I have two students (both 6th graders) with moderate asthma who carry their inhalers in backpack. Parents cannot get act together, so I don't have med consents. I finally asked students to bring inhalers to front office and explained to them that if they feel wheezy, they need to come to the office.
I have fully explained (multiple times) to parents that their "grace period" is over and that from hence forth, the parents will have to drive to school and administer medication because I don't have a physician's written consent or their written consent.
But what if a student has an asthma attack, the parents are 30 minutes away, and I am left with a very wheezy student and an inhaler in my hand?
Yes, in terms of "turning a blind eye," I allowed the kids to carry the inhalers on them while I made phone calls to parents (and documented), mailed extra consent forms home, spoke with teacher, PE teacher, secretary, principle. Kids are dropped off and picked up by their parents. I definitely made sure to send inhalers home with families at the end of the day :)
Yes, most inhalers are left in the nurse's office for the entire school year. In order for a student to carry medication in backpack in our school district (usually 6th graders and up, sometimes younger if VERY bad asthmatics), their medical provider must check 3 boxes on the medication consent form: 1) that the student is knowledgable of the medication and when to take it, 2) the child can demonstrate safe/proper administration 3) the student can carry in backpack and self administer.
Some parents tell me their insurance wont cover 2 inhalers. My usual reply is that if they specify that it's for school, they can usually get it covered.
I'm just wondering how this is any different from having all of the other kids' inhalers in the office? The younger kids need assistance with their inhalers, so they are kept in the front office. The 6th graders carry their inhalers in their backpacks because they know how to independently use them.
Inhalers are very unlikely to cause harm if used incorrectly- even if, worst case scenario, another child got their hands on it and decided to try it out. The risk of confiscating the inhaler are much, much, much greater, legally and medically.
I'd let the kid carry it while i worked to get the necessary documentation. I am having trouble thinking of a scenario where I'd feel it was safer to confiscate it.
I am not currently a school nurse, but i used to be one at a boarding school for high schoolers with mental health issues. I held the daily inhalers and a back up rescue for students, but the ones who needed it carried a rescue inhaler at all times. These were kids at high risk of risky behavior, and it was *still* deemed safer to allow them unfettered access.
Taking away those inhalers was not a smart decision. I understand you want the parents to follow up etc, but holding that students life line as leverage is a bit over kill. I know there are rules but there are also EXTREME risks with denying someone access to there emergent inhaler. It's not like they were carrying around Tylenol. I also can't believe it was a legitimate question of whether or not to give the inhaler if the children were having an attack 😳😳😳 that doesn't take nursing judgement, just common sense.
I would rather lose my job than make it complicated for a child to breathe. Why don't you go to the classroom, hold your breath, and see how easy it is to get to the office.
Schools have went too far with this medication crap. Things like epi pens and inhalers need to be kept with the student.
Taking away those inhalers was not a smart decision. I understand you want the parents to follow up etc, but holding that students life line as leverage is a bit over kill. I know there are rules but there are also EXTREME risks with denying someone access to there emergent inhaler. It's not like they were carrying around Tylenol. I also can't believe it was a legitimate question of whether or not to give the inhaler if the children were having an attack 😳😳😳 that doesn't take nursing judgement, just common sense.
ok, so while we're on the topic of self admin orders - if you have a student that you know yourself is capable of self administering an inhaler, but the AAP comes through with that box clearly checked that they are not approved to self medicate - AND the parent has already sent the child packing with that inhaler in their backpack (i suppose with the intentions that the child would self admin) would you let it slide and let the child self admin or pursue the self admin order?
Specializes in Complex pedi to LTC/SA & now a manager.
ok, so while we're on the topic of self admin orders - if you have a student that you know yourself is capable of self administering an inhaler, but the AAP comes through with that box clearly checked that they are not approved to self medicate - AND the parent has already sent the child packing with that inhaler in their backpack (i suppose with the intentions that the child would self admin) would you let it slide and let the child self admin or pursue the self admin order?
Call the physician. Maybe the wrong box was accidentally checked.
I may hold the Inhaler in my office during school hours. I have allowed the student to take it even with no paperwork on file under my supervision.
However, I always give it back at he end of the day to take home if they tell me they only have one. In the meantime, I keep reaching out to the parent to provide proper paperwork.
My thought is "what would a resonable and prudent nurse do" and to me that is to not let paperwork get in the way of a student having access to an emergency medicine.
clockwood
50 Posts
Yes, in terms of "turning a blind eye," I allowed the kids to carry the inhalers on them while I made phone calls to parents (and documented), mailed extra consent forms home, spoke with teacher, PE teacher, secretary, principle. Kids are dropped off and picked up by their parents. I definitely made sure to send inhalers home with families at the end of the day :)