.


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## Epi-do (Sep 15, 2011)

I was really trying to refrain from making any comments on this thread, after reading all of it.  However, just like others, I just can't resist the lure of the train wreck.



Happy said:


> No, I am not. I even said multiple times that the Paramedic would most likely be more educated in dealing with those types of illnesses, but when it comes to the day-to-day patient education and the understanding of fundamental education is where Paramedics lack and so do RN's, until the certificate is awarded. You haven't read the thread obviously.



And how to you arrive at the conclusion that paramedics are uneducated in "day-to-day patient education"?  I call tell you there is rarely a shift that goes by where I don't educate at least one patient about something, whether it is answering questions about a chronic illness, a medication, specific acute episodes, or what have you.

You keep dragging back up this all important certificate, that the nurse must have to be a school nurse.  For sake of argument, let's pretend the department of education (or whichever government agency it was in your state that dictated it) removed the requirement of a BSN to take this all-important certification, and anyone with medical training, no matter how little, could take this class, challenge the test, and receive the holy certificate.  How then is the nurse any more knowledgeable in the "specialty" of school health care provider? 




Happy said:


> Here, your making assumptions. Do you really know most of EMS ? No, you do not. So for you to make generalized statements as such aren't truly conceivable,* I will agree that teaching it is not a skill that is difficult. But again, the School Nurse has more training and experience with such documentation.* I never once said a Paramedic couldn't be a school health provider, they would just need the correct certification to do so and not take the title "nurse."



Since when is teaching a skill that isn't difficult?  Wait, let me add a qualifier to that, and make it "good at teaching."  Heaven knows there are countless people out there, even those with a Bachelors or Masters in Education, that are far from "good at teaching."  A couple prereq classes while in college do not make a nurse (or a medic for that matter) a good instructor.  Just because someone can teach, doesn't mean they should.

And what documentation is it, exactly, that the nurse has more training and experience with?  If you are talking documentation in general, both medics and nurses are required to do plenty of documentation.  If you are referring to job related documents, then of course the person working within that specific capacity is going to have more knowledge and experience.  Anyone who isn't employed by the school will not be familiar with the paperwork the health care provider needs to complete.  I would be willing to bet that there are even some variations from one school district to another.




Happy said:


> This is true, but do they teach in a specialized environment such as schools and are trained to do so and even required to pass an exam on such subjects ? No, they do not. They certainly could, but I know very few Paramedics who would be comfortable with such situations, it simply isn't in their specialty to make public speeches on such topics. Not saying it isn't possible, but further education must be pursued.



Making public speeches isn't part of the job for most nurses either.  And, who said you have to be educated to be a good public speaker?  Some people are just a natural at giving speeches.  That being said, giving a public speech isn't the same thing as educating a group of people.  A speech is typically one sided.  The speaker says what they have to say, and there may or may not be an opportunity to address him or her regarding various points of the speech.  When you are educating a group of people, there is typically some sort of interaction going on between teacher and students.  And again, not everyone is a good teacher.  

There were several other points I read that I thought about addressing, but I wouldn't really be saying anything that hasn't already been said.  Because of that, I thought I would just jump in on the most recent ones.  

As for the issue of people claiming to be nurses when they aren't, yes it is wrong.  But so is claiming to be a police officer, janitor, hobo, or anything else that you are not.  However, how often is the person in the position of "school nurse" claiming to have that title, and how often is it other people just using it as a generic title for a specific set of job requirements?


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## Sasha (Sep 15, 2011)

Happy said:


> True, my point being before you even assess for the BGL, you would already know that it is a likely cause. My main point is it would take more time ruling out other things, when the School Nurse has a decent health history all ready.
> Agreed. Good, I like a nice ride.



Just because they have diabetes doesnt mean it is always the cause of being pale, sweaty etc or even their hypoglycemia. 

Dont be so short sighted. Diabetics can have other medical problems too

Sent from LuLu using Tapatalk


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## Nerd13 (Sep 15, 2011)

Epi-do said:


> However, how often is the person in the position of "school nurse" claiming to have that title, and how often is it other people just using it as a generic title for a specific set of job requirements?



Exactly! I think that may be the entire problem that started this whole thread.


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## JPINFV (Sep 15, 2011)

Once again, I feel required to point out that everyone is picking the low hanging fruit and ignoring that the school nurse is doing more than basic first aid, keeping a filing cabinet, and teaching CPR.  

I'd also be remissed to note that the 1000 hour, no real pre-req NCTI style wonder grad is much more common than the awesome community paramedic that everyone seems to think represents the average paramedic.


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## Katy (Sep 15, 2011)

ffemt8978 said:


> This is the type of attitude that will get this thread deleted from here...so this is the last warning to everyone in this thread.
> 
> PLAY NICE or become the focus of my complete and undivided attention.


My apologies, sadly I let my emotions get to me a little bit too much at that point
To the rest of this thread, I can't simply keep replying to your comments and questions in a timely manner, I have a life outside of this place too. Again, not saying a Paramedic can't be a School Nurse, but they don't have the education without proper certification. Sorry, but I have decently lengthy responses and comments on the whole issue in this thread.


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## Katy (Sep 15, 2011)

Sasha said:


> Just because they have diabetes doesnt mean it is always the cause of being pale, sweaty etc or even their hypoglycemia.
> 
> Dont be so short sighted. Diabetics can have other medical problems too
> 
> Sent from LuLu using Tapatalk


Sigh, I understand that diabetes is not the only illness they can have, obviously. I'm simply stating, that when coming up to the patient, it is not likely that the EMT would automatically do a BLG, the Nurse with health history will most likely.


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## JPINFV (Sep 15, 2011)

Epi-do said:


> And how to you arrive at the conclusion that paramedics are uneducated in "day-to-day patient education"?  I call tell you there is rarely a shift that goes by where I don't educate at least one patient about something, whether it is answering questions about a chronic illness, a medication, specific acute episodes, or what have you.



So because you answer random questions, you can weigh in on meeting where a student's educational plan is being impacted based on their condition or medications? 

So you feel prepared to discuss things like puberty with preteens?

How good are you on recognizing developmental delays in young elementary school students?


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## Sasha (Sep 15, 2011)

BGL is part of my standard vitals on anything that isnt a routine discharge.

Sent from LuLu using Tapatalk


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## IRIDEZX6R (Sep 15, 2011)

Happy said:


> My apologies, sadly I let my emotions get to me a little bit too much at that point.



*cough*



Happy said:


> Not saying a Paramedic can't be a School Nurse.



Yes you are.




Happy said:


> but they don't have the education without proper certification. Sorry, but I have decently lengthy responses and comments on the whole issue in this thread.



They're more than capable, just not in your skew sense of reality... School nurses, are very BLS... Anything more and they call, what? Thats right paramedics...  

My little sister whos 10 has a quote... Never argue with a moron, they'll drag you down to their level and beat you with experience.. 

Not calling Happy a moron... But I don't feel that arguing our point will ever change her mind, she's set on her thought process.. no matter how askew it may be and we can't change it... Same goes for us, she couldn't change our minds either.. 

This ends my thoughts, because lets face it.... I do not want to become the subject of the sherrifs' undivided attention..


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## Sasha (Sep 15, 2011)

JPINFV said:


> So because you answer random questions, you can weigh in on meeting where a student's educational plan is being impacted based on their condition or medications?
> 
> So you feel prepared to discuss things like puberty with preteens?
> 
> How good are you on recognizing developmental delays in young elementary school students?



When i went to school the last two were done by the teachers and guidance counselors. The school nurse was just there to let you take nap because you had a headache

Sent from LuLu using Tapatalk


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## Katy (Sep 15, 2011)

Epi-do said:


> I was really trying to refrain from making any comments on this thread, after reading all of it.  However, just like others, I just can't resist the lure of the train wreck.
> 
> 
> 
> ...


It doesn't make them any more knowledgeable, I have said that numerous times. But because it isn't possible, you can't logically say they get the proper certification and training. 
My "day-to-day patient education" in a school setting. 






Epi-do said:


> Since when is teaching a skill that isn't difficult?  Wait, let me add a qualifier to that, and make it "good at teaching."  Heaven knows there are countless people out there, even those with a Bachelors or Masters in Education, that are far from "good at teaching."  A couple prereq classes while in college do not make a nurse (or a medic for that matter) a good instructor.  Just because someone can teach, doesn't mean they should.


Depending on the age group and the subject, it varies. But the basic principles of teaching aren't that complex. I know that, a close family member has a Master's in her Education, so I have a good bit of knowledge regarding that aspect of Education. No, it doesn't, it does however make them a better instructor than one who doesn't have the qualifications, which the paramedic can't. This is true, but why would it matter in this discussion ? 



Epi-do said:


> And what documentation is it, exactly, that the nurse has more training and experience with?  If you are talking documentation in general, both medics and nurses are required to do plenty of documentation.  If you are referring to job related documents, then of course the person working within that specific capacity is going to have more knowledge and experience.  Anyone who isn't employed by the school will not be familiar with the paperwork the health care provider needs to complete.  I would be willing to bet that there are even some variations from one school district to another.


Educational documentation and principles, specifically to the School Nurse. No, I'm not. 






Epi-do said:


> Making public speeches isn't part of the job for most nurses either.  And, who said you have to be educated to be a good public speaker?  Some people are just a natural at giving speeches.  That being said, giving a public speech isn't the same thing as educating a group of people.  A speech is typically one sided.  The speaker says what they have to say, and there may or may not be an opportunity to address him or her regarding various points of the speech.  When you are educating a group of people, there is typically some sort of interaction going on between teacher and students.  And again, not everyone is a good teacher.


It is of the School Nurse, hence why I keep stressing the point. It is better to be educated, even if one has a natural ability at public speaking, a formal education is necessary in order to best use those natural skills. No, but one has more knowledge than another if they have had training teaching. 



Epi-do said:


> There were several other points I read that I thought about addressing, but I wouldn't really be saying anything that hasn't already been said.  Because of that, I thought I would just jump in on the most recent ones.
> 
> As for the issue of people claiming to be nurses when they aren't, yes it is wrong.  But so is claiming to be a police officer, janitor, hobo, or anything else that you are not.  However, how often is the person in the position of "school nurse" claiming to have that title, and how often is it other people just using it as a generic title for a specific set of job requirements?


That is fine, but this will most likely be one of my last posts in this thread. Well, it is also illegal. Doesn't matter how there using the title, they cannot, and I never really got that far to question the usage of the name other than the initial surprise.


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## DrParasite (Sep 15, 2011)

Happy said:


> Sigh, I understand that diabetes is not the only illness they can have, obviously. I'm simply stating, that when coming up to the patient, it is not likely that the EMT would automatically do a BLG, the Nurse with health history will most likely.


Sigh; I would argue that an EMT (if permitted by their state or medical director) or paramedic with that very same health history would do so within an equal timeframe as a school nurse.


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## EMS_cavalier25 (Sep 15, 2011)

Nerd13 said:


> Some actually. When was the last time you had a dental exam in the school nurses office beyond checking to see if you have all of your teeth and what kind of condition they were in.
> 
> 
> 
> Yes, but I did not say "nurse" I said "school nurse". I don't think there is any technical requirement for what kind of 'nurse' a school nurse must be. Can they be an LVN? CNA? If there is no steadfast rule I don't think it can be argued that they have to be one particular level of care provider. Just my two cents though. That one is open to interpretation.



I agree just as military combat "medics" are not all paramedics.


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## Katy (Sep 15, 2011)

IRIDEZX6R said:


> *cough*
> 
> 
> 
> Yes you are.


I am if they don't have proper training and certification, yes, if they were capable of completing further education, so be it. 






IRIDEZX6R said:


> They're more than capable, just not in your skew sense of reality... School nurses, are very BLS... Anything more and they call, what? Thats right paramedics...


No, they are not. They do not have the education, you keep bringing up the BLS and emergent side, when that is little compared to the rest of the job. 



IRIDEZX6R said:


> My little sister whos 10 has a quote... Never argue with a moron, they'll drag you down to their level and beat you with experience..
> 
> Not calling Happy a moron... But I don't feel that arguing our point will ever change her mind, she's set on her thought process.. no matter how askew it may be and we can't change it... Same goes for us, she couldn't change our minds either..
> 
> This ends my thoughts, because lets face it.... I do not want to become the subject of the sherrifs' undivided attention..



Good point.


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## Katy (Sep 15, 2011)

DrParasite said:


> I would argue that an EMT (if permitted by their state or medical director) or paramedic with that very same health history would do so within an equal timeframe as a nurse.


Agreed, but the whole point you all aren't getting is I am not stressing if they had access, because they don't. The Nurse is the only one who can, which is why it is important to note.


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## DrParasite (Sep 15, 2011)

Happy, I'm gonna quote your original post, so you can see what you wrote in your first post:





Happy said:


> Okay, so why when I am at a local camp or school function, and I look to see the First-Aid tent and clinic center. I start to talk to the person giving care, and come to find out they are an EMT-B! :glare: I'm sorry, but there is something very wrong with an EMT-B functioning as a School Nurse or Camp Nurse, I wouldn't even put a Paramedic in this job because they aren't a "nurse" first of all, and second, I'm all for EMS being techs and assistants in the clinics, but to be the primary care giver in a education setting ?h34r: What do you all think ? Any experience with this ?


you said an EMT or paramedic can't be the school or camp nurse, because they aren't "a nurse."  

What I am saying is if you replaced the "nurse" with an EMT or Paramedic, making them the school EMT/Paramedic or camp EMT/Paramedic, giving them the same time spent in the office, same access to the history forms, than it doesn't matter if the person is a "certified school nurse" or not.  

Going further and putting the paramedic in the nurse's position (since no one wants an EMT with their limited scope of practice and education) as the primary care giver in an education setting, your argument still holds no water.  a paramedic can function similarly to a nurse, exceeding a nurse is some way and falling short of a nurse in others, and what they fall short on, can be made up with training (ditto an RN acting as a medic, they need to learn more to become an MICN)



Happy said:


> Agreed, but the whole point you all aren't getting is I am not stressing if they had access, because they don't. The Nurse is the only one who can, which is why it is important to note.


so, back to my previous post, if the paramedic or EMT has access to these files, that means not only the nurse has access, which means you don't need to be a nurse to have access to the files, which pretty much eliminates the need to have the nurse (which is what you just said, in what was important that you note), and they can be replaced with a paramedic.

Lastly, and this is the last thing I will say in this thread, I have worked as an EMT at major events, worked alongside doctors, nurses and paramedics, and were able to manage all medical emergencies and injuries to the best of our abilities, and shipped out what we couldn't handle to the local ER. and oddly enough, we didn't have a patient history sheet filled out for every patient that walked into the stadium or who was admitted to the event.  the majority of the requests for service involved band-aids, Tylenol, and minor injuries, with the minority of anything serious being treated and transported to the hospital for further evaluation.


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## EMS_cavalier25 (Sep 15, 2011)

abckidsmom said:


> You are again showing your inflexibility of thought.  There is a guy at one of our senior apartment complexes that always takes his insulin and doesn't eat.  We get dispatched and know from the address that it's going to be a hypoglycemic patient.  Then we arrive and find a guy with an altered mental status, pale, cool, sweaty skin, tachycardia, and snoring respirations, and low blood glucose.  We start an IV and give him D50 because we are clinically astute, and recognize his problem, not only because he's got low blood sugar.
> 
> One of these times we're going to go for him and he's going to have a head bleed, and you know what?  We'll recognize that for what it is, too.
> 
> Have you had a good class in physical exam, or pathophysiology?  When you get that education, it's super easy to recognize a problem when you see all the pieces to a puzzle fall into place in front of you.  It has nothing to do with your history with the patient, and everything to do with clinical assessment.



EXACTLY


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## CAOX3 (Sep 15, 2011)

I for one agree, paramedics and nurses are not interchangible, and that isnt a slight against paramedics.

Yes you may have a similar skill set, but the educational foundation of a BSN far surpasses that of a paramedic.

I could take a couple of add on classes and treat the majority of injury an illness that I encounter daily.  Would that make me a paramedic?  No, see the correlation.

A paramedic could handle the majority of the duties of a school nurse, but that wont make them a nurse.


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## nmasi (Sep 15, 2011)

24 pages is too much to browse through, if my post has already been made, please forgive.


When the school nurse goes "oh :censored::censored::censored::censored:!"  who do they call?  A Paramedic.


How do you know that the person with the "School Nurse" pin wasnt also an EMT-B?  I know many nurses who are both RNs and Paramedics, not to mention the highly regarded Physicians that maintain their Paramedic cert just so they can come have fun with us.

As an offshore flight medic, I am routinely the primary medical provider with no other resources available.


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## sdennislee (Sep 15, 2011)

I solved the puzzle. Change the sign on the office door from School Nurse to School Medical Person.

In the case of school nurses it's a position or title not a certification. Just because the EMT, Paramedic, etc... is filling the role as obviously requested by the school does not me they are trying to pass themselves off as a nurse.

Not sure why anyone other than a nurse would be offended by this activity.

Nothing illegal about filling a position of school nurse as long as you are not passing yourself off as a nurse.

Candy a suggestion in the future do not start threads with titles containing wanna be when addressing a group of senior professionals. It will almost always go bad for you. I think you would have had a more positive discussion had you started off with something like - Recently there seems to be an increase in the number of EMTs or Paramedics filling the role of school nurse, what is your opinion on this? or words to similar. As it was IMHO your opening remarks made you sound like a holier than tho valley girl.


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## JPINFV (Sep 15, 2011)

nmasi said:


> When the school nurse goes "oh :censored::censored::censored::censored:!"  who do they call?  A Paramedic.



When the emergency physician says, "Oh shoot, this patient needs to be at a hospital with a cath lab?" Who do they call? Ok, are you going to claim to be superior to an emergency physician because you come in an ambulance? 

Oh, this also doesn't touch on the fact that the people who are specialized in prehospital *emergency* care might be good at *emergency * care, but might not be at everything else. By that accord, the average paramedic should be able to take over a shift as a SNF RN, correct? How about a primary care physician because he calls 911 when one of his patients is having an emergency? So, how good are you at the chronic management of obesity, HTN, PAD, and type II diabetes, because when you get called because that patient has chest pain, you obviously must be able to handle managing everything else. 




> As an offshore flight medic, I am routinely the primary medical provider with no other resources available.


Is the average paramedic able to be plucked off an ambulance and thrown into an offshore flight medic position? I'm betting on "no."


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## JPINFV (Sep 15, 2011)

sdennislee said:


> In the case of school nurses it's a position or title not a certification. Just because the EMT, Paramedic, etc... is filling the role as obviously requested by the school does not me they are trying to pass themselves off as a nurse.


I'm baffled at how everyone seems to think that the training and education for one job is someone inherently linked to the training and education for another job that's only tangentially linked. 



> Candy a suggestion in the future do not start threads with titles containing wanna be when addressing a group of senior professionals.





> Training: EMT-Basic



May I suggest that we not try to throw around terms like "senior professionals" quite so carelessly? The concept of "professional" means something, and given the attitude commonly taught and used in EMS, there are legitimate questions about whether EMS is a technical trade or an actual profession. A topic for a different thread however.


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## IRIDEZX6R (Sep 15, 2011)

Happy said:


> No, they are not. They do not have the education, you keep bringing up the BLS and emergent side, when that is little compared to the rest of the job.
> .



What is the all holy "rest of the job" that you keep mentioning? What EXACTLY are you saying, that medics can't do that a school nurse can? "With the proper :deadhorse: certification" that is...


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## sdennislee (Sep 15, 2011)

JPINFV said:


> May I suggest that we not try to throw around terms like "senior professionals" quite so carelessly? The concept of "professional" means something, and given the attitude commonly taught and used in EMS, there are legitimate questions about whether EMS is a technical trade or an actual profession. A topic for a different thread however.



I don't throw it around carelessly. I see no reason why a paramedic would not be classified as a professional. GIven the number of years some of the paramedics in the forum have put in I see no reason why they wouldn't be considered senior professionals. What would you require of them to be classified as a professional?


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## ffemt8978 (Sep 15, 2011)

Okay...that's enough of this one.  I'll get out the ban hammer tomorrow morning and start swinging away.  

Sent from my Android Tablet using Tapatalk.


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