Medication Mishap - page 4

Got a student who has ADHD badly and she tends not want to take her medication and I was told in the beginning that she's a liar and that we need to keep an eye on her to take her medication. I... Read More

  1. by   Viviana
    Amethya,

    What is an AP? You may want to consider buying lunch cups of Applesauce, put a spoonful of applesauce in a medication cup, then open the capsule into the applesauce and administer with a spoon. Never, ever allow medication to leave your administration area. It should be swallowed, and a buccal check done to assure that the med has not been cheeked or placed under the tongue.
  2. by   Amethya
    Quote from AJJKRN
    Are you serious? This "brat" isn't the one that made the mistake! If the kid gets severe stomach pains, vomits, and can't eat on her medicine do you really not understand her "difficult" behavior. Aren't you the adult?

    Regardless of whether you truly want to help children and need your job, I find your reasoning both extremely jaded and dangerous. I have yet to meet a MA that has the skills and education to appropriately give medications. Your actions should have consequences...from somebody...like a state board or something and then maybe there would be a greater incentive to get your act together and keep it together.

    Geez, I did try to stay out of it but repeatedly bashing/blaming a child that is acting like a child just frustrates me to no end.
    I'm sorry you feel this way. I tried to be extremely patient with this child, and it's hard. Yes I did make a mistake and I already talked it out with the people in charge of me.

    The reason I'm upset with the child because my trust with her is gone and it was my fault for trying to trust her.

    Before she came here I was told by her files and such that she's a compulsive liar and manipulative, very hard to reason and very defiant. I was warned on this behavior, but I wanted to give her a chance. As someone with ADD, I kind of understood her difficulties and wanted to help.

    Before I gave her the first dose, I explained to her that I want to trust her and work with her on this. But as time went on I saw and been told if things happening, both students and staff. She's violent and aggressive , constantly fighting and acting out. I tried to talk to her, our counselor and AP tried to work with her and her mother asked me basically to do the tongue check because she will not take her medication at home. It's a struggle for us here with her and she refuses to cooperate! I understand why she's like this because of my research on psychology and personal experience.

    I have suggested mother that if she feels the medication is not a good fit to go talk to her doctors to see what other medications they can try.

    But today it became apparent that I can't trust this kid. I want to but I can't now.

    I understand that what I'm writing seems mean but it's hard to understand from my perspective and I'm honestly trying to help her.

    I can't force her to take her medications but I'll try my best with her.

    i forgot to mention she's a 13 year old girl.
    Last edit by Amethya on Dec 6
  3. by   Been there,done that
    Quote from Amethya
    I honestly don't feel supported. The person in charge of me is always getting up on my case on things, and throws me under a bus when something happens. Then the person above me, doesn't like me and is always upset with me.

    I'm honestly not comfortable here anymore, because while I understand I do mistakes, I'm not a nurse and I keep getting in trouble for things I wasn't told what to do for things that happen.

    I really want to find another job, but I don't want to work in clinics anymore, but in schools, helping an RN doing her job with children.
    Wherever you work, they should not have you administer medication.
    Last edit by dianah on Dec 7 : Reason: Terms of Service
  4. by   SaltineQueen
    Quote from ruby_jane
    I will never, ever let any medication with street value out of my office unless it's been swallowed in my office. Change your policy immediately and you will then lose the she said/she said about whether the student took the med or not.

    As far as re-administering...do you have anyone with a nursing degree in your district whom you could ask that question?

    Child no longer has your trust. You've changed the way you do business. End of story.
    I'm late to the party, but I agree with this. Kids take their meds in front of me, controlled substance or not. I've had kids who we thought were cheeking meds & I made them show me their (hopefully empty) mouth. No more taking meds to the drinking fountain, period.
  5. by   Flare
    You can't blame the 13 year old here. Heck, i've had 8th grade students that have appeared to swallow pills only to find out that they've been cheeking them and spitting them out later to prove that they don't need them. You can be sure that when I figured out that was happening, the trust was gone, and that child spent the rest of his time with me doing a swallow and then opening his mouth "wide, like a lion" he hated that - but you have to control the situation. With grace and tact. Even now, i have a smaller one that doesn't really give me problems with taking her medication - but won't swallow her pill unless prompted - she will stand there and hold it in her mouth (yuck) and the kicker is the reason she does that is because she says she hates the taste of it. I have tried to explain over and over again that if she were to just swallow it quickly she wouldn't taste it - but that message hasn't gotten through yet. So we continue to do this dance and she does NOT leave my office until she opens that mouth.
    I like the idea given to seek work as a paraprofessional or nurses' aide type position in the school. I really do feel that the OP does care for children and does have their best interests at heart - but I feel that the cumulative posts show a pattern of being overwhelmed by this job and a lack of support by the rest of the staff and admins. A job working one on one with a child with needs may be the right fit.
  6. by   OhioBPH
    Quote from AJJKRN
    I have yet to meet a MA that has the skills and education to appropriately give medications.
    I find this pretty insulting. As a CMA with 7 years of experience giving medications and injections I have an incredibly low error rate, and have made no errors while working in school health.

    Our department is managed by a local children's hospital and we have detailed policies and training and strict rules to follow within the the clinic. We also have a district nurse as well as a whole administrative team available just a phone call away. Every new med that comes in, the RN comes to review the order, and it is administered by me, and MA. Most of our districts utilize MAs in clinics if there is not a demanding medical situation within the school. We are quite successful as a department, and have a strong reputation within our region.

    I think the ability of a MA to pass meds adequetly is all in the training and policies. There is another organization here that staffs clinics with MAs and they are terrible, but even their nurses are terrible.

    Its frustrating to see nurses making sweeping generalizations about medical assistants as a whole. The educational process and training varries greatly from school to school and workplace to workplace. Just like any job there are bad ones and good ones.
  7. by   JenTheSchoolRN
    Quote from OhioBPH
    I find this pretty insulting. As a CMA with 7 years of experience giving medications and injections I have an incredibly low error rate, and have made no errors while working in school health.

    Our department is managed by a local children's hospital and we have detailed policies and training and strict rules to follow within the the clinic. We also have a district nurse as well as a whole administrative team available just a phone call away. Every new med that comes in, the RN comes to review the order, and it is administered by me, and MA. Most of our districts utilize MAs in clinics if there is not a demanding medical situation within the school. We are quite successful as a department, and have a strong reputation within our region.

    I think the ability of a MA to pass meds adequetly is all in the training and policies. There is another organization here that staffs clinics with MAs and they are terrible, but even their nurses are terrible.

    Its frustrating to see nurses making sweeping generalizations about medical assistants as a whole. The educational process and training varries greatly from school to school and workplace to workplace. Just like any job there are bad ones and good ones.
    Sounds like you have wonderful support and training, which is great! I think that is essential and with it MAs are invaluable in a school setting.

    But I don't think the OP has that support or training, which just stinks for everyone - her, the kids, the staff.
  8. by   OhioBPH
    Quote from JenTheSchoolRN
    But I don't think the OP has that support or training, which just stinks for everyone - her, the kids, the staff.
    I agree, and she has supported that. And it does stink. I just get my feathers ruffled when my profession is disregarded. It also makes me apprehensive about entering nursing school, because I do not want my teachers, peers, and preceptors to assume that my experience has no value.
  9. by   tining
    Quote from rkitty198
    This is a terrible situation. At first I thought OP was an RN and was internally roasting her for the error. After reading through and realizing she has a position in which she does not have the skills qualified for the job, shame on the school for having a staff member give pills to kids who are not nurses. I feel for you OP. I see that you are in a hard place. You clearly love kids, need a job and want to help, and know you are in over your head. I don't think you go to work thinking "I can't wait to harm a child today!" It's a very hard position to be in I am sure. I do empathize with what you are going through.
    I would be direct with what happened. Don't get into any emotional aspects, just the facts, as anything more will shake you up and it won't bode well.
    Write a statement, one of the facts of what happened, what you plan to do personally to fix it and what you plan to do policy wise to fix it.
    Good luck.
    I am being harsher towards Amethya as her many previous posts have alarmed me and I am trying to convince her that her reputation is on the line and student safety. For the student/patient/client safety I will stick my neck out to be a bad guy. She is inadequately supervised at this charter school. There are other MA's who do a fantastic job and I am guessing they have adequate support. There is a history with this OP being overwhelmed and definitely not supported by her office or Lead Nurse. I believe she would be valuable in a different kind of position with children.
  10. by   JenTheSchoolRN
    Quote from OhioBPH
    I agree, and she has supported that. And it does stink. I just get my feathers ruffled when my profession is disregarded. It also makes me apprehensive about entering nursing school, because I do not want my teachers, peers, and preceptors to assume that my experience has no value.
    I actually think you will find the opposite - I have several friends in nursing school with CMA and MA experience that was valued. They also had great connections, which helped in the job search after.
  11. by   NutmeggeRN
    Quote from tining
    I am being harsher towards Amethya as her many previous posts have alarmed me and I am trying to convince her that her reputation is on the line and student safety. For the student/patient/client safety I will stick my neck out to be a bad guy. She is inadequately supervised at this charter school. There are other MA's who do a fantastic job and I am guessing they have adequate support. There is a history with this OP being overwhelmed and definitely not supported by her office or Lead Nurse. I believe she would be valuable in a different kind of position with children.
    This.
  12. by   ohiobobcat
    Quote from Amethya
    The reason I'm upset with the child because my trust with her is gone and it was my fault for trying to trust her.

    Before she came here I was told by her files and such that she's a compulsive liar and manipulative, very hard to reason and very defiant. I was warned on this behavior, but I wanted to give her a chance. As someone with ADD, I kind of understood her difficulties and wanted to help.

    Before I gave her the first dose, I explained to her that I want to trust her and work with her on this. But as time went on I saw and been told if things happening, both students and staff. She's violent and aggressive , constantly fighting and acting out. I tried to talk to her, our counselor and AP tried to work with her and her mother asked me basically to do the tongue check because she will not take her medication at home. It's a struggle for us here with her and she refuses to cooperate! I understand why she's like this because of my research on psychology and personal experience.
    If mom told you to do a tongue check on the student, then you do the tongue check EVERY TIME. You do not allow the student to leave the room to take her medication unsupervised when mom has specifically asked you to visually assess whether the student has taken her medication or not. Medication administration is NOT the time to try to establish trust with a student who has the history you are describing.

    It sounds to me like you wanted to be "the one" who this student could come to, and that you are empathetic to her situation. I can appreciate that, but you were told by multiple people/her files that she is defiant and a compulsive liar, yet you trusted her to leave your office and your supervision, to take a controlled medication on her own. And even though you have some personal experience and have read some stuff, you are not trained or qualified to be the person who helps this student overcome her issues, unfortunately.

    I have to agree with other posters here. Based on this and the multiple other issues you are having at this place of employment, it might be time to consider another career option. And maybe do some soul searching. A lot of the issues you seem to have are with your coworkers. In my opinion (for what it's worth anyways), I can see having an issue with 1 or maybe 2 coworkers. You seem to have issues with everyone, from your secretaries to your AP, to your direct supervisor. You talk about reporting people for real (or perceived) things they have done to you. Have you considered that the common denominator for all of these people you have issues with is.....well, you? Things to think about: do you come off as abrasive? Are you polite (even if you are super irritated inside)? Do you ask questions when you are unsure of something? Do you talk down to people? Do you smile? Do you engage in small talk... like "Your son was sick the other day, is he feeling better?" What do you think you can do to improve your relationship with your coworkers?

    I am not saying you do or don't do any of these things. Just some food for thought for you.

    I know you have been struggling a while in this position. And I truly believe you do have the best interest of your students at heart. But you have to be SAFE about it. And what you did with this student was not safe (I think you know that now).
  13. by   SchoolNurseTXstyle
    I have to agree, my medication kids take their medication right in front of me - no ifs, ands, or buts. I also would NEVER give a second dose unless I had that first does in hand (or in sight at least). I would rather have the student miss a dose than get double dosed. This means a call to the parent to explain everything.

    In fact, I have a few kids that take ADHD meds at home but have a few extra at school just in case. The parent has to e-mail me (so I have something in writing) that student did not take at home and parent is requesting. This is how I cover myself. I don't want someone coming back later saying their kid had all these bad side effects because I double dosed.

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