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Marissa Morales, RN District Nurse Coordinator
Educational Excellence-The Right of Every Student
La Joya Independent School Distr ict
Health Services Department 200 West Expressway 83, La Joya, Texas 78560 Tel (956) 323-2615 Fax (956) 323-2617
Board of Trustees
Johnn V. Alaniz, President Joel Garcia Sr., Vice-President
Juan Jose “JJ” Garza, - Secretary
Jesus “Chuy” Avendaño, Member Oscar “Coach” Salinas, Member
Juan “JJ” Peña, Jr., Member Esperanza “Espie” Ochoa, LVN/RN Supervisory Protocol
Texas Board of Nurse Examiners states “BoardRule217.11(2)(A)(ii)and(iii)clarifiesthatLVNsmaynotinitiatecareplans;however,theyshouldcontributetotheplanningand...implementationofthenursingcare.LVNsmayparticipateinthedevelopmentandmodificationoftheongoingnursingcareplan.OnlytheRNmaydeveloptheinitialnursingcareplanandmakenursingdiagnoses[Rule217.11(3)(A)(ii)and(iii)].”La Joya currently employs eight LVNS who under their scope of practice cannot formulate care plans for initial, three year, and special procedure 504s as well as ARD initial and special procedure care plans. As of the beginning of 2015-2016 school year, there are over one thousand students who have been identified as 504 Medical and over five hundred Special ED students currently in need of a medical care plan throughout the district who require at least one meeting per year. Licensed Vocational Nurses require appropriate supervision of a registered nurse and creating nursing care plans is considered outside the LVN’s scope of practice, therefore, a protocol for LVN supervision must be developed and adhered to for all school health related services at La Joya ISD.
District Nurse Coordinator Duties:
• District Nurse Coordinator will visit each campus where an LVN serves as the campus nurse together with the Supervisory Nurse as needed.
• District Nurse Coordinator will accompany Supervisory Nurse and will travel to the designated school for a pre-arranged half-day visit within the first month of the school year to become familiar with the needs of the campus and at least on additional visit for each semester and as needed thereafter.
a. The supervisory nurse must ensure that a nurse assistant or another nurse remain at his/her primary campus and should never leave the school clinic unattended.
b. Supervisory visits can be rescheduled. • District Nurse will meet with Supervisory Nurses every other month to review Supervisory Logs
and ensure protocol is being adhered to. • District Nurse will accompany LVN to 504 when supervisory nurse is unable to and/or in special
medical cases that require District Nurse presence.
Marissa Morales, RN District Nurse Coordinator
Educational Excellence-The Right of Every Student
La Joya Independent School Distr ict
Health Services Department 200 West Expressway 83, La Joya, Texas 78560 Tel (956) 323-2615 Fax (956) 323-2617
Board of Trustees
Johnn V. Alaniz, President Joel Garcia Sr., Vice-President
Juan Jose “JJ” Garza, - Secretary
Jesus “Chuy” Avendaño, Member Oscar “Coach” Salinas, Member
Juan “JJ” Peña, Jr., Member Esperanza “Espie” Ochoa, Additional Supervisory Registered Nurse Duties:
• Review the campus health conditions list and medication list
• Ensure that physician orders have been requested and updated in a timely manner
• Assess students whose medical needs require follow-up
• Create an individualized healthcare plan (IHP) and emergency plan for students whose medical
diagnosis warrants it. The plan should be based on: a) direct observation of the student, b) parent
information, c) staff information and d) health care provider’s information as needed.
• The IHP may be developed but not limited to the “Individualized Healthcare Plans for School
Nurses” program and be kept accessible for the campus nurse.
• The supervisory nurse shall ensure that staff receives training related to the IHP as needed.
• Attend all meetings with the campus LVN (parent, staffing, ARD, 504, etc.) for students with
SEVERE or complicated issues. If however the supervisory nurse is unable to attend, the LVN
campus nurse should attempt to attend these meetings.
• Be available for phone consultations as needed when the LVN has questions or concerns
regarding a student’s medical condition or for other issues that may arise. If the supervisory RN is
unavailable and the issue is time-sensitive, then the LVN should call to the District Nurse
Coordinator immediately.
• Assist with updating the campus medical emergency plan
• Document visits and all communication on the LJISD Supervisory Log.
The LVN’s duties will include:
• Initiating the first communications with families of students with medical problems, obtaining as
much information as possible about the problem. This includes obtaining a medical history as
well as information regarding all current medications and treatments being provided
• Initiating the process of obtaining MD orders and communicating with MD’s as needed
Marissa Morales, RN District Nurse Coordinator
Educational Excellence-The Right of Every Student
La Joya Independent School Distr ict
Health Services Department 200 West Expressway 83, La Joya, Texas 78560 Tel (956) 323-2615 Fax (956) 323-2617
Board of Trustees
Johnn V. Alaniz, President Joel Garcia Sr., Vice-President
Juan Jose “JJ” Garza, - Secretary
Jesus “Chuy” Avendaño, Member Oscar “Coach” Salinas, Member
Juan “JJ” Peña, Jr., Member Esperanza “Espie” Ochoa, • Assisting with the development of IHP’s, then regularly providing feedback to the RN after the
IHP’s completion
• Assisting with staff training related to IHP’s and medical needs
• Attending initial ARD, staffing, 504 and parent meetings together with the Back-up RN and all
annual meetings.
• Screenings as mandated by state.
• Care as allowed by Scope of Practice
Taking on this responsibility is not to hinder the RN’s function at his/her own campus. The District Nurse Coordinator will discuss supervision responsibilities with each RN to ensure that supervision is occurring appropriately and to remain informed of health issues at the supervised schools.
