Forcing meds

[GreenWitch]

I am a busy middle school nurse in a school with 1200 students seeing between 90-100 students per day. I have several parents wanting me to force their children to take their meds. I explained that I can't FORCE them as it is illegal, also, seeing so many students I can't track them down for their meds, and their parents signed a sheet acknowledging that they understood their children were responsable for remembering to come take their meds. Has anyone else had this problem? If so, how did you handle it?

Thanks in advance!

[bergren]

If you accept a doctors order to administer a medication, it means you must do what a "reasonable, prudent " (legal terms) nurse would do. Just because you are in a school and you ahve a heavey assignment, does not absolve you from establishing a system to make sure students are sent to the office for medication. There is a big difference between a minor child presenting in an office and refusing a med (which you would then phone parents) and a minor studnet who just does not show up. If they have a diagnosis that would make them more likely not to remember, all the more onus on the school to implement an intervention to resolve the issue. Some schools use beepers, some call the teacher or the teacher commits to send them. Even sending an aide to the classroom to retrieve the child are options. You cannot use an overhead announcement "Send Jacob Finney to the nurses office" as it violates the child's privacy rights.

[jen42]

Eek, 90-100 students a day??

I think if you have had the parents sign a sheet saying that it is the student's responsibility to come get their meds, and the students repeatedly aren't, call the parents. Tell them the kid never comes down and ask them to talk to their kid. You could also give a list to teachers of what kids to send down when. For my kids who constantly forget, I have good teachers who always remember. We have one kid who is on a "pass" system- he can't go back to class after lunch until he has a pass saying that he came for his meds.

When you said "forcing" I pictured you prying the kid's mouth open, putting in the pill, and stroking his throat, like the vet does to my dog... :)

[Keepstanding, ASN, RN]

Like Martha has stated...if you fail to give the med..then that in itself is a medication error. At times I have to chase down students who may be at PE, Technology Lab, Music class, etc. but I know that I must somehow get them in to insure that the med has been given. If for some reason, a med has been overlooked (for whatever reason) I always call the parent and let them know and ask if they want me to give it even if it is 45 minutes after the required time. Being up front is the best policy I think.

One year I had a 5th grader who refused to get himself to the clinic for his meds on time......I told him that starting tomorrow I would come get him, escort him to the clinic and escort him back to his classroom. Oh the dreaded school nurse escort ! LOL :rotfl: That solved that problem. From that day on, he was one time like clockwork ! hehe

Good luck !

[GreenWitch]

Thanks for the ideas. I've tried to enlist the teachers help, but they are not very cooperative

I guess I'll just have to close the clinic and "chase" them down! :chuckle

[Jeanine]

You cannot use an overhead announcement "Send Jacob Finney to the nurses office" as it violates the child's privacy rights.

I always page the student to the main office using the overhead. The staff in the main office knows that if they didn't page the student, they need to send them to the health office and check with me. I am right next to the main office and usually intercept the student in the hallway before they get there.