Job Description

1:1 School LPN (Medically Fragile Student)

District: Lenoir County Schools Department: Exceptional Children (EC) / Student Services Reports To: School Principal & Lead School Nurse (RN) Employment Type: Full-Time

The 1:1 School LPN is responsible for providing continuous, direct medical care and support to a specific medically fragile student during the school day. This role ensures the student can safely access their education in the least restrictive environment. The LPN functions under the supervision of a Registered Nurse (RN) and in accordance with the North Carolina Board of Nursing Scope of Practice and the student’s Individualized Healthcare Plan (IHP).

Essential Duties & Responsibilities

Direct Clinical Care

• 1:1 Medical Management: Provide continuous observation and nursing care for the assigned student throughout the school day.
• Procedural Skills: Perform specialized medical procedures as required by the student’s IHP. Common procedures may include:
  • Enteral feedings (G-tube/J-tube management).
  • Tracheostomy care and suctioning (oral/nasal/trach).
  • Seizure monitoring and administration of emergency medication (e.g., Diastat, Nayzilam).
  • Catheterization or ostomy care.
  • Oxygen administration and pulse oximetry monitoring.
  • Diabetic care (insulin administration, carb counting, pump monitoring).
• Medication Administration: Administer daily and PRN (as needed) medications in strict accordance with physician orders and district policy.

Student Safety & Transport

• Transportation Support: Accompany the student on the school bus to and from school to monitor medical status and intervene during emergencies (this is a standard requirement for 1:1 roles).
• Mobility Assistance: Assist with transfers (e.g., wheelchair to stander), positioning, and lifting as required to prevent skin breakdown and promote comfort.
• ADL Support: Assist with Activities of Daily Living, including toileting, diapering, feeding, and hygiene.

Documentation & Communication

• Charting: Maintain accurate, timely, and confidential documentation of all care provided, vital signs, and unusual incidents using the district’s health log system.
• Collaboration: Communicate effectively with the supervising RN, classroom teacher, and parents regarding the student’s health status.
• Emergency Response: Recognize signs of medical distress and immediately implement the Emergency Action Plan (EAP); initiate CPR/First Aid if necessary and contact EMS (911).

Qualifications

Education & Licensure

• License: Current, unrestricted license to practice as a Licensed Practical Nurse (LPN) in North Carolina.
• Certification: Current Basic Life Support (BLS) / CPR certification for Healthcare Providers (American Heart Association or Red Cross).
• Experience:
  • Minimum of 1 year of nursing experience preferred.
  • Prior experience with pediatric patients or in a school setting is highly desirable.
  • Experience with specific equipment (ventilators, feeding pumps) relevant to the student's needs.

Knowledge, Skills, & Abilities

• Working knowledge of the NC Board of Nursing laws regarding delegation and scope of practice.
• Ability to remain calm and proficient during medical emergencies.
• Physical ability to lift up to 50 lbs and perform duties requiring standing, bending, and kneeling.
• Sensitivity to the social and emotional needs of students with disabilities.