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Tube feeding, injections: Not trained to do that, say student assistants

What if something goes wrong? That's the worry of NAPE members who look after children with serious medical issues — with little or no training.

Stress levels rise as 1 student assistant wore bubble wrap to prevent injuries from biter

NAPE President Jerry Earle said student assistants are frustrated and under high stress in the classroom, because they are being asked to perform duties outside of their job description. (Eddy Kennedy/CBC)

Student assistants are performing medical procedures on children in schools without proper training or certification, according to their union, and they're worried something could go wrong.

Some assistants regularly handle tube feedings and do injections. In some cases, the only instruction they get is from parents.

Jerry Earle, the president of the Newfoundland and Labrador Association of Public and Private Employees, said there have been no serious mishaps to date, but the union is concerned about liability issues.

"If it did [go wrong], where would that liability fall?" he asked. 

"Would it be on the school board? Would it be on the student assistant performing that delegated medical act without proper training?"

'I think this is so wrong'

"Student assistants are performing very delicate duties without proper certification," said one student assistant who has nothing to show she is capable of administering feeding tubes.

"Brenda" [not her real name] wishes to remain anonymous to protect the identity of the student in her care.

The child uses a gastrostomy tube, which comes with a high risk of complications, most of which are minor, and include wound infections and leakage. Major complications are rare, but can be fatal.

The student's mother came in on the first day of school, and five student assistants gathered around to watch as she tube fed her child.

After the demonstration, four of the student assistants began doing tube feedings unsupervised, while Brenda refused.

I love my job ... But I would not advise anybody to become a student assistant.- Brenda, student assistant

She requested a nurse from public health to train and certify the assistants, as was the procedure a decade earlier when she last had to tube feed a student.

Brenda said a public health nurse did come to the school, but did not offer any official certification. Without it in writing, she is afraid of legal ramifications if anything goes wrong.

"At the present time, I am expected to perform a tube feeding on a regular basis with no certification to show that I have been properly trained. I think this is so wrong."

Difficult situations

With inclusive classrooms bringing students of various needs together, Brenda said assistants are unsure of which students fall under their care. Instead of offering one-on-one help to students with severe needs, they are tending to children they are not required to care for.

Brenda said the student assistants end up looking after younger children who need help in the bathroom, or students without a diagnosis who are acting out in class.

And then there are the horror stories.

Brenda described a co-worker who bubble wrapped her arms to protect her from a student who was a biter.

The extra duties, mounting stress and dangerous work is taking its toll.

With nearly three decades of experience, Brenda still enjoys aspects of her job, but she doesn't know how much longer she can work.

"I love my job ... But I would not advise anybody to become a student assistant," she said.

Stress level a 9 out of 10

Student assistants are currently in collective bargaining, and their union has heard about the rising stress levels.

"If I was to use a range of one to 10, it's certainly at a nine," said Jerry Earle. "They are very stressed. I think the education system itself is stressed."

NAPE said student assistants are being asked to perform medical tasks without proper training or certification. (Eddy Kennedy/CBC)

Earle said student assistants should not have to deal with the situations they find themselves in.

"Nobody chooses a line of work expecting not to have sufficient resources or have some bureaucrats make decisions that's going to affect the education of the child they are assisting," he said.

"They are certainly not there to see a child harmed or have harm caused to themselves."

ABOUT THE AUTHOR

Ryan Cooke is a journalist with the Atlantic Investigative Unit, based in St. John's. He can be reached at ryan.cooke@cbc.ca.