Cindy has been a RN in a middle school for a large school district…
Question Cindy has been a RN in a middle school for a large school district… Cindy has been a RN in a middle school for a large school district for the past 12 years. Currently she has approximately 1150 students and 120 staff in her school building. One of the special needs students that she cares for has a severe seizure disorder. Cindy has spent a great deal of time developing and implementing the Individualized Health Plan (IHP) in collaboration with the student’s physician and parents. She has worked to educate the teachers and staff on seizure disorders, including recognition of an aura, recording of signs and symptoms, safety during a seizure, use of rectal medications and when to notify school nurse and EMS. Up until recently the rectal medication prescribed by the student’s neurologist had been working. During the last several months, the student’s seizures have worsened with no relief after rectal administration of diastat and twice the school nurse has had to activate EMS, both times the student was transported to the ER and remained in the hospital for several days. The parents arrive at the school one morning with a new medication that they would like to leave at school. The inhaled sedative, to be given during the aura phase of a seizure, has not been approved by the FDA in the US for use in children with epilepsy. The father is an anesthesiologist and is aware of studies in Europe where this medication is being used with some success. The father is prescribing this medication for his child and has instructed Cindy that the student’s neurologist is not aware that they are trying this medication and she is not to call him. The father also instructs Cindy that she is not to call EMS anymore, only the parents, when the student has a seizure. Cindy is concerned about this new development and tries to discuss with the father her duty to provide for the student’s safety. The father becomes angry and leaves the school building. Cindy reports the incident to her building principal and to her Health Service Coordinator and discusses with them that she plans to invoke Safe Harbor.· Can Cindy invoke Safe Harbor if she works as a school nurse in a large school district? Can she invoke Safe Harbor if she is in the middle of her school day?· Do you think Cindy is invoking Safe Harbor in “good faith”? (Why or why not?)· What standards in Rule 217.11 have the potential for being violated if Cindy accepts the assignment? Where on the Safe Harbor Quick Request Form would Cindy document these standards?· What protections are provided when a nurse properly invokes Safe Harbor?· As she completes the Quick Request Form, Cindy decides that she cannot accept the assignment of administering an experimental drug to a child. She considers that she does not have life-saving equipment available in the school health clinic and she has not been trained to intubate a patient, should the inhaled sedative cause the student to lose her protective reflexes after slipping into deep sedation. According to Rule 217.20, what must Cindy do when invoking Safe Harbor and refusing the initially requested assignment? What section of the rule contains this information?· Assuming a safe assignment is worked out between Cindy and her Health Service Coordinator, what other critical actions must be completed prior to Cindy going home in the morning? Health Science Science Nursing NURS 2504 Share QuestionEmailCopy link Comments (0)
