Do you ever say "no" to an inhaler request?

kidzcare · Dec 12, 2016

I have not. I think the backlash could be pretty severe from a parent. I have given inhalers when I don't see a clinical reason to, but I can only assess chest tightness based on patient report. It would be the equivalent of refusing to give pain medication to a surgical patient who said their pain is 8/10 while chatting with friends. Sure it doesn't LOOK like the pain is so unbearable, but it's subjective.

I did once have a parent very upset with me because their child told them that I refused to give her an epi pen after she asked (never happened, she was not in anaphylaxis and she most definitely did NOT tell me she needed the epi pen). I don't know if the parents ever believed me but almost all her teachers came forward to say that she is a habitual liar.

Nurse_JackieVA, BSN, RN · Dec 12, 2016

I want to but I haven't yet. Some of the kids use their inhaler as an excuse to get out of class and wander the halls then see me right before they go back to class. I'll always give it to them because I don't want it to bite me in the butt later.

The ones that I know abuse the system I'll make it "hard" by assessing their lungs and actually watching them like I was teaching someone to use the IS but the others I grab the bag and hand it over - don't even watch.

BeckyESRN · Dec 12, 2016

I've never told a kid no, but I have called home about frequent use when I suspected that it was some thing other than actually needing the inhaler.

Flare, ASN, BSN · Dec 12, 2016

It's rare - but there are times that I do. I refused last week because one of my kiddos wanted it because she was just running in PE and her "heart was beating real fast" but when i listened those lungs were clear as bells. So i gently told her no, got her a cup of water and took her pulse instead. I also explained to her why I wasn't giving her the inhaler.

AdobeRN · Dec 12, 2016

I have not but sometimes I want to. I do send an email or call parents when I notice a kid using the inhaler more than usual.

SchoolNurseTXstyle · Dec 12, 2016

Never tell a kid no. However, if they are usually using frequently - I do a medical referral requesting a review of maintenance medications.

JerseyTomatoMDCrab, BSN · Dec 12, 2016

I never tell them no either although there have been several occasions where I wanted to. I'm asking because a kiddo today came in "for coughing" and asked for his inhaler. Lungs CTA, coloring great and not a single cough while he was waiting for me to finish with another student. He is a real frequent flier but never asks for his inhaler so I gave it to him. I later asked the teacher how his cough was and she said he wasn't coughing at all, before or after his visit, so when little darling came back an hour later (for something unrelated--- I told you he is a FF) I asked why he said he was coughing when Mrs. Teacher said he wasn't. His reply? "She's a liar."

He's 6.

Oy.

grammy1 · Dec 12, 2016

We have on occasion. Frequently, after running the mile at PE, they mistake SOB from running for asthma. If their lungs are perfectly clear we'll have them wait a few minutes and hydrate. That usually takes care of it. Then there are those that you can hear wheezing as they walk through the door--no stethoscope needed!

kidzcare · Dec 12, 2016

Frequently, after running the mile at PE, they mistake SOB from running for asthma.

This drives me nuts! When the PE teachers are sending me kid after kid who just need to catch their breath on pacer day. Yes, running will make you short of breath. It DOES NOT mean that you need your inhaler.

JerseyTomatoMDCrab, BSN · Dec 12, 2016

This drives me nuts! When the PE teachers are sending me kid after kid who just need to catch their breath on pacer day. Yes, running will make you short of breath. It DOES NOT mean that you need your inhaler.

There is a PE teacher here who keeps a pulse oximeter on her at all times (I didn't give it to her, no idea where she got it) and sends me kids with a note "Pulse ox 95%, needs inhaler"

I can't.

GdBSN, RN · Dec 12, 2016

I had a student last year who was coming pretty regularly for his inhaler, lungs always sounded clear, so I called Mom and discussed not giving it to him as often, she agreed. I talked with the student and teacher (who was also as asthmatic) what symptoms to come to the clinic for. After this, his visits dropped to almost zero. He was definitely using the inhaler just to get out of class.