Do you need an order for otc's

[RNOTODAY, BSN, RN]

I have a question for you guys...

Inorder to give otc meds, such as tylenol, do you just have to have consent from a parent, or is a md order needed, and does this vary from state to state? I am asking because I work in a residential facility for psych/behavioral prob kids , that also has a day school on campus. We, the nursing dept, give all sorts of otc's with no standing doctors orders,to the kids that reside there (with a consent from parent/social worker upon admission)... but accept a letter from the parents for the day students.

I am not comfortable with this, as as nurse, I think we are doing the wrong thing by giving any otc w/o an order, .... but then again, for kids at our school, and in regular public schools, just a signed form from the parent will do. I dont know where to find this info.... can anybody provide insight?

I am uncomfortable giving kids that reside at this facility tylenol, cold syrup, etc w/o an order. help!!!

[EricJRN, MSN, RN]

The schools where I sub will give both OTC's and prescription meds as long as a parent note accompanies the med in its original container.

[RNOTODAY, BSN, RN]

The schools where I sub will give both OTC's and prescription meds as long as a parent note accompanies the med in its original container.

eric, is there a standing order somewhere from an md?

[EricJRN, MSN, RN]

No standing orders... and there are no meds sitting on the shelf for any student that may need them. If it's not the student's own med and if the student's parent doesn't provide the note, they get no medication.

[NRSKarenRN, BSN, RN]

Same in PA: No standing order from MD needed. School sends out treatment request card. Must have returned card from parent approving acetaminophen, ibuprofen or Tums AND supplying med in our school district.

One of my staff is Philadelphia school district RN, and they have stock med bottle due to many low income students not supplying and don't want kids to miss school, still need signed card or phone call is made to parent for permission.

This may vary from state to state depending on state regs.

[RNOTODAY, BSN, RN]

thanks... would anybody know if this would apply to kids in a "residential facility"? Like I said, we have a consent signed, but no order from any md.

it just doesnt seem right.

[luvschoolnursing, LPN]

the school where I work requires consent from a parent for otc and from a physician for prescriptions. I hate it. Half the kids there have an order for tylenol/motrin and don't think they can get through the day-hit by a dodgeball, headache without otc. I think making it this easy for kids to get tylenol, etc is teaching them the wrong thing. I wish it was a little harder to get it ordered for them.

[michigooseBSN]

In our town we practice under the following state law. "Under Massachusetts General Laws, a licensed nurse must have a medication order from a physician, dentist, nurse practioner, or physician's assistant in order to administer any medicine, whether it is a prescription drug or over-the-counter medication" No room for confusion.

[Jolie, BSN]

Our school district (in Nebraska) requires a physician's order and parental permission for OTC meds. If a child requests Tylenol, Motrin, etc. but does not have an order, the parent is called to bring it in and give it.

Our district does not employ FT nurses in any of the buildings, so most of the time, it is the secretary or a TA who administers approved medications.

[Jeanine]

New Jersey state law requires a written MD order and parent signature for all medications, including otc's. This order needs to be renewed every year, and parents are required to supply the student's medications in our district. To diagnose/prescribe medications is outside the standards of the nurse practice act.

The school physician has written standing orders for oxygen and epi-pen in an emergency situation, and Mantoux as required by the state law.

We are also not allowed to dispense otc's to staff. I do have a locked box with a stock supply of apap, asa, ibuprofen, antihistamines, tums, and mylanta that the staff have access to and may help themselves as needed. I'd rather have a locked, stock supply than have teachers keep their own in their desks.

I don't know how the law appllies to students in residential facilities though. I think that there are certain differences when your facility is considered the guardian/caretaker of the child. You need to search your state laws in that regard because you don't want to risk your license.

[bergren]

This is a state by state issue.

Even if your state allows it, your district may have a policy against it.

You should not be giving OTCs to adults in building either if state law prohibits it.

[luvschoolnursing, LPN]

That's interesting, because we hand out Tylenol or ibuprofen to adults all day long...now I'm wondering if that's legal.