Controlled meds on field trips

[Achevy, BSN, MSN]

How do you all handle controlled medications (mostly ADHD types) on field trips?  Do you sign out the whole bottle and have your delegate hold a lock box all day?  I was told I can't just sign out a dose into a different bag or bottle because then it's unlabeled and technically "dispensing."  I asked my other nurses and it appears we're all doing it differently.... our field trip policy doesn't say anything about this specifically.  Something we'll need to write a procedure for, for sure.  I'm in NC and it's my first year in this role.

[NutmeggeRN, BSN]

I sure as heck would not give them a whole bottle!! In my state, we can send one dose and I ask the parents to prove another bottle that is labeled appropriately. Only what  is needed is sent. I hope this helps.

[Achevy, BSN, MSN]

yes it does, thank you!  I definitely wasn't going to send all of it and our lead nurse said I couldn't take out one dose because that was dispensing.  I did a little policy searching, and as nurses, we are in fact allowed to send one dose for a field trip legally.  There's no special consideration for Schedule I or II medications in our policy, we just treat them as securely as we would treat all the other medications.  In leiu of an extra labeled bottle from the pharmacy, we can make our own label as long as it has all the needed components of the order.  Hope this thread helps anybody else new that might wonder how to do it!

[chare]

Achevy said:

yes it does, thank you!  I definitely wasn't going to send all of it and our lead nurse said I couldn't take out one dose because that was dispensing.  I did a little policy searching, and as nurses, we are in fact allowed to send one dose for a field trip legally. ...

As I recall, the North Carolina Board of Pharmacy rules regarding dispensing, and what they consider dispensing.  If you haven't done so, you might ask them for their interpretation of what you are considering.

Best wishes.

[Achevy, BSN, MSN]

great idea, I'll see if they can clarify a difference between regular medications and controlled, thanks!

[beachynurse, ASN, BSN]

If the field trip is during school hours, we have small medication envelopes that we label and put the medication in to give to the teacher. If it is outside of school hours it is the parents responsibility to provide the medication for the trip. 

[londonflo]

beachynurse said:

If the field trip is during school hours, we have small medication envelopes that we label and put the medication in to give to the teacher. If it is outside of school hours it is the parents responsibility to provide the medication for the trip. 

Then you are dispensing ergo with medication in small medication envelopes/ 

[Achevy, BSN, MSN]

In case this is an issue for anybody else, I ended up finding what I needed in our NC School Health Program Manual:  "Early planning for field trips enhances safety of the student during the activity. Guidance provided from the NCBON in its revised 2021 position statement, Assisting Clients with Self-Administration of Medication states, "The unlicensed assistive personnel may not perform pre-filling and labeling of medication holders or syringes.” Guidance from the NC Board of Pharmacy in 2007 instructs parents to obtain a second labeled, child-resistant prescription vial for each medication when possible. The NC Board of Pharmacy also directs that school nurses may "repackage a day's worth" of medication for a field trip."  

[elemnurse007]

We count meds, have teachers sign them out, and recount on return. I'm pretty lucky with a super trustworthy team though!

[Eileen Harrington]

I am looking for some help/advise on how you all do overnight trips. I will be traveling to Disney for the Senior Class trip. Any tips would be greatly appreciated. 

[GdBSN, RN]

I have parents complete the district medication forms for all medications that the student would be taking on the trip. The parents would bring only the amount of medication needed for the trip. The same district policies that are followed on the campus are also followed on the field trip. 

[k1p1ssk, BSN, RN]

Eileen Harrington said:

I am looking for some help/advise on how you all do overnight trips. I will be traveling to Disney for the Senior Class trip. Any tips would be greatly appreciated. 

Not sure where you're located, but the BON in Massachusetts instructed us that if on a domestic trip that crosses state lines, we need to contact the BON at the destination state to get written permission to treat your students for the duration of the trip. They also advised that all care done during the actual travel time should be performed in a neutral setting (I.e. on the bus/plane/in airport) as once you step foot off the bus, you are technically across state lines (and would need to get permission in that state as well).

With that said, I used to do a lot of field trip subbing, and nearly every trip crossed state lines and I was sometimes asked to step in for the trip only a few days before we went. I highly doubt the school I was working for was doing any kind of notification and outreach.