As medically fragile students with ventilators and other specialized equipment arrive in classrooms, school nurses must know how to deal with their healthcare issues.
An RN-led pilot initiative providing free training to school-based nurses in Prince Georges County in Maryland, through a partnership with Bowie (Md.) State University and the Specialized Health Needs Interagency Collaboration program, might serve as a template for using community resources.
Six LPNs, who serve as backups to RNs in the Prince Georges County school district, learned how to suction a tracheostomy, among other hands-on skills sessions, during three days of training in January at Bowie States simulation laboratory, where a high-tech mannequin provided them with patient care experience. Training for additional school district RNs is scheduled to take place in October, possibly at Bowie.
“We were able to use equipment we never could have afforded in our school system,” said Patricia Papa, RN, MSN, pediatric nurse practitioner for the school district. “More students come to school on ventilators and with trachs and [gastrostomy tubes]. If you havent done it in a couple of years or 20 years, you better not do it until you can practice.”
Papa assisted with the training, which included case scenarios based on incidents that occurred in schools.Barbara Obst, RN
The virtual clinical environment enabled the LPNs to learn skills to provide safe care to children with complex medical needs, said Barbara Obst, RN, MS, nurse consultant/co-coordinator for the SHNIC program, which is a collaborative partnership between Baltimores Kennedy Krieger Institute, the Maryland State Department of Education and local hospitals.
“You may have to help a child who had a heart transplant or a child with a traumatic brain injury,” said Obst, who along with Papa, conducted training.
“The technology in the schools now is like running a mini-hospital.”
Testing skills safely
The simulation pediatric doll used during training is programmable. For example, it can be programmed to have symptoms of asthma and its breathing and heartbeats can be manipulated. Obst used her training dolls to teach skills such as how to remove, insert and clean a trach tube. The participants competencies were measured before and after training.
The lab training allowed nurses to test critical-thinking skills in a safe environment.Keith Plowden, RN
“If they make a mistake, we can make the mannequin respond in a negative way, but then its not like its a human life thats lost,” said Keith Plowden, CRNP-PMH, PhD, chairman of Bowies nursing department.
Nurses appreciated the training, said Karen Bates, RN, MS, supervisor of the Office of Health Services for Prince Georges County Public Schools. She coordinated the process with Bowie and will ask whether they can use the training facilities again.
“I think they will be willing to do that because we still have their nursing students and we provide a practicum experience for their nursing students for school health,” Bates said.
The idea to provide the lab occurred when Plowden met with lead nurses for the Prince Georges County school district last year.
Since the school district served as a clinical site for the universitys nursing students, he asked how the university could assist school nurses.
“They said, ‘We need a facility to train our nurses,” Plowden said. “I believe in partnerships, and as a state institution we owe something to the community to give back.”
Robin Farmer is a freelance writer.