School Nurse Wanna Be's

[squrt29batt12]

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

 

[DrParasite]

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

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.

 

[Katy]

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.

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.

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.

 

[Katy]

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.

 

[abckidsmom]

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.

 

[Katy]

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.

 

[luke_31]

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.

 

[abckidsmom]

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.

 

[Katy]

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.

 

[DrParasite]

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).

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...

 

[Katy]

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.

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.

 

[Nerd13]

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.

 

[ffemt8978]

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.

 

[Epi-do]

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.

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?

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.

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?

 

[Sasha]

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

 

[Nerd13]

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.

 

[JPINFV]

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.

 

[Katy]

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.

 

[Katy]

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.

 

[JPINFV]

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?