Am I the only one

[abc123RN]

Need a little advice here. First let me say I love this job, the school and the students! However there is one that I cringe when I see them walk through the door, I really hate feeling this way! So how to handle this? The student is refuses to take meds properly, the family won't return phone calls or answer their phones. I guess that is why I dread seeing this one because of the family. She needs medical attention beyond what can be done at school! I leave messages for the family, send home notes and no response from them. Everyone in the building is aware and everything has been done up to and including phone calls to outside agencies (CPS). All suggestions are welcome! I feel like I am beating my head on a brick wall some days!

[OldDude]

"She needs medical attention beyond what can be done at school..." That statement tells you what you need to keep reminding yourself of. You can only do what you can do within your scope of practice. I will appease and coax a child to take medicine but that's where it stops. I don't wrestle them down and try to force medication administration. If it has to go that far, the medicine won't be given by me at school.

[Wave Watcher]

Can you call the prescribing physician and talk with them? Sounds like you are doing all you can as a school nurse. If we force anything then isn't considered assault/battery?

I had a child that was like that 2 years ago and we ended up using rewards to coax him into taking meds. I think the teacher gave him coins that he could turn in for different things he really liked such as extra reading time, ice cream during lunch, pencil from teh book store....small stuff that meant a lot to the child. Eventually, he would take his meds without any issues and we were able to stop the reward system the following year.

[abc123RN]

Thanks OldDude. I'm dealing with a 5th grade student that no matter what I try they just won't use the inhaler correctly! I get the reply of "dad says this is how you do it" the student then grabs the inhaler, takes two puffs quickly and thinks she is ready to leave.

[100kids, BSN, RN]

Thanks OldDude. I'm dealing with a 5th grade student that no matter what I try they just won't use the inhaler correctly! I get the reply of "dad says this is how you do it" the student then grabs the inhaler, takes two puffs quickly and thinks she is ready to leave.

I swear I have the same student here! I think a spacer would help her greatly and I even asked her prescribing physician if she needed a spacer when I sent them paperwork to fill out but it came back written the same as always except she wrote "no spacer needed." There's only so much we can do.

[NutmeggeRN, BSN]

Ahhh.....I think there is one or two a year that just set me on edge when they come in....usually not very communicative, or they go with one word answers....it is like pulling teeth to try and figure out what is going on....and when you DON'T they go home and say the nurse didn't do anything for me! And then you get the questioning email from the Assistant principal who is "relaying a concern" from a parent. So those are the kids I do over diligence on! A more thorough assessment than maybe warranted with excruciating documentation!!

OK Enough about me!!

I would keep on plugging, try the MD/parent again, and document, document and document!!

Good Luck!

[JenTheSchoolRN, BSN, RN]

There is always one. I've had one teenage student that does great on meds, but when that student runs out, refuses to go to the doc to be seen to get a refill. The kid bounces between family members, so I was always trying to figure out who was best to talk to, have had CPS involved (for many other reasons), and only when the student ran into trouble with the law and a probation officer was added to the mix did anything happen.

I just document, document, document. But it doesn't mean I feel any less frustrated, of course.