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Does your district allow narcotics in the clinic?

Posted

Specializes in Peds, Oncology. Has 4 years experience.

Our policy has always been no... if your child still requires narcotic medication, they should be at home getting it, due to the side effects, plus we don't like having it at school regardless of whether or not it's locked up.... We like for kids to come back to school when they're on prn Tylenol or Ibuprofen.

Anyway... I have a precious little snowflake who has already been out 8 days for a broken foot, and mom brought her back in today and mom went absolutely nuts on me because she couldn't leave Tylenol 3 in the clinic for her to receive at lunchtime. She had it home this AM before school. Mom said, "I should have just kept her home then!"

She did end up leaving ibuprofen but she was not happy about it, and was even more upset when I said I would not send home the ibuprofen home daily with her student, that she had to provide a bottle to stay at school.

Happy Monday morning!

Our students are allowed, by district policy. Grammy's policy....really try to talk parents out of it. We've only had it here once, made the student so groggy mom had to come back to pick up snowflake. She took it home with her that day.

cooties_are_real

Specializes in School. Has 10 years experience.

We will, but try to talk parents out of it due to side effects. Have had one student take Tylenol 3 one time and was fine, but took it a 2nd time and it made her really sleepy. So when she came in again for the issue, we called mom to bring IBU. The difference in the 2 days she took it was the 2nd time, we had testing day and she had to sit in a room for an extended period of time, so she got sleepy.

NutmeggeRN, BSN

Specializes in kids. Has 25 years experience.

I certainly discourage it. Often I will encourage them to take hald of a pain pill instead of the whole, (with approval from MD), if the benefit is they get a enough pain relief and not be snowed. I have HS kids who have orthopedic stuff from MVAs and sporting events that need to be here.

It really is a case by case scenario.

ruby_jane, BSN, RN

Specializes in ICU/community health/school nursing. Has 10 years experience.

Hi! Long-time lurker, first time poster. We have an administration of medication form that generally requires a signature for all Rx medication. So, it's possible that a narcotic pain (or any other) medication could be in the clinic. Having said that, unless the kid has sickle cell or another chronic disease where we know that ibuprofen won't work...I discourage it, as previous posters have said. And in that rate event I do accept the medication, I count it in with my aide and document the heck out of how many they started with (I encourage the minimum number of pills, just like for ADHD medication).

Farawyn

Has 25 years experience.

We don't have policy, but I discourage it. I did have a student last year I had benzos for. She took one like...once a month.

We are allowed but I encourage parents to leave me tylenol or Motrin and give the narcotics at home.

Yes. We have to have a doctor signed form on file for all medications, including OTC meds. (We do not provide ANY oral medications. If pumpkin needs tylenol or ibuprofen, guardian must provide and pediatrician must approve.)

I'd rather a Tylenol 3 in my office than all the Adderall, Ritalin, and Focalin that we give daily.

SassyTachyRN

Specializes in Peds, Oncology. Has 4 years experience.

My medication cabinet only LOOKS secure. Sure it has locks on the front, but it's just a wood cabinet you could buy from any store and then had locks installed. The back is just a piece of cardboard backing stapled on. All you'd have to do is basically rip that off and you'd have access to anything you want.

Yuck!! Will the district upgrade??

I'm thankful we have a legit med cart in our nursing office. What freaks me out is all the windows in our office, which was converted from a classroom. If the wrong people knew what windows are ours... :wideyed:

foggnm

Has 8 years experience.

Yes we allow it and I would rather have a kid with side effects then sitting at home missing class!

JustbeRN

Has 17 years experience.

I look at it like my post op days- narcotics are for home use..

Too many liability issues at school, side effects and than there is the daily count that should be done by two RNs. That's what we had to do every day in recovery. anyhow- I would never advise an adult post op to drive under the influence so why would I think its okay for a pediatric post op at school? Its come up like once in my school nursing career so far

JerseyTomatoMDCrab, BSN

Specializes in med-surg, IMC, school nursing, NICU. Has 9 years experience.

I've never had a parent even ask to keep narcotics here. One of my kids had surgery on his foot 2 weeks ago and mom kept him home until he was comfortable enough on Motrin to come back.

I suppose it would be a case by case basis if someone were to ask... although I wonder, like Nurse in MT, how different this is compared overwhelming amount of stimulants I administer on a daily basis.

MrNurse(x2), ADN

Specializes in IMC, school nursing. Has 28 years experience.

Tylenol3 isn't even used in the hospitals, IBU is given instead.

kidzcare

Has 5 years experience.

Tylenol3 isn't even used in the hospitals, IBU is given instead.

My daughter was given Tylenol 3 in the ER with her broken arm last year. But her ortho switched it to Norco right away. And post-op she had Norco and dilaudid.

I have had a student have Norco in the school once. It was after a surgery and a "just in case" dose. He never needed it. I think mom brought in 2 pills.

It depends on how it affects you. I can have Norco and the only result is pain relief. I could drive or otherwise fully function as an adult. But Tyl #3 knocked me out for 12 hours once. The last time a dr suggested it, I declined.

3ringnursing, BSN

Specializes in ICU; Telephone Triage Nurse. Has 25 years experience.

My son missed 2 wks of school for a Fx'd clavicle in 7th grade, and he absolutely still needed the vicodin when he returned still in a sling, poor guy.

The middle school he went to didn't have an RN, or even an MA - it was manned by volunteer parents if you can believe it (the district was in dire straights after a school board member embezzlement and fly by night).

The parent health office monitor was very upset I wanted to sign in 2 vicodin. I was on medical disability at the time, so if he needed it I just drove to the school, signed in and met him at the health office with a snack to go with it. It sucked, but what else could I do? Missing 2 weeks of school was a nightmare to make up, and he was getting stir crazy. By this time he was already acclimated to it and not unfit for school duty.

The day he said he didn't need the vicodin any more was a joyous day for everyone involved.

JustbeRN

Has 17 years experience.

I have to ask- are you really seeing MD prescribing Tylenol with codeine anymore ? Codeine is contraindicated for pain in children. I didn't like it when I did ambulatory surgery and recovered kids and that was years ago.. now they are adding Tramadol to this list....

i know my daughter is a ultra metabolizer via genetic testing years after her T/A. She had a terrible time with Tylenol and codeine after that surgery- switched to two days of roxicet and she was fine.

Edited by JustbeRN

kidzcare

Has 5 years experience.

I have to ask- are you really seeing MD prescribing Tylenol with codeine anymore ? Codeine is contraindicated for pain in children.

It was prescribed in the ER for my daughter's displace humerous fracture a year ago (she was 11). She took it for a week before it was switched to Norco.