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Medical Needs at School: Feeding, schools, nursing



Our daughter is g-tube fed at school at noon. The school nurse refuses to feed, and our school district pays for a private nurse to go in to feed her. Our daughter will soon need to be fed twice in school. Is there a law that states that schools are responsible for feeding the GT kids that are enrolled there? She is fed via a pump for approx 45 min. It would be a waste of money to hire a nurse for the entire day for only two feeds. I fear a battle coming on and would like to know my "legal grounds."

Answer of our experts

Yes, the school MUST provide G-tube feedings. First, the varying states have regulations on WHO performs these procedures but the school is responsible, during school hours IF the child is determined to have special education needs and IF the child requires specialized health care services DURING the day. Tube feeding, suctioning, colostomy care, ventilator management, catheterization, medications, etc. are all being done in schools now

There is no national legislation or regulations regarding who performs health care procedures. It is based on each state's Nurse Practice Act and state rules and regulations. Here in NH, teaching assistants (with training) are allowed to G-tube the children but NY, for example, has more strict regulations regarding the WHO

The question raised is a real big one and goes far beyond G-tube feeding. There are many cases facing lower courtspartly because of increased inclusion, there is a nursing shortage, fear of liability if something goes wrong, lack of knowledge and training, a re-defining of the traditional role of the school nurse, etc

Regarding paying the "feeder," be it an RN, LPN, CNA or other trained person, it usually is the responsibility of the "sending" school district unless there are specific contractual arrangements with the facility receiving the student. The school district may be able to collect Medicaid reimbursement for part of the cost if it is a nurse

MM/ TK 7-13-10

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Find other pages that share the same topic as this page Atención médica Dificultades de alimentación y problemas dentales


Atención médica

Las pacientes con SCdL y sus familias necesitan atención durante toda su vida, proporcionada por profesionales sanarios y servicios sociales, quienes deberían formarse en el SCdL.
A cada persona con SCdL y sus cuidadores se les debería ofrecer, mediante toma de decisiones compartida, planes de atención personalizados que fuesen específicos del síndrome.


Dificultades de alimentación y problemas dentales

En cada paciente con SCdL que tenga dificultades graves y prolongadas para alimentarse, la evaluación multidisciplinar (profesionales sanitarios de varias disciplinas) debería considerarse la colocación (temporal) de una gastrostomía (abertura quirúrgica al estómago a través del abdomen) como un complemento a la alimentación oral.
En pacientes con SCdL que sufren infecciones respiratorias repetidas, debe descartarse la existencia de reflujo gastroesofágico y/o la aspiración de jugo gástrico o alimentos a los pulmones.
Debe examinarse detalladamente el paladar. En caso de síntomas sugerentes de fisura palatina (submucosa), está indicado remitir al paciente a un especialista.
La exploración y limpieza de los dientes debe realizarse con regularidad; podría ser necesario un examen o tratamiento ortodóncico más exhaustivo bajo anestesia.

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