Question
I am an RN and I do some home care for a 3 year old boy. This young child was born at 23 weeks gestation due to abruption of the placenta. He had some rough months in the NICU and then went home on a ventilator 5 months later. He has done very well since
Answer
Many school clinicians of my acquaintance have very high caseloads, consequently, they are very busy people! Since they are in a position where they do not always have regular contact with families, they may not automatically provide home programs. However, most that I know will gladly provide a home program if they know there is interest in one.
First, let the parents know that you are interested in facilitating a home program, and find out if the parents are interested in doing the same themselves. If they are, they should contact the school therapists to express their interest and begin the process. The parents can choose to share the information they receive with you.
If the parents are unable to work on a home program at present, it would still be good to let them know that you are interested. They will need to sign a release for you to communicate directly with the school therapists. Once they have done so, you can call the school and discuss home program activities directly with the therapists, and arrange for some form of regular communication as the program progresses and the child advances. Ask if you can come to the school to observe if your schedule allows. This can be an excellent way to begin a collaborative process.
If you are employed by an agency, your agency may have some sort of release form for you to use. If there is no form, a simple letter signed by the parent stating, "I give permission for the therapists for (child's name) to communicate by phone, in person, or in writing with (your name, RN) for the purposes of home programming and coordination of care." This can be sent to the school, to the attention of the therapists. The school may require a similar sort of release to be signed by the parent on one of their own forms. Be sure to include your phone number on the form.
It would not be ethical or even possible for me to make any more specific suggestions in this case without knowing the child. Your best resources will be the child's therapists. I suspect they will be quite pleased to know that you are interested in facilitating progress at home.
Thank you for your interest in doing this for your patient!
Lynn Marty Grames, MA, CCC-SLP, has been a team member of the Cleft Palate and Craniofacial Deformities Institute at St. Louis Children's Hospital since 1982. Her practice with the Institute focuses on cleft palate/craniofacial diagnostics, therapy, and clinical research.
