724R-A - Non-school Employees Working in Schools

Private-duty Nurses in the Classroom 

When a physician determines that it is medically necessary for one-on-one services during the school day from a private provider, then the physician shall provide a written medical care plan to the school. 

That care plan shall include: 
  • The medical reason(s) for having the private-duty person present during the instructional day. 

  • Level of care required; i.e., RN, LPN, or nursing assistant. 

  • Orders from the physician to the school listing the medical services to be provided to the student at school. 
The school site administrator is responsible for: 
  • Meeting with the school nurse, parent/guardian, private‑duty person, supervisor of the private‑duty person, and teacher(s) prior to the private duty person’s providing services. 

  • Reviewing school and school board policies for: 

    • Confidentiality. 

    • Expectations for professionalism. 

    • Importance of not interrupting instructional time for all students. 

    • Channels of communication. 

    • Documentation of services and access to those records. 

    • Medication policies and security protocols. 

    • Crisis response and safety procedures. 

    • Coverage during lunch and other breaks. 

    • Coverage on field trips. 

    • Documenting the conference and obtaining signatures of all participants. 

    • Providing appropriate documents to the agency and private-duty staff. 
The agency employing the private-duty staff shall be responsible for: 
  • Providing a name and phone number for the supervisor of the private-duty staff. 

  • Providing a written description of the duties of the private-duty staff. 

  • Providing documentation of appropriate TB test results of private-duty staff. 

  • Providing documentation of appropriate criminal background checks of the private-duty staff. 

  • Providing an appropriate substitute and informing the school site administrator in the event of the absence of the private-duty person. 

  • Providing the review of school and school board policies for the substitute. 

  • Assuring the private-duty staff complies with all Frederick County Public Schools policies and regulations. 

  • Collaborating with the school site administrator to resolve any conflicts that may arise. 

  • Assuming responsibility for liability issues that may arise with the private-duty staff. 
The school nurse shall be responsible for: 
  • Managing the student’s cumulative medical record. 

  • Collaborating with private-duty staff to implement the medical care plan. 

  • Assist with implementing the care plan in the event of an emergency. 
The classroom teacher shall be responsible for: 
  • Implementing the instructional program. 

  • Assuring confidentiality for all students is not breached. 

  • Managing the classroom. 
The private-duty staff shall: 
  • Provide primary care for the student as directed in the medical care plan. 

  • Maintain documentation of necessary treatments, procedures, and assessments that occur during the school day. 

  • Provide a copy of that documentation to the school nurse. 

  • Refrain from interrupting classroom instruction. 

  • Model expectations for professionalism and maintaining confidentiality as stated by the school site administrator. 

  • Follow all school site rules for staff as deemed appropriate by the school site administrator and agency supervisor. 

  • Comply with all appropriate Frederick County Public Schools policies and regulations. 

  • Report any changes in the medical care plan to appropriate school staff. 

  • Report any changes in the student’s medical status to appropriate school staff; i.e., need to alert parent or call 911. 
The parent/guardian shall: 
  • Provide a copy of the current medical care plan to the school. 

  • Collaborate with the school nurse and other school staff to assure appropriate care for the student and to support providing an appropriate instructional environment for all students. 

Adopted: January 4, 2005