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.
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:
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.
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.
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.
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
- 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.
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.