Section 3: Delegation of Assisted Daily Living Skills (ADLS) by the School Nurse

Introduction to care

The paraprofessional or delegatee (educator or other school and program personnel):

• is a member of the team
• understands the responsibility and importance of their role assisting students with special healthcare needs who attend a school or school sponsored program
• shows compassion, patience, empathy and understanding when assisting students with healthcare needs
• knows how to perform basic assistive tasks such as hand-washing, oral care, feeding, transfers and diapering, and other tasks as delegated
• Understands the importance of their role in communication
• Maintains confidentiality
• Documents the delivery of care

Put yourself in the learner’s shoes

When providing care for learners, the delegatee puts themselves in their child’s shoes. It is important to remember that kids are kids first, regardless of their age, ongoing health needs, or disability. Learners want to participate in their educational program with their peers as much as possible. Encourage children to be as independent as possible, when developmentally appropriate. The delegatee should work with the delegating school nurse and education team to determine what skills the learner can do independently and ones that they need assistance with. The role of the delegatee is to support the student’s access to their education program. There are many serious conditions that necessitate special treatment and all children deserve compassion, empathy and respect. Familiarizing yourself with the  child’s conditions or disabilities and the impact on their daily functioning will assist you in providing quality delegated health service delivery.

Preparing to provide care

In the new role or prior to providing any care to a student, the paraprofessional or delegatee will want to learn more about the learner, their health, and their treatment needs. Communication with the school nurse, child’s parents or program staff who have been providing care is vital. Great questions to ask include:

• Who has been providing care prior to you?
• What routine has been followed?
• What is the student capable of doing?
• What limitations are present?
• What are the child’s triggers or calming techniques to use (if applicable)?
• How can you help the student practice self-care?

When working with any learner, the paraprofessional will need individual training and required supervision from the delegating registered nurse as they learn the interventions associated with the child’s overall plan of care. As the paraprofessional continues to work with the licensed nurse and child, they must stay up to date through communication with the delegating nurse and document the care they provide, the student or learner’s response to that care, and any observations they have to share.