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Can a school district employ 2 LVN's in place of an RN? They both are experienced nurses in whom we have the utmost confidence. We do not know if there is a law stating that a district must employ an RN. We look forward to hearing from you.
Thank you for your inquiry.
There is not a mandate for school nurses, so each school district can make their individual decisions.
The Texas Administrative Code does state, however, that the only person that can use the title, "School Nurse" is an RN. (TAC Chapter 153) Definition of a School Nurse--An educator employed to provide full-time nursing and health care services and who meets all the requirements to practice as a registered nurse (RN) pursuant to the Nursing Practice Act and the rules and regulations relating to professional nurse education, licensure, and practice, and who has been issued a license to practice professional nursing in Texas.
The LVN is supposed to be supervised, either by an RN or MD. Do you have additional RNs in your district, or an MD that is willing to take that responsibility? RNs are licensed to perform nursing assessment and diagnosis and create an Individualized Healthcare Plan for students with chronic conditions, such as asthma, seizure disorders, diabetes, etc. An LVN is not licensed to do that.
LVNs can be an excellent addition to the health services provided in the school setting. To assure that there is supervision, they can be helpful on a campus, where there is a very large number of students or several students with daily invasive procedures, but the RN is also in the building for supervisory purposes. Also some school districts have a "School Based Clinic" where there is an MD or Nurse Practitioner that can be the supervisor.
An experienced nurse is very important in the school setting, whether the nurse is an RN or LVN. It is an independent practice setting, so nursing decisions have to be made with confidence and accuracy, without another nurse or M.D. in the building. Experience in other independent practice settings can be very valuable, such as Public Health or pediatric care in a Home Health setting. Most of the other health care settings have other nurses or doctors in the same building.
In the School District where I was recently School Health Services Supervisor, we had an RN assigned to two elementary campuses, if there was not any children with daily special/invasive procedures, such as catheterizations, tube feedings, suctioning, etc. An LVN was assigned to those same campuses and would cover the clinic that the RN was the other campus. The assignments were usually in close proximity to each other, so the RN could get to the other campus quickly. That way we were able to cover both clinics, but the RN still knew all the students and could still write the Careplans for the students with chronic conditions and support the LVN. All the secondary campuses and the elementary campuses that had special/invasive procedures were covered by a full-time RN.
There may be other members of our Board that can give alternatives, so I will forward this inquiry to them also.
If I can answer any other questions, or clarify anything I have stated here, please let me know.
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