IEPs and nursing

LVMom23 · #1 02-13-2011, 02:00 AM

We are strongly considering sending Hannah to preschool when she turns 3 (with the school district). They have a nurse on staff, but it is one for an entire school (between 600 to 900 kids).

Hannah not only has a trach, but she has other conditions that make her situation more complicated, such as a movement disorder, hypotonia, and problems with her neuromuscular system.

She would love being involved in a class. The socialization and new experiences mostly. But she requires someone with her every moment of the day. If she pulls her trach out, I can't even picture them running for a nurse while she is desatting and turning blue -- just not going to happen. Or what if she needs suctioning? Or if she falls over because of her ataxia?

Has anyone ever been able to get one of their nurses to be able to go to school with their child? Has anyone successfully got a nurse on the IEP? I would love to figure out a way to have Hannah go but with the comfort of knowing there is someone right there with her at all times.

kadiera · #2 02-13-2011, 08:46 AM

We did over the summer, but apparently part of the deal was that our insurance pays for nurse to go anywhere Alexander goes; if medicaid was paying for our nurse, they'd expect the school to pay for it (and the law says the school has to provide a nurse).

Now....where we live, I hear that it's very difficult to get the school to actually provide a nurse. Most of the time, they pay for some sort of aide.

I'd say start with a letter from your doctor stating that someone trained (and some details on minimum training would help) must be in the room with her at all times, and provide that as part of your IEP meeting.

kctwinmommy · #3 02-13-2011, 10:28 AM

Our daughter has one-on-one nursing for school. Although she's in full-time school, first grade now. But she also had it in kindergarten. The school district is required to pay for it. So it doesn't come out of our medicaid waiver hours or money. Of course, this also means that it's a nurse that they hire. Or, they have agencies that they contract with, and they supply the nurse. Our situation wasn't great with the nurse we had. Luckily, one of our favorite nurses we used at home, wanted to work with Kira. So we recently had her change, she got hired by one of the agencies they contract with, and now she's Kira's nurse.

Our pulmonologist wrote up what needed to be in the IEP. She HAD to have 1:1 nursing, the trach care, no stairs (her school last year had about 40 stairs to get from the first to second floor - very scary!), plus the various little things. I would start now, contacting the school district, and having your doctor work on it now.

Oh, and Kira's case is also complicated. There's a little boy in the preschool at her school who I see with a trach. But he's on a PMV all day. He has a paraprofessional with him it appears, but not an actual nurse I don't think. Kira's got the trach & the ventilator at all times. And her condition is so rare that it's difficult to really explain it to even nurses. But that's why she NEEDS to have one with her. She's never alone at school or at home even.

Momoffive · #4 02-13-2011, 01:59 PM

In our province, the requirement is that a child with a trach (with or without ventilator and or any other diagnoses) in daycare or school must have a Registered Nurse with them, 1:1 . I cannot imagine my son being in a school of any size with a nurse who was responsible for the rest of the population. There is a funding body that funds the nurse for school and the travel time to and from school.

carolinec74 · #5 02-13-2011, 02:04 PM

Alec attends school with his 1:1 nurse. We ultimately decided to send HIS nurses from home care with him, so we can control their training and shifts, not the school. Plus, we just found on friday at his ARD, that if the school contracts out and pays for it, they can decide if they will pay for a para or an actual nurse. Alec needs a nurse, so I wasn't going to give them that option. Get with your district, and get an order. Your district may need to do background checks and fingerprinting on your nurses before hand...if you use your own anyway.