Published Feb 27, 2002
HOOPS
5 Posts
Can any of you school nurses given me advice on dispensing medication at school. Our rural school does not have a full-time nurse. My husband is a 4th grade teacher and keeps medications in his room, i.e., inhalers and some sort of cardiac medication. He gives it to the students at certain times during the day. Is this legal? I was a former nurse for 11 years but now stay at home doing medical transcription and to take care of my son who has type 1 diabetes. He is also in kindergarten at the same school this year and I worry about him next year when he will be there all day. They have no policies in effect for his situation as well. Any helpful hints. The school contracts with the health dept. for a nurse but she is only there to do hearing, vision screening, etc. She is not there everyday.
Thanks
Huganurse
317 Posts
Your delema is not just a rural problem. Your husband is considered a UAP. Unlicensed Assistive Personell. The nurse practice acts state that only nurses can give meds. We are not allowed to "dispense medications" either. Only a pharmisist can do this. Giving meds is different than dispensing meds. Your husband and anyone else that gives meds in schools should have had some kind of med administration training that was given by the nurse. What he does is legal though and they assure me the UAP's are not under our license as nurses. They therefore carry their own liability through the schools. If your husband makes a mistake though or doesn't follow school guidelines, he would be on his own and could be personally liable. The teachers in my area have used their union to avoid doing medical procedures and med administration. Our secretaries are the UAP's. The problem is, schools are for education, not health care and the budgets, as tight as they already are, do not include nurses in every school. Many people don't realize this because they remember the school nurse. I currently cover 1000 students each day in different schools. Our nurses cover over 4500 students. We only have time to do immunizations, vision screens, teach med admin to the UAP's and do health awareness lists. There has been a push for years to have a nurse in every school but there is never the money to provide them. How sad it really is that we don't treasure our children more than this during their school years. Many children's only contact or primary contact with a health care expert is the school nurse. Many times it is the school nurse who saves a life or identifies a health problem. It is impossible to educate a student that is not feeling well or has a chronic illness that is not under control via tx/medications. Until we have nurses in all our schools dangerous situations like yours will continue. If I were you, I would be teaching my son everything so that he will know what to do, how to do it, and will know if someone is making a mistake. It is the parents who have the greatest and most powerful voice. It is your tax dollars being spent. You have rights to a safe environment for your child. In public schools it is usually the squeekiest wheel that gets action. They may tell you to come do the care yourself though because they don't have any other resources but I see your husband will be at the same school, I'd suggest that your son go see Dad for his diabetic management. I'd also suggest all parents to contact their legislature reps and school boards to demand a nurse in every school.
Shopper
1 Post
Just read you post. I am a secretary handing out meds in school. I have been looking for info on protection for myself and my family against lawsuits. I had an incident with a diabetic student and parents stated that they were going to get a lawyer. My principal stated that I was protected by the district. I had heard that I COULD be sued personally. Just looking to see what other people have read.
I am outraged that society would be "ok" with a secretary giving meds and not a nurse. If you think about it, in many cases the secretary has about as much education as the students she is helping, much less than the rest of the staff in a school building, yet they are the ones responsible for major health care (life and death) needs of students. The days of just bandaids and throwup are long gone.
hypnotic_nurse
627 Posts
When my kids were in elementary school, we were not allowed to send medicines to school. If the child had to take a medicine at school, the parent had to show up and give it.
bergren
1,112 Posts
"The nurse practice acts state that only nurses can give meds." Actually each state has its own nurse practice act and in some states the principal can administer medication or direct another employee to administer. You would want to check the Board of Nursing and the state's education code for guidance on that issue. Another resource would be to contact your states school nurse consultant.
If a child qualifies for a Section 504 plan, a school cannot refuse to give medication and cannot insist a parent come to school to administer.
Certainly any individual can be sued for harm (I am not a lawyer, but see In Schwab, N.C.& Gelfman, M.H.B., Eds. Legal issues in school health services. North Branch, MN: Sunrise River Press). However, your district is required to provide training for anyone administering medications and should have a policy and procedure for administering medication and its documentation. Most states require a doctors order for a nurse to administer a medication in school, and most school districts will not administer over the counter medications without a doctors order, especially with the increased attention reactions such a Steven-Johnson Syndrome are getting.
Your husband, the 4th grade teacher, should find out if the health department nurse is contracted for specific services (such as those you mention) or if she is contracted to provide health services, or is contracted to provide consultation to staff. I would think talking to her might be a good place to start. Asthma and cardiac meds are nothing to be casual about and could definitely cause harm, and even death, is administered inappropriately. In some states his actions would be considered practicing nursing/pharmacy without a license. In any event, there is an accountable individual in his district (assistant superintendent, superintendent, Director of pupil personnel, or special ed director in most districts) who is responsible for student health and he should find out who that is and find out the district's position.