Something for all you school nurses...

Specialties School

Published

First off, I am not a nurse. I am a caregiver for a diabetic relative who has mobility issues due to a stroke. I am also a teacher assistant for a first grade class in a school that has a large population of health-challenged students (mentally and physically).

There is a student in my classroom who has been just diagnosed with asthma. Her mother brought an asthma inhaler to the school nurse without the proper letter from the physician/documentation. The school nurse where I work (an RN) accepted the asthma inhaler from the mother because, as the nurse said, she would rather we have the inhaler there and explain it later than for it not to be there and the child have an attack and need it. The nurse one day called me to the door of my room and told me the child would be carrying it in her backpack (backpacks are kept in lockers during school hours). She said she had discussed it with the child's mother, and they had agreed to keep it in the child's backpack, but not let the child know that it was in there because she would be tempted to take it out and play with it (that was the red flag right there that she wasn't responsible enough to have it in her backpack). The nurse told me that if she needed the inhaler, to let the office know. The child has never been observed having any asthma symptoms at school.

It sounded like a bad idea to me, but I have only been in education for about 7 months (most of that time as a substitute teacher). However this RN is the one that approves how meds are handled in the school, so I didn't argue with her.

Well, the crap hits the fan yesterday! I find out the child is carrying the inhaler around in her pocket. I take it from her and remind her that she is not supposed to have it. Too late! While on the playground during an activity that where neither the teacher nor I was present, this child has let about 8 children take puff from the inhaler!! All of those parents had to be called, and there are parents that are still upset today.

I am not a nurse, and I am not trying to act like I am, but I think it was a bad idea to accept the inhaler from the parent without the proper documentation in the first place. If this had of been a different kind of medication, then this could have been much more serious. I mean, I am sorry if a child does not get the meds they need because their parents do not bring the proper documentation, but that is the parent(s) fault and not the school's. The other kids have to be protected too. If it is a medication a child really needs, and the parent goes through the right process to have it at the school, I can't see a school not working with that parent.

Just thought you all might find this helpful or interesting.

I had a run-in with a parent at the beginning of the school year wanting to drop off an inhaler. Although the inhaler had the prescription on the box, we can't accept any without a physician filled out and signed Asthma Action Plan. The family had just moved from out of state and hadn't gotten a local pediatrician yet so the form couldn't be signed. After a long battle over district policies, I refused to carry on and simply stated that I don't write the rules, I just enforce them. I gave her the blank Action Plan and let her know that I was glad to take the inhaler when she has a pediatrian sign it and she huffed out of my office. A couple of days later the teacher found the inhaler in the girl's backpack which is against multiple policies with the district and our school (we are only K-2..too young to be carrying their own meds). I once again had to address the mom who was not happy. They've now been in town for a month and a half which I feel has been more than enough time to find a pediatrician...we are a small town and only have a couple of pediatric practices...so I've ran out of sympathy. The girl's backpack gets checked everyday with no inhaler being found, and the mom has failed to contact me further.

We never want anything bad to happen to the students, but if anything did, it's on mom now. She knows our policies and was given the Asthma Action Plan and has now had more than enough time to find a pediatrician. It's so sad but with our school getting sited for taking meds without that sheet last year and me being a new health aide this year, I have been very carefully crossing all of my T's and dotting my I's.

Specializes in School Nurse, Maternal Newborn.
Keeping it in the office would not be acceptable. If a child has an asthma attack they need it right away.Time spent going to get it, unlock a door or a drawer could be the difference between life or death. A young man died in my area because he had left his in his locker.By the time someone managed to get it he was gone.

But I do agree that he proper documentation should be followed.

When dealing with a 1st grade student, we do NOT let them carry, it IS kept in my office. If an asthmatic child is complaining of respiratory symptoms, they would be escorted down to my office by a teacher or another student. If doing that poorly, the classroom would call me in my office and have me bring it, but if they were that bad, I would probably need to call 911, anyway.

There is not much information given regarding the boy that died in your area from "his inhaler being in his locker". The boy probably would have had other things going on, such as bronchitis or other respiratory infection, or perhaps exposure to an asthma trigger, thus exacerbating his asthma. Also, there obviously was a problem with staff not recognizing his distress and not calling 911 in time to save him. This is what asthma action plans are for!

Specializes in School Nurse, Maternal Newborn.
If I were a betting gal, I would bet the nurse put it in the backpack to cover her butt for not having the proper documentation from the doctor. After all, it's not in her possession, right? Pretty dumb way of handling the situation, though. Look how it backfired!

I know a mom who frequently self medicated her child and shares her kids' meds. She's also one who stops abx early because, after all, the kid isn't sick anymore. She puts them in her cupboard for the next time the kids get the sniffles. That mom is what makes me say what I'm going to say next:

I understand that if a child needs their inhaler, they need it NOW, but if it were my @$$ on the line, that parent would have driven home or to the doctor's office or wherever she needs to go to get the doctor's note. I wouldn't accept a med without it. Not worth the insanity that this nurse is about to go through, and rightfully so. I'd be mad as hell if one of my kids was one who used that inhaler.

I think it was a pretty crummy thing to accuse the nurse of; "planting" the kids inhaler in the child's backpack. What evidence to you have for that?

+ Add a Comment