School Nurse Incident in Orlando. What Would You Have Done? - page 2
I'm not a nurse yet, so I only know how I feel about this. What should this nurse have done? What would you have done? Nurse refuses student inhaler during asthma attack School says medical... Read More
21May 25, '12 by mc3I apologize in advance if this posting is too long. I live in the county next to the one this occured in. I am also an elementary school nurse. The FL State Dept. of Health works with the schools in creating a clear protocol for medication administration. Students are not allowed to carry inhalers, period, unless the parent has signed an authorization for the school to administer it, and the MD has authorized it. Otherwise, the inhaler is brought to the clinic by the parent in the original box the Rx is on, and they sign a consent. The Rx is considered a doctor's order. If there is no Rx label on the box, there is no way for the nurse to know if he is truly supposed to have the med, or did he take it off Uncle Fred's dresser. And yes, that has happened. It addition, there is no route, no time, no dose, etc that every MD order must have.
Therefore the nurse can't give it. That is the law! This is made clear in the student handbooks signed by both the parent and student at the beginning of each school year. It is also clearly spelled out in each individual school's web sites. It is also explained to parents if they bother to call and ask. Students have been known, in the past, to carry inhalers, not tell anyone, but then play around with it and let their friends try it out with unintended consequences. Believe me, it has happened in my district!
I watched the news story several times. I saw it and was astonished. First, as I understand it, there were no, repeat no signs of any respiratory distress. There was none observed by the nurse, nor was it observed by any other witness in the school that was there at the time. He was sitting in the administrator's office waiting until his mother came. Does anyone seriously think that a nurse, administrator, and anyone else in the office who even thought they something wrong would not have called 911 if it was needed? Second, the school found the inhaler in his backpack during a security check. He wasn't trying to get it out and use it. It was found. The school did not know he had it. There is no order on file for it. The school called the parent, and they were on the way.
The nurse followed the protocol, the law, and the Nurse Practice Act. Is it not drilled into our heads since Day 1 in nursing school that you do not give medications to anyone without a doctor's order? And yet, the nurses name and schools name have been dragged through the mud. Now the parents plan to sue the nurse, and the school district. Of course. And their attorneys comment? "even if it was the law, the law needs to be changed". And changing the law starts at the expense of this girl's livelihood, and the school's reputation? I do not know the circumstances of what lead up to the student supposedly being locked out of the clinic. I'm sure I'll hear it and whether it's the truth or not, we'll never know.
I'll just end this by saying I am sick, sick, sick to death of parents like these. All school nurses know exactly what I mean when I say every school has them. The ones that couldn't be bothered to spend 5 minutes filling out paperwork. The ones who have no clue about what really happened, but go shooting their mouths off without knowing the facts. And the lawyers who latch on to the nuts in the name of "justice" but it's really just lining their pockets that matters. I've had kindergarteners bring in needles from Dad's supply. I've had kids bring in liquids and pills, ear drops, eye drops and insulin/syringes that their parents told them to give me. Does anybody think about what could happen if the inhaler, or pill, or syringe gets into the wrong hands? And these parents have brains?
All I can think is, this could have been me. It's just blowing my mind. This could have been me.
mc3Last edit by TheCommuter on May 26, '12 : Reason: reformatting
0May 25, '12 by PetsToPeopleWe really don't need any more info than was provided. The child complained of SOA (whether he was faking it or not is no matter), he had a prescribed inhaler but according to school policy the school nurse was not allowed to administer it or give it to him to admin to himself so 911 should have been called immediately. This covers the school, the nurse and above all, the complaint of the child/student. When the nurse did her PA, if there were no s/s of SOA the nurse should have tried to get a hold of the mother, but if she was not immediately available then 911 should have still been called.
Of course the student became irrate...I suffer from asthma myself and so does one of my children...it must have been horrible to feel like you are suffocating and have the people who are supposed to keep you safe do nothing, and we can all agree that nothing was done as the inhaler was not administered and 911 was not called.
3May 25, '12 by Anna Flaxis, ASNI am witholding judgment until more information is available. So far, we do not have the nurse's side of the story.
0May 26, '12 by PetsToPeopleWhat info is needed from the nurse? The kid complained of SOA, he had to be treated. If she could not give him his inhaler, then she should have called 911.
0May 26, '12 by jeannepaulWow, My son has asthma and I had to get the form signed but they still didn't let him carry his inhaler with him. My son can be a "drama king" but I would rather error on the side of caution and just give it to him than not give him something he needs.
6May 26, '12 by Esme12, ASN, BSN, RN Senior ModeratorQuote from PetsToPeopleI agree that if someone is in distress, yes call 911. But this is also a school full of teenagers who love drama and to disrupt things.We really don't need any more info than was provided. The child complained of SOA (whether he was faking it or not is no matter), he had a prescribed inhaler but according to school policy the school nurse was not allowed to administer it or give it to him to admin to himself so 911 should have been called immediately. This covers the school, the nurse and above all, the complaint of the child/student. When the nurse did her PA, if there were no s/s of SOA the nurse should have tried to get a hold of the mother, but if she was not immediately available then 911 should have still been called.
Of course the student became irate...I suffer from asthma myself and so does one of my children...it must have been horrible to feel like you are suffocating and have the people who are supposed to keep you safe do nothing, and we can all agree that nothing was done as the inhaler was not administered and 911 was not called.
The other thread has a link to an aired news story. It gives a different point of view. Parents Of Student Denied Inhaler Get Attorney - Orlando News Story - WESH Orlando
At 17 y/o aggression is not the solution when you are short of breath. Inhalers are abused for the "hyped" up feelings that are produces when abused. I am skeptical that the young man had blue fingers and lain on the floor. The other news story was a little more credible.
It sounds like the school has had issues with this family/young man in the past and he was in no danger. It seems the young man was never given medical attention even after his mother was called and she went to the school finding him "blue". The mothers attorney is the attorney for Casey Anthony's parents.......a bit of a media monger.
I am skeptical........http://allnurses.com/school-nursing/...es-714434.html.
3May 26, '12 by xoemmylouoxI am sure that as the truth comes out we will find out that the young man was not knocking on deaths door. I have horrible asthma. When I have a "severe attack" like was described a puff from an inhaler doesn't cut it. I hope this nurse gets herself a good lawyer. I see drama all the time from parents, and I'm guessing this is more hype than anything else.
6May 26, '12 by Whispera, CNSI wonder how much time elapsed between the taking of the inhaler and the asthma attack. Was it the same day or days later--days in which the mom could have filled out the needed paperwork. Did the student often have asthma attacks? Wasn't the inhaler and its packaging in rather unused condition? Wouldn't this indicate it wasn't used or hadn't been used much? The mom was called when the asthma attack occurred and she came to the school...
The student ended up ok. How'd this happen? Was he given his inhaler after his mom arrived? How was he able to use it as he had collapsed, closed his eyes, and felt like he was dying? Was he conscious? Was 911 called after he collapsed? Otherwise, how'd he get revived? Or, was his collapse an act for drama-purposes? Or were other things going on that triggered an asthma attack and things escalated from there? I'd wonder about the usual behavior of the student.
The locking of the door bothers me quite a bit. I can't figure out a reason for that at all. Otherwise I think there was a huge lack of communication as well as some media focus on things for sensationalism.
1May 26, '12 by JustBeachyNurseQuote from PetsToPeopleWhat is SOA? That's not an abbreviation I've heard before. I've heard of SoB (shortness of breath) in relation to respiratory complaints. I'm a severe asthmatic myself...if my child were asthmatic all paperwork required would have been in place prior to the school year start.What info is needed from the nurse? The kid complained of SOA, he had to be treated. If she could not give him his inhaler, then she should have called 911.
If the child was a drama king faking an asthma attack out if spite, then call 911,and let mom deal with the repercussions of an unecessary ER visit that might not be covered by insurance. If his behavior was threatening and escalating an assessment by psych emergency screening services may have been ordered by the ER doc too.
0May 26, '12 by Esme12, ASN, BSN, RN Senior ModeratorQuote from Ladylynn6That's ok.....they'll merge it if they feel they need to.My apologies. I didn't know there was a school nurse forum, or that this was already being discussed.
0May 26, '12 by LongislandLPNJust going by the story printed ( i think theres more to it) I would have called 911 immediatley, put him on 02 2L/min NC and probably given him the inhaler.
0May 26, '12 by unleish05I'm trying not to pass too much judgement because this sounds kinda fishy but this is horrible !! 911 should have definitely been called and if you have the ability to save a life then you should do so as best you can...not standing there waiting for the cows to come home...smh !!! I'd probably sue the school if i had a child in that situation.
0May 26, '12 by VICEDRN, BSN, RNI gotta say as an ER nurse and former EMT, I would have called 911 the minute he presented to me without a signed release form. I have seen asthmatics ambulate to the ER and be intubated inside of 30 minutes as their condition deteriorated. I think the fact that 911 was not called before the mother arrived pretty much says it all and then he died.
I agree that you can't administer the medication without the release form and the lines have to be drawn and enforced on this stuff but I still would have called 911!!!!!