Asthmatic Child

I probably would have done the same thing. If you felt like the child wasn't in any danger, your only choice was to put him on the bus, since mom wasn't able to come. You don't want to keep a child off the bus, then have to try to figure out how to get them home.

I didn't feel he needed the squad, but I also wasn't 100% comfortable whim getting on the bus w/o a parent or health care personnel, despite he was going back to his baseline. What should I have done if she didn't answer the phone? It just through me for a loop! Thanks I'm advance!

That's because you're a good nurse! Document the pants off of "parent declined to pick student up." If you could not reach a parent and you did not feel confident sending the kid on the bus....I'd have called EMS. Even though I know that the bus driver will stop and call EMS if needed. Those are individual judgment calls that are made as you are assessing your student and there's no cookbooking them. I would rather not be "that nurse" that sent the child on the bus if s/he is going to worsen. You could document that the child had improved, and that parent declined pick up despite being told the situation. Good job.

I Agree with the others, you did the right thing but make sure you document it well. I would prepare a care plan and emergency action plan detailing what to do in case of emergency, including if Mom does not answer. Get some good emergency contact numbers also.

I am only a sub right now and there was emergency plan but it was very basic. But i also

Seen in the medication log The student had been coming down more Regularly for inhaler within the past week. Maybe the regular should look into a prophylactic dose? His attack was stimulated by activity it was "fun Friday".

Or since he does have asthma w/ frequent pen inhaler use he should be assessed during school hours and not just when he has an attack. But you guys know more than me, I'm Still very new to this type of nursing!

So I asked the Head school nurse and she said if you can't get ahold of mom in that situation and the child was moving air and symptoms were

Improving and not declining put him on the bus. He was not critical enough to be squaded out,

But I felt a parent should have been with him until attack completely subsided. However though my mom is an ER nurse who said she wouldn't have put him on the bus if mom didn't answer put noticed the principal who should have been able to drive student home ( I don't know about this and she isn't a school nurse)

Like I've said I'm still learning everything, but don't the bus drivers get a copy of the care and action plans ?

Like I've said I'm still learning everything, but don't the bus drivers get a copy of the care and action plans ?

It depends. I am required by my policy to send the "bus barn" a list of students who have medical conditions (asthma, diabetes, those with EpiPens, those with seizures...)

The bus barn then communicates this to the drivers - BUT even when we used to train our drivers, we learned that there are always sub drivers who have zero knowledge of what's going on. So reasonably, the only thing I can expect is for the driver to call EMS.

Regarding your replaying this scenario with other nurses: good nurses do this - we trouble-shoot our responses all the time. Never make a clinical decision on what any other nurse thinks or says, though. You're the one on the ground. You are seeing what you're seeing. If your gut tells you to call EMS, do it! No principal I know would drive a kid home....if we're worried enough about the kid getting on the bus then we should call EMS.

There was a catastrophic situation in Philly where an asthmatic child died because nobody was willing to call EMS. Unfortunately, that school didn't have a nurse on duty that day.