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.
Specializes in med-surg, IMC, school nursing, NICU.
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.
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.
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.
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.
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.
I think that will change with the newest FDA guidelines coming out regarding codeine and tramadol. ( I have never seen tramadol prescribed for a pediatric patient )
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.
I just saw the newest recommendations yesterday posted on the AAP site. Mom did hand me the bottle and it was Tylenol with codeine and this kiddo is 8 years old. I am not sure if the ortho prescribed or if the ER prescribed. We are now 12 days post injury and the child is still on it.
Our policy is very vague and we are discouraged from accepting them. I won't accept them unless there are very extenuating circumstances, like cancer or a chronic pain diagnosis where the student has shopwn tolerance for the med. I think that narcotic pain relievers are unsafe in the school setting, and sets us up for a lawsuit. If we administer the medication, knowing the side effects, and the student develops side effects, drowsy, dizzy, and falls down the stairs and becomes injured, we get stuck holding responsibility since we should have known the potential for something like that could happen. Besides, if they are impaired by the prescribed med, whats the difference between being impaired by an illegal drug. Impaired is impaired, it's simply a safety issue.
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JerseyTomatoMDCrab, BSN
588 Posts
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.