Field Trip Toolkit Post Session Follow-up

By Louise Wilson, MS, NCSN, RN, BSN posted 08-01-2020 17:32

  

Field Trip Toolkit Post Session Follow up

Thank you for attending or listening to my session on meeting the health needs of students on field trips. During the session, there were multiple “chats” related to not being informed of field trips in a timely manner. Seems school nurses everywhere would like policies requiring 10 -30- 60-day notices (local-out of state-international) as suggested in the toolkit!

Meeting the health needs of students during the school day while on campus is challenging. Doing so off campus on field trips even more so.  I addressed some of the issues and challenges during our time together. The following are some answers to lingering questions and more resources as school nurses navigate the complexity of field trips.

Medications

The use of parents to administer medication to their own child or other students while on a field trip, like so much else, depends on state law and local policies. Per my state’s (Wisconsin) law, “volunteers” can be trained and authorized to give students medications.  If allowed by your state law, you could craft your medication policies to allow this. Do consider training and confidentiality issues if this becomes part of your practice.

I mentioned self-administration of medication by older/capable students might be a solution for some of the issues surrounding overnight or out of state field trips.  School nurses will need to look at any state laws, state-level guidance, and district policies on how to handle self-administration of controlled substances. Is this something that your district currently allows? How will you address safe storage? See page seven of the toolkit for more considerations.

Here is the link to the Wisconsin Department of Public Instruction’s medication training materials I mentioned during my presentation. (https://dpi.wi.gov/sspw/pupil-services/school-nurse/training/medication) They are available for use by anyone. No certificate is produced after viewing the basic medication module. The viewer can send confirmation of participation and passing the quiz to an email address of their choosing.

Standards of Practice

I am not a lawyer so cannot tell you if as a school nurse you are obligated by law to travel with your students on field trips. This most likely is a contractual obligation with your employer. Section 504 and IDEA require accommodations and planning for students so they can participate in the field trip and receive FAPE. It these accommodations cannot be provided, rather than the individual student with the health need not being able to participate, the field trip may need to be canceled or postponed until the accommodations (needs) can be met. See page nine of the toolkit for more discussion on this topic.

If a parent requests a school nurse accompanies their child on the field trip and there are 504 or IDEA issues, the above would apply. Parents may request an IEP meeting or reevaluation of the 504 plan to address their concerns. But, if there are no such issues and parents simply “would feel more comfortable” with a school nurse present, then this is an ideal situation to empower parents to use their voice and advocate for school nursing services!

Likewise, my non-lawyer status prevents me from providing an answer for a school district’s responsibility to provide medication administration for students on a self-funded trip over spring break. My suggestion is to discuss your concerns regarding the school’s responsibility and liability with your administrator and suggest they seek legal counsel. Each state is different. Know your state laws regarding student medication administration. In Wisconsin medication, administration to students is not a delegated nursing procedure and the responsibility (if anything goes wrong) is the school administrator’s. Pointing THAT out gets their attention!

NLC/NPA

Standards of practice (what is allowed or not allowed) vary state by state. It is important to know your Nurse Practice Act (NPA) and the NPA of the state you are going to be practicing in. That is why the Board of Nursing (BON) websites are listed in the chart on pages 27-36 of the toolkit. The BON sites are a starting point to find out where the Nurse Practice laws are located. The link to find out which states have decided to participate in the NLC is found on page 12 of the toolkit.  If your state and the state you are going to practice in are both NLC states, then your registered nurse license is accepted in that other state. You must practice according to their NPA while in that state. Additionally, you are accountable for your own state’s NPA. Here is an additional article about NLC states: Russell, Kathleen A. 2017. “Nurse Practice Acts Guide and Govern: Update 2017.” Journal of Nursing Regulation 8, no. 3 (October):18-24.

Toolkit/Resources

Here is a copy of my PowerPoint with only two slides per page so they are more readable (larger). All the forms I discussed and mentioned are in the toolkit and available for downloading. The direct link is: https://dpi.wi.gov/sites/default/files/imce/sspw/pdf/Meeting_Student_Health_Needs_While_on_Field_Trips_Tool_Kit.pdf.  You can use any of the forms as is, or adapt to fit your own needs.  My hope is that you use the toolkit to develop or enhance your policies, practices, and tools to increase collaboration among school staff and parents when planning field trips.

I look forward to a time when our paths cross at a NASN conference and students are once again able to participate in local, state, and international field trips. Until then …

Be SAFE, be WELL, be KIND

We are all in this together,

Louise

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