Advice for Medication Administration

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Hi fellow school nurses,

I am currently dealing with an issue that has taken over my entire day at the school since the holiday break and really need some advice/insight.

I have a 10 year old student with Autism and is non-verbal. It has been such a struggle to give him his medication for months...and without this medication he is very dysregulated. In short, it is a power struggle: he has a voice, he can say no, and just doesn't take it. Eventually (after like 2 hours) he will give up and take it. 2 hours to give one medication to one student is just not a sustainable plan. So here is where I need your help...

Any out-of-the-box, creative ideas to med administration? He has a very limited diet, does not drink anything but water, and has extremely sensitive taste buds.

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Specializes in School Nursing.

Is there a behavior plan of any type in place? A reward system he works for that this can be added to as a "task to complete"? Does he do the same amount of refusal at home?

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Specializes in ICU/community health/school nursing.

This probably is one of those multidisciplinary issues that needs at least the involvement of SPED and consolation with his ARD. I can't imagine how frustrating that must be for you. All my kids willingly take their meds....

Awkward question - does he have the right of refusal? It's an ethics question and I don't know the kid. Age 10 seems young to be able to refuse but I think a lot of that is dependent on individual district factors.

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Specializes in Pediatrics Retired.

Is the medicine available in a transdermal patch like Daytrana?

Is this a booster dose, after getting the am dose at home, you are giving at school?

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We are a DIR school (http://affectautism.com/wp-content/uploads/2016/05/What-is-DIR.pdf) so a reward system, task completed, etc. is not part of our methodology. However, we have used a comparable system and even that isn't working. Its all about him feeling empowered and having the ability to say "no" to something that he does not want to do (which is fantastic!), but lacking the ability to understand that taking his medication will help him.

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Yeah...we have the ENTIRE team working on this...

Because he is 10, parent has guardianship, but I will have to look into that. given that he has Autism he may not be granted the right legally. Good questions!

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He had a patch previously and couldn't tolerate it...

I thought about contacting a compounding pharmacist, which hopefully mom will agree too.

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No...they are the first dose

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And yes... same amount of refusal.

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Specializes in Pediatrics Retired.

And what is the reason he can't have this at home before school?

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He gets one medication at home (7 am) and another one in school (9:30a) per the order. He is refusing to take it at home also.

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Specializes in School Nurse, past Med Surge.

What kind of things will he eat? Applesauce, pudding, cheese? What kind of rewards is he motivated by?

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