Field Trips

I send emergency medications (ie: Seizure meds, diabetes meds, Epi-pens) with the school staff that have been trained in their administration. I also have some first aid materials in the "emergency bag".

If meds are needed, a nurse is required to go. Our staff can only administer Epi for students with known allergies.

I have a kiddo with a scheduled daily medication that must be given on time due to her liver transplant. Dose was drawn up. Bottle included with prescription information. Copy of the medication administration consent form included in a locked cash box that the teacher carried. Kiddo had a great day on the field trip. I wish they all went that smoothly.

13 minutes ago, nursekoll said:

I send emergency medications (ie: Seizure meds, diabetes meds, Epi-pens) with the school staff that have been trained in their administration. I also have some first aid materials in the "emergency bag".

I do the same. For kiddos who take regular daily medications, I call the parents to see if they can skip. If so, I document and rejoice. If they can't skip, I send 1 pill in the original labeled bottle (I keep an extra bottle when I get refills or ask the parents to ask for an extra for me at their pharmacy). Don't just put the med in an envelope and label-this is considered relabeling, and is not supported by your nursing license.

What does your policy dictate you do?

I am required (and the BON supports this) to teach the teachers to administer on a field trip. Which is ok except when we get to the non-delegable (intranasal midazolam for seizure) or the icky (rectal diastat for seizure). If it's a non-delegable medication the parents have been told that they need to come on the field trip (which violates FAPE, I know).

27 minutes ago, ruby_jane said:

What does your policy dictate you do?

I am required (and the BON supports this) to teach the teachers to administer on a field trip. Which is ok except when we get to the non-delegable (intranasal midazolam for seizure) or the icky (rectal diastat for seizure). If it's a non-delegable medication the parents have been told that they need to come on the field trip (which violates FAPE, I know).

I know this is not my thread, and sorry to briefly hijack, but this brought up an important question for me. What do you do for athletes/cheerleaders/etc who require diastat since they go off campus often for "school related" functions??

49 minutes ago, CanIcallmymom said:

I know this is not my thread, and sorry to briefly hijack, but this brought up an important question for me. What do you do for athletes/cheerleaders/etc who require diastat since they go off campus often for "school related" functions??

If you're lucky...they're in HS and there's an athletic trainer who can be trained (not really delegated since they have their own certification) to do this? My athletic trainers did a great job with the kid with new onset diabetes who played three sports.

Question for all the school nurses: for those of you that need to go with the students requiring a med, does that leave the rest of your student population without a healthcare professional to administer their meds?

3 hours ago, BeckyESRN said:

If meds are needed, a nurse is required to go. 

I send daily meds and epipens on field trips, to be admin by the trained teachers (which is simple delegation in my state). I also send along inhalers and instructions to call me if a student is requesting to have it so I can hear about their symptoms or the activity. No OTCs are sent. Seizure rescue meds or diabetic students would require a nurse on the field trip.

Presently, my one seizure disorder student with Diastat is participating in an afterschool club that is school sponsored, and so I am staying late that day in order to cover him.

9 minutes ago, Caprica6 said:

Question for all the school nurses: for those of you that need to go with the students requiring a med, does that leave the rest of your student population without a healthcare professional to administer their meds?

No, we obtain a per-diem nurse; If no sub/per-diem is available, we have a chain of events that go into place where we contact the families and notify them that there will not be a nurse in the building; Then it is up to them - do they want to send the kid knowing they won't get their med (if its a daily med), come in to admin the med themselves, or keep the kid home (more for emergency med kids/diabetics)?

Then, another nurse in the district is "on-call" for emergencies only. We have a "basic first aid" policy/procedures for all staff members to provide basic first aid, but no one will administer meds. If it came down to it, our admin. assistant will make the call to send someone home d/t illness/injury.

Our school policy and Medication Permission Form allow any trained staff member to administer medication if a nurse is unavailable. If a student has a scheduled medication due during the time of a field trip and it is unable to be rescheduled we send the medication (along with proper documentation) with a trained staff member to administer. All teachers have been trained on how to administer inhalers and Epi-Pens so those are all sent on trips. We have a few parents who insist their child needs Dramamine for a 15 min bus ride. Those parents get to stop in to give it immediately before the trip or chaperone!

22 hours ago, jess11RN said:

I do the same. For kiddos who take regular daily medications, I call the parents to see if they can skip. If so, I document and rejoice. If they can't skip, I send 1 pill in the original labeled bottle (I keep an extra bottle when I get refills or ask the parents to ask for an extra for me at their pharmacy). Don't just put the med in an envelope and label-this is considered relabeling, and is not supported by your nursing license.

I had honestly not thought of this, so I looked up the Texas NPA regarding Delegation for the School Nurse.

"According to Board Rule 225.11(1), a RN may delegate the administration of medications from a daily reminder pill container. This rule section also applies to RNs who delegate medication administration to UAPs in the school setting when there is from a properly labeled unit dosage container filled by a registered nurse or another qualified district employee...

Thus, the RN may prepare unit dose medications in a separate container for the designated UAP to administer. There are training requirements stipulated in the rule and it is strongly advised that the RN label the medication including such information as the name of the medication, student's name, dose, time to be administered, and route and adverse effects which may be associated with the medication. Although it is beyond the purview of the BON, Texas Education Code, Chapter 22, Section 22.052 grants immunity from liability to school district employees, as long as current district policy is followed, have a signed parental consent form and the medication appears to be in the original container or single dose container."