ADHD Student on Rampage

[Amethya]

We got this student who has ADHD and maybe something else, he used to be worse in behavior but after his parents got him his medication approved to be given twice a day instead of once a day, he has been getting better in behavior. He's a very sweet Kinder student and he's extremely lovable.

But we had an issue last Friday, he was not wanting to cooperate in taking his medication. Usually he's a champ about it and does it, no questions asked. But that day, he was clearly upset and wouldn't listen. I kept asking him what's going on, but he kept just moaning and acting like a little animal (And I mean literally, when he's off his medications, he's speech and all his normal behavior disappears and acts like a small little animal, not speaking and gets into a small ball and refuses to come out.) I thought maybe his mother forgot to give his morning dose, but not that day, he did get his first dose, but he was upset about a situation before I came in. He got a stamp and he was stamping all his classmates and it got taken up. He got mad and that's why he was acting like this.

We kept trying to cohort him out and to listen to me. But he kept just saying "No!" and this kept going to an HOUR. At one point, the elementary coach came and grabbed his hands and was playing it off as she was hugging him, so I took the opportunity to give the medication, but he turned as I pushed the syringe and spit the medication back at my face. I was livid, but I tried to play it off so he can come with me, but he still refused. As I said, this took an HOUR and I was suppose to do my last group of Kinder of Hearing and I wasn't able to.

I'm just at a loss right now, what we should do? The medication has a 4 hour lifespan, (Procentra 5mL solution), and when he gets the medication, he's a good kid, but now I'm not so sure if it's working at all. And not only that, I'm not sure what I should be doing myself, because I'm pretty sure I can't handle him and only a few teachers have the training to handle the children, so I'm not sure what I can do if this happens again.

Any advice?

[OldDude]

Yea, you work in a school, not a psych unit, so forcing a student to take a medicine isn't in your job scope. I will try to convince an unwilling child to take their medicine, I will sit with them and try to re-direct them, etc., I will walk away and return a few times to give them the opportunity to take the med but if that doesn't work I report to the parent that the child is refusing to take the medication and leave it at that.

Along these lines...I do not participate in restraining a student unless I perceive there is imminent danger to themselves or someone else.

[KKEGS, MSN, RN]

I agree with OldDude. If a child refuses to take their meds I call a parent and leave it at that.

[Farawyn]

Yea, you work in a school, not a psych unit, so forcing a student to take a medicine isn't in your job scope. I will try to convince an unwilling child to take their medicine, I will sit with them and try to re-direct them, etc., I will walk away and return a few times to give them the opportunity to take the med but if that doesn't work I report to the parent that the child is refusing to take the medication and leave it at that.

Along these lines...I do not participate in restraining a student unless I perceive there is imminent danger to themselves or someone else.

[kidzcare]

There is more to this than ADHD. I'm surprised a diagnosis of ADHD was even made at such a young age.

Restraining is not appropriate in the school (unless, as OD said, there is imminent danger).

[AdobeRN]

Same here...I would call the parent. I have a similiar situation - If my kid is not cooperating with me I call the Principal, AP or a member of our "Core Team" and they handle it. I just document "student refused, admin and parent notified".

I am not allowed to restrain unless there is a danger to myself, others or the child and even then I have to be careful what I do. Only members of our Core Team are allowed to restrain.

[Eleven011]

Same. I will try for a bit to give the med, but if a child refuses, I let the teacher know and if the student is otherwise causing problems, our director of SPED and her staff step in to take care of the situation. I don't fight with the kids over meds. I will make myself available to them, even coming to where they are at, anytime afterwards if they believe the child is ready to take it.

[Farawyn]

Hamster on a Rampage!!!

[kidzcare]

I am not allowed to restrain unless there is a danger to myself, others or the child and even then I have to be careful what I do. Only members of our Core Team are allowed to restrain.

I've never personally had to restrain a student but at the last school I worked at, there was a SPED student who needed to be restrained d/t lashing out and banging her head on the wall pretty frequently. After each incident, her teacher would bring the student to me and I would check her for any injuries that resulted either from the restraining or self injuries from the lashing out.

[BeckyESRN]

I agree with everyone above. Just wanted to add that maybe on a less animalistic day, you could offer incentives for taking his medication. I've used marshmallows, M&Ms, and go-gurt as incentives in the past with great success.

[Amethya]

The problem is that the admin are always on my butt about giving his medication. If he doesn't take it, he acts out more, and one of the admin gets upset and tells me why I didn't give him his medication. I can't force him to have it, so if he acts out, I can't give it to him.

They sometimes had to restrain him because he had the tendency to run off. I do think there's more to what he has because while we were waiting for mom to pick him up (His behavior got worse, admin ruled he would go home), he started to scratch his arms and face all up until he bled and then he started to bang his head hard on the walls and door, so we had to restrain him for a while, but he kept moaning and whining.

[Farawyn]

^^^ Then this is what you say.

End of story.