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Board mulls action on student DNRs

Spotsylvania School Board considers medical policy, approves 2006-07 budget

By MELISSA NIX

Date published: 5/27/2006

By MELISSA NIX At an all-day work session yesterday, the Spotsylvania School Board discussed developing a schoolwide policy on "do-not-resuscitate" orders.

Such an order tells medical providers how to respond in the event of an individual's serious illness or injury. A personal doctor usually issues the directive, based upon a family's or individual's wishes.

Spotsylvania County has one student with a DNR order. Board members grappled yesterday with whether school personnel should observe the orders or give all the life-saving care possible to any student near death. Life-sustaining care could include mouth-to-mouth resuscitation or restarting a heart that stops.

Legally, only medical personnel are bound to follow a DNR directive. School nurses, as school employees, are not.

Representing different points of view were two school nurses and Don Taylor, assistant chief for Spotsylvania County's fire, rescue and emergency services.

Taylor referred to the orders as a means for someone to "pass away with dignity."

"That does not mean EMS personnel don't give care; it means we will not breathe for you or restart a heart," he said.

"We will respect DNR orders regardless of which policy you choose to follow," Taylor added.

However, if resuscitation of a person with a DNR is initiated by school personnel before an EMS team arrives on school property, Taylor said, emergency medical technicians would move the child to an ambulance, continue resuscitation and seek further direction from hospital officials.

"We'll say, 'This is what we have: a child with a valid DNR. Should we continue resuscitation or stop our efforts?'"

Registered nurse Patricia Smith, who directs the schools' health services division, said a schoolwide policy is needed.

"We are most liable when we don't have a policy about DNR," she said.

Board members asked the nurses for their opinions.

Laurie Dykes, Parkside Elementary's nurse, said she would follow school policy, whether it followed DNR orders or not. She just needed a policy, period.

Chancellor High School's nurse Maggie Mahalak took a different stance.

"If I have a doctor's order to DNR [a student] and the school issues an anti-DNR policy, I would be very troubled," Mahalak said.

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Date published: 5/27/2006