Who delivers PT? (aka round 2 already)

Discussion in 'Special Ed 101' started by slsh, Oct 2, 2006.

  1. slsh

    slsh member since 1999

    IEP states 60 mins of direct PT. Apparently, 1:1 RN is being instructed by PT on how to do ROM exercises on Boo. She cannot do his lower extremities for various reasons (her age and a previous injury combined with- Boo's tone resembling a 2 x 4). Isn't someone with- some kind of certification supposed to be doing this?? My goodness, for a program that wanted an rx just so he could eat a sandwich, you'd think they'd pay more attention to who is doing PT (which in my mind could have much more serious consequences if done wrong????).

    I'm going to check ISBE site because I seem to recall there is actually a "best practices" packet for Occupational Therapist (OT)/PT there, or there was 3 years ago, but I'm about to *stroke* out here because RN is ticked off (assertive woman which is good for Boo), PT is not doing any ROM with Boo, and per RN PT's reasoning is that a more appropriate nurse should have been hired (like RNs are falling out of the sky around here). If we lose this RN... we're down to 1 day of school every other week until a replacement is found. Venting here and hoping for rational reasoning because I'm about fit to be tied. It's going to be a *long* year.
  2. Sheila

    Sheila Moderator

    I would assume there may be some things a Physical Therapist could train an aide (nurse) to do, however, Physical Therapists are licensed/certified by the State of Illinois.

    Regarding school, PT is a related service just like Occupational Therapist (OT), speech-language therapy, etc., and should be provided by the corresponding professional in that field. The IEP should state who the school district appointed to deliver the service.

    If the school district doesn't have a PT, they can (and should) contract with a private provider.

    Yep, sounds like it's going to be a long year.....
  3. Sheila

    Sheila Moderator

    I found this right off the bat.

    Sec. 0.05. Legislative Intent. This Act is enacted for the purpose of protecting the public health, safety, and welfare, and for providing for State administrative control, supervision, licensure, and regulation of the practice of physical therapy. It is the legislature's intent that only individuals who meet and maintain prescribed standards of competence and conduct may engage in the practice of physical therapy as authorized by this Act. This Act shall be liberally construed to promote the public interest and to accomplish the purpose stated herein.
  4. dreamer

    dreamer New Member

    Usually an RN can and does do rom under the direction of a PT. A pt is needed for assessment, evaluation and periodic review, but rom is a maintancne thing done several times daily as routine.
    The nurse should be able to provide rom as part of her care that she is there to provide. (actually even aides can perform rom)
    I have a feeling the school is going to say that if this nurse cannot do rom due to her own health problem, then it is the nurses health problem that is the problem and that she does not have the physical ability to do what could be considered part of her job. Isn't her job attending to his ADLs and needs? If she is being paid to do this job....they could view this as having to pay extra for someone else to do what they consider they are paying her to do.
  5. dreamer

    dreamer New Member


    Even a simple nurses aide can deliver rom. (nurses aides are certified and go to one semester of schooling and then state tested. LPNs and LVNs go to school usually 2 semesters and are licesned by state and RNs go to school 4 semesters or more and are licensed by state)
    ROM is one of the many competancy skills learned and tested on.
  6. Martie

    Martie Moderator


    Sorry I am late on this one.

    Do you want to keep this RN or not? If she is otherwise good, and it is her health problem, then I would push for contracted outside services. This comes up ALL THE TIME when SDs think they can just "skip" related services bec. the PT or Occupational Therapist (OT) or S/P is out on meternity leave, in an auto accident, takes family leave, yadda, yadda, yadda.... Suffice to say that the substitute teacher system isn't great BUT if any of the above happened to a teacher, SDs do NOT close the classroom because "no one is available."

    Related services are regarded lightly by most school district and can be extremely important for certain students. I would not let this one go.



    This is a "push out" but I always say that--because I believe this will be never-ending until the school district understands that Boo is not leaving school with his class.
  7. slsh

    slsh member since 1999

    Thank you ladies. Yes, I want to keep this nurse (LPN actually). She's been with- Boo before and I feel extremely confident that she can handle any medical crisis that comes up - I can't say that about all his nurses, but I have very little say in who is his nurse. And it's not like there's a wide selection of available nurses to choose from.

    I have call in to head nursing supervisor with- the program, and also to PT. PT stated, per nurse, that she didn't have enough time to do Boo's ROM because there are so many kids. Sounds like a personal problem to me.

    Will document conversations, since this is the second time in 2 weeks I've been told or heard excuses about not enough staff to comply with- IEP, and send documentation certified to appropriate admin staff.

    D'ya think if I just sent a certified letter to all adminstrators involved advising them that Boo *will* be remaining in the program thru ESY of 2010, regardless of stunts, they'll back off??? (ok, kidding... maybe)

    I'm also trying to get some support re: the whole IEP thing anyway. You would be *stunned* at the junk they snuck in there (my bad for not reading it 3 weeks ago). 30 mpw of "interagency linkage". My eye. There *is* no interagency linkage. 30 mpw of "vocational". Nope. Not a single solitary vocational thing until next month when I go look at workshop. Sigh. I have a call in to ARC, who has a fantastic transition manual, to see if there's a been there done that person who can help with- this. As a transition IEP, it fails completely to address anything remotely related to transition and I feel like I'm pushing a boulder uphill to get them to do it. I just don't know what to ask for, what's reasonable, and school district staff is astonishingly mute on the subject, other than I *must* do the stupid PUNS and apply for SSI for him. Educationally meaningless.

    If school district is going to force me to address these trivial *ridiculous* things, then I might as well address the whole shebang. I'm flunking warrior 101 because I am just so tired of pounding my head against an immovable wall.

    Thanks again.
  8. Martie

    Martie Moderator

    You are not flunking. It's just harder than average now because they want Boo to leave.

    BE VERY CAREFUL THAT THE TRANSITION does not contain a terminal date before Boo turns 22. The could sneak it in if you are not careful.

    When you said it sound like a personal problem, I'm confused....Did you mean "personnel?" It could be either: staff shortage or staff back problem. It does not matter, really, but lack of adequate staff is becoming a problem.

    RE certified letter: I would be very tempted to send it--after you can articulate what you want for the intervening years. I'm sure you can come up with sequential goals.

    Why will ARC be helpful/appropriate? I guess I don't have a clear picture of Boo--when you talk about his humor and opinions, I do not picture him as cognitively delayed but do realize he has quad CP. Am I missing something?

    You need to keep your :warrior: on tight. I know it is hard.