Crazy Parents

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I had a 7th grade student come to school yesterday with a bottle of Focalin in his back pack. He brings it to me in the morning with no papers from the parent or doctor. (The bottle is labeled). I called the mother and told her I am not able to give her child his medication without a medication consent form that is signed by the doctor and her, and said she will need to come give him his med and also, that an adult needs to bring his medication to school. She said her car has been broken down for 3 weeks and she can't do anything about it. She said, "Well have fun with my son's crazy behavior then." I faxed her the medication form so she can sign it and send to the doctor. I come to work today, beginning of the year, DROWNING in shot records, and of course I still have nothing for this student. OF COURSE. He comes in to take his med and I tell him I cannot give it to him because I still have nothing from his mom or doctor. I call her and she is IRATE that i will not give him his med. She says that she faxed it to the doctor and it is out of her hands now and it is ridiculous that I will not give him his med. Her car is broke down (she tells me again) and she can do nothing. (NOT MY FAULT RIGHT???) She said her son is going to get sick now because he isn't getting his med. She says to just hand him the bottle and let him take his med. I told her to call my supervisor and I also had my principal call her. We heard nothing back so far. She was yelling at me so crazily. I am so stuck!!! What would you have done??? Of course now I think something is going to happen and he is going to get sick because he has no meds. She has gotten to me and I shouldn't let her. She could take the bus, cab, call a friend. She has had 3 weeks to figure it out. she said her son has been in the district for 5 years and expects me to use orders from previous years. UGH!!

It may be a huge liability. I'm shocked EMTs can give any medications other than EpiPen, glucagon & MDI (or asprin & nitro) even in the role of "school health assistant". You may want to check with your state certification board. If something goes wrong you risk your certification as medication administration (other than the few above) is out of the scope of EMTs. Medics in my state are considered EMTs unless working on a MICU/ALS service and only under the direction of an emergency department physician protocols. I know of no state that medics or EMTs can work under the direction/delegation of an RN.

There was a huge issue at a local camp that used an EMT instead of a nurse for health officer. She missed an assessment and in turn a significant medication error. She knowingly acted out of scope and was not covered by her liability policy. She lost her certification at the national level for acting out of scope. Now the camp only hires LPNs or RNs now offering tuition in lieu for reduced pay to save costs (a better deal as the cost for camp was not cheap)

If an EMT, who doesn't have the scope or training, to assess for an OTC or PRN Rx (other than EpiPen, glucagon, MDI or ASA/nitro), makes an error in judgement the liability will be huge!

In our state we can provide medications if it is under the supervision of our on staff medical direction. We have an LPN on call at the D.O. as well as a partnership with a doctor's office that will routinely provide training on different areas such as vision and hearing screening and dental issues.

Our liability falls on the higher staff if issues arise. At least, this is what I learned when going through school. I will definitely be double checking this issue.

This is also why we can not give out any OTC unless there is a signed Rx from a doctor with all important information.

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I find it extremely annoying when parents make it MY issue to make sure their child has a med order. It's not my responsibility to fax the dr and request a new order every year but yet I'm expected to more and more because the parents know I'll do it. I do it for the kids not the parent. Now if we could just figure out a way for me to go pick up their kid's medication for them...

My district supervisor expects this from all Health Technicians. I believe it is because we have just enacted what they call a "new health initiative" regarding OTC and Rx.

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Its not the kids 99% of the time. It's the parents.

I can't like ^ enough!!!

mc3 :nurse:

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I won't fax orders as a general rule either. It sets a bad precedent. The only time I have done it is if I KNOW the parent has tried to no avail. I know this will sound snarky but I find it interesting how some parents can always find a way to get to the store for cigs but the MD? No can do. Ridiculous.

Like the parents who tell me they can't pick their child up with a 102 fever. "No car."

Call a neighbor, friend, someone...But get here. No excuses.

Yeah can you tell I am gearing up for the school year? :bugeyes:

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I had several meds show up on the first day either with kids or dropped off with the secretaries. I called parents and told them I would give the med one day on their verbal ok, and that they would have to sign the permission forms I sent home with the child and send it back the next day. It worked pretty well and I got them back.

I won't even do that.....if they can't come give them the med, they need to come pick it up and give it themselves as I will not. No verbal OK's. And no, I'm not sending it home with the student. Call me mean, but I've been burned way too often.

mc3:nurse:

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I have seen some kids freak out if they miss a day of medication, but it is more mental than anything physical (Routine interrupted, etc). And the child may not have taken this medication over the summer (many don't), so would be starting up again at the beginning of the school year.

However, given what the OP presented, I have a feeling this will be more than just one day without a med. It could take quite a while for this parent to follow through and I understand how frustrating that can be.

Yup!!!

mc3:nurse:

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The doctors office cannot fax us anything anymore without the parent signing a release. I tried all that. Today was the worst so far. She has done nothing but try and make this my fault and has been super condescending. I told her I refuse to speak with her if all she is going to do is insult me. It is a three times a day med. we finally got the orders and of course they say for 1130 and 330 (when school gets out). His lunch is 1230 - 1. I had to call and clarify with her and she was so mean. My principal is so amazing. She said she will be the one to deal with her from now on. What a nightmare. Is it even worth it? I feel so abused.

Try not to take it to heart.....you did what you should have done, you were polite and you followed policy. You have a principal that backs you up, which is wonderful. Yes, it is worth it when a parent thanks you for taking care of their sick child, or a kindergarten class makes homemade cards to give to you for Nurses Day, or you get sticky hugs :) from your little ones!

mc3:nurse:

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Specializes in Community Health/School Nursing.
I have sent my district's School Medication Permit home with the student for the parent to fill out their portion and return. Once I get it back I FAX to the physician to complete their portion. Generally works out well.

I do this more often than not because if I wait on a parent then it could be half the year before I get all my paperwork completed. Plus, I can hand the paperwork to the parents and they will royally screw it up. They will fill in all the blanks where the doctor needs to fill in. Like for an inhaler where it says dosage and a parent writes "Squeeze it two times when he can't breath". Oh, thanks. Got it. lol That cleared it up.

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I have sent my district's School Medication Permit home with the student for the parent to fill out their portion and return. Once I get it back I FAX to the physician to complete their portion. Generally works out well.

That form gets mailed out by each school with all the registration stuff during summer break so hopefully they get it done before the first day of school. But not always.

You are better than me. I won't do it.

I won't do it either.

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Specializes in School Nurse.
I won't fax orders as a general rule either. It sets a bad precedent. The only time I have done it is if I KNOW the parent has tried to no avail. I know this will sound snarky but I find it interesting how some parents can always find a way to get to the store for cigs but the MD? No can do. Ridiculous.

Actually, most of the time I am doing this for hard working parents to save them the trip. I see this as a way of advocating for my student. While many of my parents are on top of it and get the form filled out prior to school, some do drop the ball and forget. Or, the need for a med is unexpected, such as an injury (I've had 2 broken legs and a sprained ankle already this year) for which the student needs to take an anti-inflammatory, and the parent is not familiar with the district policy because their child has never had to take medication at school. It takes me 10 seconds to FAX an order so I do not mind. Also, I have a good relationship with a couple of large pediatric practices so I tend to get my Medication Permits back very quickly, often with a few hours.

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I find that some MD offices will gladly fax thing to me, while others will not without a signed release form...So more often than not, the parent has to go there anyway to give permission. I think it is ridiculous that some offices won't even share a physical form with the school, especially since it is state law that certain grades have it done!

I understand advocating for a student, but with 600+ students, I would be spending a lot of my time faxing back and forth AND trying to get the parent signature on the forms. I have done it, but I won't allow it to become the norm. I have already spent too many hours than I can count calling, mailing, faxing begging for my incoming students to have the proper immunizations. This year it seems I have taken hand holding to a ridiculous level already.

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We have to have a signed release to get any info from the doc faxed . . . . .

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