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Feel terrible having to do medical procedures
Old 04-25-2015, 06:34 AM
 
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When I applied for my job there was no mention of profound students. When I arrived, I found more than one in that range.
One we have to tube feed with an opening in her stomach and do everything for as the student is totally helpless.
I didn't receive any training except from my TAs. There is a nurse but she travels between schools and so isn't there most days and anyway never does anything in our room. And nurse did not go over anything with me.

Well after almost a year (I started midyear) we find that we should have been elevating the head of the student while feeding and for 1 hour afterwards. I had noticed that the student seemed uncomfortable after being fed and also was licking lips like tasting something but it didn't always occur but lately had seen more of this. At first I didn't connect anything because it was all so new to me and figured it was just how things were having no background in this type of thing.
The student has been out a lot with respiratory things as the student has cerebral palsy and cannot really clear lungs.

Anyway I googled tube feeding and found out we were doing it wrong and the prior teacher was doing it wrong too. Then we asked the nurse and nurse told us yes of course you need to elevate head. She had apparently trained the prior teacher but had left that out or else prior teacher forgot. Now remember that this was a new type of student for the class.

I feel like I have been hurting this student all along and that some of her respiratory issues could be due to me feeding her wrong. I hate having to do these nursing things and I never learned about having to do them in school. I feel like only a medical person should do these things.

Do you have to do these medical procedures too?


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Parents?
Old 04-25-2015, 08:37 AM
 
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Do the parents realize the student's needs are not being taken care of by a nurse?

Is there any information in the IEP as far as accommodations?

I have not worked with profound students in a school setting, but I can see a smaller district putting a profound child in a resource room with an aide as it would be cheaper than actually sending the child out of district. I DO have experience with administration being less than truthful about what a job entails. Sadly, it is very common as some jobs are hard to fill otherwise.

It sounds like you did the best you could. The fact that you care and want to do the best for your student says a lot. Hang in there and keep your head up going forward.
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Old 04-25-2015, 10:21 AM
 
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Parents don't know that a nurse is not taking care of their child and nothing in the IEP re this. The other day we had to let intestinal 'gas' out of the tube. The TA was showing me how and told me I had to line up everything right and not put too much pressure on the connections so it didn't rupture the balloon inside the student and I felt so scared like I could kill the student by doing things wrong. I guess I am a coward but I don't like doing things that could hurt people because of my lack of knowledge and training and I do not want to do medical things or else I would be in a medical job.
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My district
Old 04-25-2015, 02:07 PM
 
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My district has nurses do the tube feedings. That used to not be the case. Up until a few years ago we only had a half time nurse in our building with two self-contained severe/profound rooms. I admit that I did put a g-tube back in for a student when the nurse couldn't get back to the building. I had been trained years before when I worked in a residential school. However, that was an emergency thing until the nurse could get there and put a new tube in. We now have two full time nurses in our building as we have 3 self-contained classrooms and several other students in regular ed with significant health needs. They tried cutting back to one nurse in our building at the beginning of the year. That did not work at all. All staff that have students with seizures are required to do seizure protocol training at the beginning of every year.
I am so sorry that you were not trained. Tube feeding isn't difficult, but you do have to be so careful to not cause aspiration. It isn't your fault. Demand that you are trained on tube feedings, seizure protocol, positioning student, and anything physical and medical that is a part of your job description. If you are not trained, then refuse to do the job until you are. That sounds harsh, but your teaching license/certificate is on the line if something should happen.
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Old 04-25-2015, 02:51 PM
 
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We have one "real" nurse for the entire district. She oversees the "health paras" who are essentially like any other para- they run the health offices in the schools but they have no additional medical training beyond the regular mandated training that all teachers get (a 2 hour training each year covering how to administer an epi pen, what to do in cases of emergency, etc.) I teach mild/mod, but I know that our severe/profound classes do not have a nurse either. The teacher is responsible for all medical things that the student needs during the day. I taught ESY one summer and hated that aspect of the job. I definitely did not feel properly trained and worried constantly that something bad would happen on my watch. I had a student who was failure to thrive and the nurse told me that she should have a feeding tube, but parents refused. This student was only voluntarily able to move her eyes. I was instructed to put tiny amounts of baby food in her mouth and then they would eventually "fall down" her throat. The student couldn't actively swallow. It took about 90 minutes for her to eat one jar of baby food, and I panicked the entire time that she would choke. I have not signed up for ESY again mainly for reasons like this!


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Hate this part of job
Old 04-25-2015, 03:25 PM
 
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I hate this part of my job esp. since I didn't know I would be doing it! I am very clumsy and feel I have a disconnect or LD in psychomotor skills which makes this type of thing hard for me to do. I know it sounds silly but doing this is hard to do for me.
And I feel like I am just babysitting the student who really is on a survival reflex basis. And her CP is getting worse and with her constant respiratory issues she has this open mouth cough that will send germs into the air as she cannot do anything about it. I'm actually worried she will die one day during a seizure as she has them every day and many times a day. I have given the medicine for the seizures and did that okay but luckily it is prepacked and ready to go. I am in a state of anxiety when she is in the classroom - she misses a lot of days due to illness but when she is here it really worries me.
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Disturbing!
Old 04-26-2015, 09:25 AM
 
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Good for you that you researched G-tube feed. The nurse should have the protocol for g-tube feeds if not the training. The school is out of compliance- there should be health goals for this student rgarding her needs. Contact sped director with your concerns. ASAP
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I had to do tube feedings
Old 04-26-2015, 10:43 AM
 
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at my last school and went the whole year without the scary feeling leaving me. I was never formally trained but had an informal training by the PARENT... That wasn't reassuring though because she was very casual about everything... The paras had been there for years and did some training as well. The only saving grace was that we had a policy that no one was allowed to do any medical solo. Feedings, PT/OT, restroom/changes, medication--all required that two persons participate.
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Old 04-26-2015, 11:52 AM
 
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Cannot contact sped director with any concerns. Everything I mention comes back at me as if I am complaining and sped director tells me other sped people have harder jobs. I was told at beginning that sped director has favorites (ppl worked with before) but I didn't go by gossip. However now experience has shown me differently. So I keep contact to a minimum now for fear I will say something that will be interpreted as complaining.
I just keep my mouth shut except for venting with my fellow teachers on this forum - thank you for listening.
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Old 04-26-2015, 12:47 PM
 
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I can't imagine being put in that position!

I have one student in my usual sub rotation who is tube-fed, and she has her own nurse who does her feedings. She is with the child at almost all times (bathroom and lunch breaks excepted), and is as much a part of our team as the paras and I are.

You are doing the best you can in an awful situation. Please don't feel guilty about your previous lack of training. A, it's on the person who trained you (or who trained that person poorly to begin with) and B, it's something you shouldn't even have to do. You are armed with new knowledge now, and things will only improve from here for the student.


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Old 04-26-2015, 03:09 PM
 
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I teach in a very large district with lots of resources, and all spec. ed. teachers and paras do tube feedings. The only time a student is given a nurse is if they have a trach. On most IEPs, it should be included that a nurse will train all staff working with the student on tube feeding protocols.

I had a similar student last year. She had CP and some other diagnoses and would seize most of the day. We were under strict orders not to call the parents or 911 unless the seizure lasted for longer than 10 minutes. It was terrifying having to set a timer and watch her eyes roll back during her seizures. I felt the same nervousness every time she was at school.

Luckily, every student that i've ever had with a gtube has also had a trach, so i've always had nursing assistance, but the classroom next to me has 1 teacher, 1 para, and 4 students with gtubes. They do all of the feedings by themselves.
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Old 05-20-2015, 01:31 PM
 
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Wow. Why wouldn't the parents have known what was going on? Why isn't there a nurse on site at your school? I don't Know where you live, but i'm pretty sure in my state that is against regulations. I can't believe the nurse didn't train you. This is not your fault but I do think if I were in your shoes I would've certainly asked for help/training as soon as I started, instead of winging it. But that actually isn't your responsibility, it is your administrations. So don't feel guilty. Sounds like a poorly run school!
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Nurse
Old 05-20-2015, 03:39 PM
 
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I have had to do some medical type things. The nurse said she was required to train me before I could do them. I also had a paper I signed stating I was trained. The nurse was on the IEP and invited to the IEP meetings. Since you came into this position mid year and your nurse travels she might not have known about the change. I wouldn't provide medical services without the training. Contact the nurse to let her know you need it ASAP. If that doesn't work I'd either notify the parent or threaten to. This isn't something to take lightly. I'd contact the nurse by email so it's in writing and print it off to keep. Good luck.
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More procedures
Old 05-24-2015, 05:49 AM
 
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Now we have to learn suctioning. Not looking forward to it. I feel like we have a hospital ward.
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UUGGHH! Sunctioning, to me, is
Old 05-24-2015, 07:03 AM
 
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far worse than tube feeding. I would never agree to do it myself but had to be there several times as my district (at the time) required two persons for all medical procedures. (Which I agree with and was thankful for most times.)

Suctioning generally happened when the student was already in distress of some type. To have him in distress, often gasping, gagging and drooling more than usual, and choking as well, then have to hope the machine worked and was cleaned, was a nightmare in the making. He also seemed as if it hurt him at times.

Tube feeding was generally a breeze compared to that. Plus, the documentation for tube feeding was basically a series of checkmarks and initials on a routine day. Suctioning required more complex paperwork detailing who, what, when, where, etc. and calls to the family and nurse. Then, if the nurse was unable to come over to our building, we had to deal with the slime suctioned out and re-sanitize the machine.
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Refused?
Old 05-24-2015, 09:19 AM
 
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If I refused to do it, I would be fired.
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No training...
Old 05-25-2015, 06:23 AM
 
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Lol my sped director said the same thing to me last year, and my replacement this year!! Must be a sped director thing!! I know you aren't my replacement, because I asked her if she was you!

Last year when I receved a severe/profound cp kiddo, we refused to tube feed her without proper training. I did get some push back from admin (they were forced to pay mom to come. Do it until we were trained) but the reality is it is our license and livelihood on the line. If we were to do something incorrectly and cause suffering, you can bet your bottom dollar that the admin would throw us under the bus and it would be our job and reputation not theirs!
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