Question:
Dear Nancy,
As an RN working in a high school are there any legal guidelines to fall back on when deciding if a student should be allowed to drive home? I usually only allow it in cases when the student needs to change clothes and a parent has given permission. However, some parents get angry if I won't "dismiss" a student who has no fever but just wants to go home because their cold symptoms are making them miserable. I have heard other nurses say "If the parents give permission, I let them drive home." I feel if the child is well enough to drive home, they are well enough to stay in school. The parent can come to the school, sign the student out and then let him or her drive, but some feel this is an inconvenience to the parent. Are there any legal precedents concerning who is liable if the student has an accident on the way home?
Hortense
Nancy Brent replies:
Dear Hortense,
Your positions described in your question ? getting permission before a student is allowed to drive home and if needed, having the parent come to the school and pick up the student ? are good, solid positions for a school nurse to take. Remember, too, that school policy should provide the school nurse with some guidance about what is acceptable for any student who drives to school, including when the student can leave the campus, what form (e.g., parental consent) must be filled out and on file or what must be done (notifying the parent if no consent is on file) before the student can drive home.
When a school nurse gets involved (e.g., the student has a cold or doesn't feel well), the nurse's duty is to assess the student's overall well-being as best as he or she can before allowing a student to drive himself or herself home, regardless of whether permission has been granted. The parental consent is to allow the student to drive home only. It does not extend to giving permission in a situation in which the student's well-being compromises his or her ability to drive home. The school nurse is always obligated to use professional judgment and do an assessment for any student who comes into the school nurse office.
The legal liability for the school nurse that might be present in allowing a student to drive home when the student should not have done so rests in the law of professional negligence. If, for example, an assessment was not done, an injury occurs and it was later determined that the student was experiencing a reaction to a medication (and "just didn't feel good"), liability may result for the school nurse and the school if the reason the student was not feeling well was not explored, appropriate interventions were not taken and the situation documented, as required by school health policy.
As another example, let's say the student is assessed and the school nurse finds no reason not to refuse to let the student leave, despite the fact the student said he or she doesn?t feel well. (Again, assuming all consent papers are in order.) If an injury occurs because of the student's driving and say, texting at the same time, no liability would result for the school nurse, since all obligations and duties were met and the accident was a result of texting and driving and not because of a failed assessment or any other obligation of the school nurse.
Resources that may be helpful to you are The American Association of School Nurses' website (www.aasn.org) and the text by Schwab and Gelfman, ?Legal Issues In School Health Services: A Resource For School Administrators, School Attorneys, School Nurses? (Authors Choice Press, 2005).
By the way, if you are not a member of the AASN, consider joining. Also, consider becoming a certified school nurse, especially if your state recognizes and requires that RNs who are school nurses be certified in this area of nursing practice.
Cordially,
Nancy
