Migraine Action Plan

  1. I'm a school nurse at a small rural school (143 kids K-8) and totally new to school nursing. One of the students has a migraine action plan (written by mom) that includes giving essential oils topically or inhaled, himalayan salt for the student to mix with some water and drink, accupressure , Advil liquigels (mom provides the salt, oils, meds) and then the usual stuff of rest, low lights, reassurance etc.

    Is this legit? I have the school form that the parent signs and it looks like our school has had this in place for this child for 3 years. I asked the previous nurse and she said it was just to appease mom and just not to do anything I wasn't comfortable with. Hmmmmm.....
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  2. 20 Comments

  3. by   ruby_jane
    Welcome to school nursing!

    OK, so...in Texas, my BON prohibits me from using treatments that are not FDA-approved/evidence-based. Even with a doctor's orders (which you don't have) I would decline to touch the child, mix the salt, or provide an oil that might cause a reaction in another child who might be sensitive to the smell of lavender/lemon balm/etc. Do I have a problem with alternative medication? No. Do I have a license that limits my delivery of that to someone else's kid? Yes.

    The Advil is evidence-based. Ice pack and darkened cot are supportive. Good luck!
    Last edit by ruby_jane on Oct 19 : Reason: *alternative, not alternate*
  4. by   WineRN
    No no no no no! Not Legit.

    And boo to the nurse who let her get away with it for so long because you are about to be the bad guy for requesting an actual doctor's order and written plan. She is going to be a monster when she is told no after being told yes for so long.

    What is your district policy about medication? Are you within your scope to do alternative treatments in your state (some nurse practice acts actually specifically mention not administering EOs)?
  5. by   JenTheSchoolRN
    Quote from WineRN
    No no no no no! Not Legit.

    And boo to the nurse who let her get away with it for so long because you are about to be the bad guy for requesting an actual doctor's order and written plan. She is going to be a monster when she is told no after being told yes for so long.

    What is your district policy about medication? Are you within your scope to do alternative treatments in your state (some nurse practice acts actually specifically mention not administering EOs)?
    This.

    Ibuprofen, darkness, rest. Yep, I've seen those and can do those with a little bit of paperwork. But do you even have a doctor's note with a diagnosis of migraines or just Mom's report?
  6. by   OldDude
    Not no...but HELL no. Don't even go there!! As the others have said...only FDA approved medication and proven comfort measures.

    Welcome to the farm! Keep us informed how this unfolds.
  7. by   theredhen
    Our policy doesn't really cover alternative meds or therapies, it just basically says "if your child needs OTC meds bring it to school with a detailed note indicating dose and time". I'm going to contact mom today, I'll let you know how it goes!
  8. by   OldDude
    That's the key...OTC medicine. The substance can't be sold as medicine unless the FDA says its a medicine; hence essential oils and similar substances used for alternative therapies are not medicine.
  9. by   WineRN
    Quote from theredhen
    Our policy doesn't really cover alternative meds or therapies, it just basically says "if your child needs OTC meds bring it to school with a detailed note indicating dose and time". I'm going to contact mom today, I'll let you know how it goes!
    Thinking of you!
    I went through a similar situation at the start of the school year and it is just now calming down.
  10. by   Amethya
    Ummmmmm....

    no.

    Ibuprofen, rest and darkness... the end!
  11. by   SchoolNurseTXstyle
    Quote from OldDude
    Not no...but HELL no. Don't even go there!! As the others have said...only FDA approved medication and proven comfort measures.

    Welcome to the farm! Keep us informed how this unfolds.
    THIS!!!!! If student needs all that, it needs to be done at home by mom......

    Himalayan salt. LOL!!!!!!!!
  12. by   theredhen
    I talked with mom and she was fine with taking those things out of the plan, she said he just "liked having options" for treating the migraines.
  13. by   MrsNurse08
    What is Himalayan salt? Asking for a friend.
  14. by   MrNurse(x2)
    The best thing about my new office? Essential oil free, no smell of the spilled oils in my old office. Still smells as I went there a week ago to get something left behind. I will never allow EOs in my office again.

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