AM meds at school

[NurseMMJ]

Hello school nurse friends! I am curious if you all are seeing a significant increase of ADHD meds given at school. Especially in the mornings? The increase at my school is so significant that I have ran out of locked drawer space. The administration and social workers who initiate the med administration at school always say something like "the parents aren't giving it at home, at least we know they will get it here!". One social worker just told me "I am attempting to help them be successful parents". My concern is that taking the responsibility off the the parents and giving it to the school, is not helping them to be successful but rather enabling them.

Im not exactly sure how to fix this or improve this. Any thoughts or ideas?

[jess11RN]

1 minute ago, MHDNURSE said:

I know our few ADHD kids here only take the meds on school days.

Same here

[ruby_jane, BSN, RN]

12 minutes ago, JenTheSchoolRN said:

But I still wonder: weekends, school vacation, summers...how to manage and navigate that.

Not my circus, not my monkeys!

[EnoughWithTheIce]

Medications should be administered at school only if not possible at home. My goal is to make the parent / student as responsible as possible. This being said, there is always the exception - no adult supervision in the morning, has early morning athletics (will give after with breakfast), etc.

However, for stay at home moms who drop their kids off at school - NOPE!!! My suggestion will always be for them to check in 2-3 pills for PRN use. Then, parent has to call or e-mail to verify they in fact did not take so we do not double dose.

As many have said, there is that window of time for the med to kick in. If they are good at coming to nurse as soon as they enter building, it may be possible. However, most of these kids cannot be found until first period and by the time I dose them - that first class is a wash!!!

[kidzcare]

I have only had this with 2 students.

One took his at school because he went to daycare for an hour before school and took a bus from daycare to school. If his parents dosed him before going to daycare, it would wear off before his lunch time dose. Daycare would not give meds.

Another was a junior high kid who had PE first thing in the morning. His heart rate would go up for a little while when his meds kicked in and he didn't want it to coincide with his heart rate going up in PE. He would come take it as soon as he was done changing out of his PE uniform.

[AdobeRN]

4 hours ago, JenTheSchoolRN said:

But I still wonder: weekends, school vacation, summers...how to manage and navigate that.

I don't worry about this. I do have some that only take meds on school days including a few where the parents will call and tell me to hold the dose if it is a fun day like field trips or Field day, when the parent feels that the med is not necessary because the kid is not sitting in class and needing to be focused to learn.

[AutumnDraidean]

Because I see several schools and am aware of some family situations I can see both sides of this coin. I'm aware of a somewhat fragile student who's meds get forgotten from time to time. I know the hows and whys and he should get these meds at school because Mom and Dad leave for work and a high school sibling gets everyone on the bus.

OTOH I saw a student with morning meds at school who should be getting meds at home and I have NO idea why the meds are given at school.

[beachynurse, ASN, BSN]

I will rarely accept medication that is admninistered once a day. I think I've only done it twice in 15 years. At what point are we taking over parental responsibility? Also, being in a high school, we are preparing these students to go out into the world as "adults". I will call them down for the first couple of days if they don't show for meds, after that it becomes a refusal. I inform the parents of this when they bring the meds into the clinic, and will contact them after the student has missed a few days and after I speak to the student as well.

[CanIcallmymom, BSN, RN]

I only have 2 morning meds, I had many more at the beginning of the school year. Both of these students, if they take it before school, end up in my office sick to their stomach and sometimes vomiting. If they take it here, we avoid that because they've had time to eat.

[NutmeggeRN, BSN]

There have been a few, where the parenting was a complete disaster, of epic proportions. Not DCYF level but hovering...he was for the most part pretty good about coming into get it first thing...it made a measurable difference for this kids success and he is on track to graduate on time....win!

[bluebonnetrn, BSN, RN]

I am in the "this can be done but should be the exception" camp here.
I agree that we need to have boundaries between what the school is responsible for and what parents are responsible for. Sometimes I feel like why should your lack of parenting/organization/memory or whatever be *my* problem.
But like someone said it is an imperfect world.
I have only had a few students I have done this for. One is an athlete who has early morning practice before school. So she comes in after she is done with practice.
Another was a student whose parents were divorced and mom and dad argued over whether or not she needed the med. One parent refused to give it so instead of alternating days when she was flopping back and forth between houses it was just easier for me to give it daily. For the record, this was one student who really did need it. The change in her was drastic and noticeable and very positive.
But for the majority we need to stand firm and enforce that some responsibilities are for home and not school. This is good health care anyway!
But it's getting harder and harder to do in this world we are living in.

[OldDude]

I like to remind myself that kids can't pick their parents and nothing I can do will change a parent's behavior, so if having their medicine at school will help them to be successful I'm in.

[ruby_jane, BSN, RN]

36 minutes ago, OldDude said:

I like to remind myself that kids can't pick their parents and nothing I can do will change a parent's behavior, so if having their medicine at school will help them to be successful I'm in.

You are among the wisest of us all.