Does this sound strange to you?

[inquiry123]

My neighbor is a school nurse in a school district that is 20 miles away from her home and the school that her child attends. The other day, I witnessed her give an injection (immunization) to her son that she had brought from her work. She said that there was a "standing doctor's order" at her school for immunizations.

Does this sound legitimate? Why wouldn't her son just receive the immunization at his school or at the doctor's office?

I posted in the "School Nurse" forum and received one response, so far. I have other concerns about this nurse's mental stability and her children's well being -- should I report this to someone or is this normal?

[caliotter3]

I have worked with home health nurses who have "procured" immunizations for the client from their other places of employment. I've stayed out of this loop because I wouldn't want to be accused of knowledge concerning theft of the vaccine or the delivery system. It is not something I would do. As for your other reservations concerning this nurse you need to take the action that you deem necessary given the circumstances to which you are privy.

[Fuzzy]

WOW

Maybe they'll start seeling human vaccinations in the feed stores next to the animal vaccines. Maybe in the dairy case next to the milk would make them more convenient. How hard can it be...to vaccinate a human? Animals are easy...it's when they get sick from the vaccination that makes it not so easy. Personally, vaccinations for humans or animals should be done with care. After all a foreign substance is being injected and once injected it is hard to get out should a reaction occur. No second thoughts after the deed is done.

For years we have had human medical personel come in saying I'm a nurse, lab tech., CNA, etc. to buy vaccinations and other injectable medications for their animals because they can "give a shot". They get mad when we tell them that some of these medications are RX only and require a client/patient/ veterinarian relationship. I tell them that we abide by the law. They have no idea that there is maybe more to the procedure than a little "skin prick". We laugh as we joke about the the human medcios vaccinating their own kids. Now I see that it's true.

Fuzzy

[TrudyRN]

You might want to anonymously call the school district DON and inquire of her, without naming the employee, the school, or any other identifying information.

It doesn't sound totally kosher to me. If there are standing orders to immunize, the shot could have just been given at school. Of course, I understand maybe she wanted the child to rest after the shot. What was the shot, anyway?

I did not know that school districts immunized. I thought that about the only meds they could administer were prescription meds that had to be taken during the school day, and some Tylenol and Motrin, with signed permission slips from the parent on file. But the only way to know for sure is to ask the District DON.

And if you do have other concerns about this nurse, such as why would she need to advertise her actions in this particular instance instead of just quietly, within the privacy of her home, giving the shot to her son, do speak up. She could be real trouble or just goofy but I hope you will protect others by speaking up. You could just relate to her superiors what you have seen (not heard from a 3rd party and not verified yourself) her do or heard her say.

You could also just speak directly to her, tactfully, non-accusingly, just as a seeker of knowledge. I know I work with a nurse whose judgement I question and I really am reaching the point where I am going to speak up, as she just hits me as more of a screwball every time I encounter her.

[TrudyRN]

Thanks for the responses.

I thought that nurses that work in hospitals had to account for all medications and that they were not allowed to take medication from the facility (except for home health care type situations.) This person definately has health ins. and takes her children to the local doctor often -- would the child's primary care physician also give her an injection to administer at her home? I think that there would be some liability issues, etc.

I also thought that immunizations were supposed to be monitored in a care facility for a short time to verify any possible allergic reactions -- she let her son immediately go to a 2-hr baseball practice unsupervised and without alerting the coach, etc.

I get the impression that a doctor's order is necessary for a nurse to administer this type of medication. If a "standing doctor's order" is in place for her school, wouldn't it apply to only the students of that school? As some have said, isn't it at the very least "stealing"? At worst, wouldn't it be administering medication without a doctor's order? Wouldn't she have to document that she took the medication for whoever? Wouldn't she have to "chart" something in a patient file? Wouldn't there have to be a consent form signed regarding the immunization?

When she called and asked me to "hold down" her son so that she could administer the injection (doesn't like shots), I refused and asked why not just take him to the doctor's office. I couldn't get a straight answer. Like I said, I have seen/heard some weird things and I don't have a clue what was in that syringe.

I figure if I tell this to someone and I'm wrong, I'll just look like a jerk. If I found out that I should have told someone and didn't, I'd be sick if somebody got hurt.

You were wise to not get involved. Yes, to all of your questions about documenting, etc.

No, I have seen clinics hit wee tiny babes with multiple, multiple vaccines and just send them out right afterwards. Scares the H out of me. Sometimes they don't even give Tylenol first.

[inquiry123]

What was the shot, anyway?

She said it was a tetorifice vaccination.

[All_Smiles_RN]

I also thought that immunizations were supposed to be monitored in a care facility for a short time to verify any possible allergic reactions -- she let her son immediately go to a 2-hr baseball practice unsupervised and without alerting the coach, etc

I have two children and every time they are immunized at the Dr's office, off we go, no waiting. Do you know how unlikely it is that an allergic reaction will occur? Isn't this woman a nurse in case a reaction were to occur?

How do you know she didn't observe her son after this? Did you follow this nurse and her son? How do you know she didn't inform the coach... were you tapping her phone line? Is it really necessary to inform him?

Come on now, I'm sure you could be spending your time doing more productive things.

[inquiry123]

I have two children and every time they are immunized at the Dr's office, off we go, no waiting. Do you know how unlikely it is that an allergic reaction will occur? Isn't this woman a nurse in case a reaction were to occur?

How do you know she didn't observe her son after this? Did you follow this nurse and her son? How do you know she didn't inform the coach... were you tapping her phone line? Is it really necessary to inform him?

Come on now, I'm sure you could be spending your time doing more productive things.

You have more questions than I do! Here's the answers to YOUR questions:

1. I AM the coach. I'm not a doctor, I'm not a nurse -- and I don't have the first clue if allergic reactions are likely or what they might be. I don't know if I should have been notified of side effects or not. His arm became very painful, swollen and he couldn't throw the ball -- I left practice and took him home.

2. I was picking up the neighbor kid to take him to practice with my son...the nurse stayed at her home with her needles and stuff.

You're an RN...don't you immunize your children at home?! Certainly you could do more productive things with your time than sit in a doctor's office waiting for another RN to do the job.

[cardiacRN2006, ADN, RN]

This really is not about protecting her child from the threat of disease. Where did she get the immunization. I work in a clinic and those immunizations are not cheap.

I know lots of people who take immunizations home to their families. In fact, every flu season, lots of people take some home. They are free to us anyway.

I don't see the big deal.

[mauxtav8r]

Ok, so the child is old enough to go to ball practice (at least 4) but won't/can't sit for a shot in the arm from the mom.

I'm very worried about what happens to that child at that house. How many such shots do you think he's had? MBP??????? Anybody?

[Conqueror+, BSN, RN]

If you are really concerned and not just nosy and maybe a little intrusive I suggest you talk to the mother. I think that lay people have NO idea how hard it is to get a license and how EASY it is to lose it or have it suspended. I think that calling and reporting her to anyone is overstepping. That is like ringing a bell. Once you do it thats it. Think along the lines of being accused of rape or child molestation. Even if its proven that the person did not do anything.... you can fill in the rest. Just think carefully because you could be ruining someones career without cause. Given that you are posting this "question" in various places gives the impression that you are overly involved in this womans business.

[DutchgirlRN, ASN, RN]

I thought that nurses that work in hospitals had to account for all medications and that they were not allowed to take medication from the facility (except for home health care type situations.) This person definately has health ins. and takes her children to the local doctor often -- would the child's primary care physician also give her an injection to administer at her home? I think that there would be some liability issues, etc.

Nurses that work in hospitals do have to account for all medications, however, this neighbor does not work in a hospital so nix that one. Home Health nurses do not take medications out to a patients home except for flu vaccine or pneumonia vaccines for those who cannot get to the doctor's office. The only medications the patient has are those which they get filled at their own pharmacies.

What difference does it make that she has health insurance and takes her children to a local doctor? Perhaps she has a good relationship with the doctor and he's fine with the vaccine. I know many doctors who gladly give me samples or prescriptions for me or for my family without the benefit of an office visit or without ever having been a patient in their office.

I also thought that immunizations were supposed to be monitored in a care facility for a short time to verify any possible allergic reactions -- she let her son immediately go to a 2-hr baseball practice unsupervised and without alerting the coach, etc.

Why are you keeping track of this woman? How do you know she didn't alert the coach? When children get vaccinated they are not monitored for a short time. They are sent home with instructions to give Tylenol or Motrin in case of a fever or soreness at the injection site. Tetnus shots do not get sore until the next day. Nothing wrong with the child going to practice.

I get the impression that a doctor's order is necessary for a nurse to administer this type of medication. If a "standing doctor's order" is in place for her school, wouldn't it apply to only the students of that school? Wouldn't it be administering medication without a doctor's order? Wouldn't there have to be a consent form signed regarding the immunization?

You're not a nurse? Sounds like you've been spending too much time on the internet/googling.

When she called and asked me to "hold down" her son so that she could administer the injection (doesn't like shots), I refused and asked why not just take him to the doctor's office. I couldn't get a straight answer. Like I said, I have seen/heard some weird things and I don't have a clue what was in that syringe.

Why would she ask you to hold down her son if she was trying to hide something?

You have more questions than I do! Here's the answers to YOUR questions:

1. I AM the coach. I'm not a doctor, I'm not a nurse -- and I don't have the first clue if allergic reactions are likely or what they might be. I don't know if I should have been notified of side effects or not. His arm became very painful, swollen and he couldn't throw the ball -- I left practice and took him home.

2. I was picking up the neighbor kid to take him to practice with my son...the nurse stayed at her home with her needles and stuff.

You're an RN...don't you immunize your children at home?! Certainly you could do more productive things with your time than sit in a doctor's office waiting for another RN to do the job.

Okkaayyy...you said that the coach wasn't notified. Evidently if you were asked to hold the child down, even though you refused, you did know the child would be getting a vaccine.

The arm would not get painful and swollen until at least 24 hours maybe longer.

I think your statement "you're an RN.../waiting for another RN to do the job" is being rude to our fellow nurse/member considering that you came here to ask for advice and just happen to not like the advice that you got.

P.S. You'd be hard pressed to find an RN working in a doctor's office. Sad but true!

I would stay out of it. If and until her child becomes mysteriously ill you'd be better off minding your own business. I think your whole story sounds hokey. JIMOHO

[TazziRN, RN]

The part that bothers me everytime I see this thread is the statement that there's a standing order at the school. I am not a school nurse but this does not sound kosher to me. I can see standing orders for a child with a chronic illness such as DM, but IZs??? Just doesn't make sense. I see nothing wrong with Mom injecting her own child, but the story is hokey.