Inhalers?

Specialties School

Published

I have a ton of students with inhalers, here at school, but I have a handful of kids who only use them when Mom tells them they need to. For example, I have a student coming in to use the inhaler because of a cough. Mom instructed the student to start using the inhaler. Am I wrong in feeling a little frustrated with this? No signs of distress, able to speak in full sentences without gasping for air, comes be-bopping in when ready to use. Maybe I'm wrong and we are preventing some full blown episode but I really have mixed feelings about this one.

Specializes in School Nurse.

Oh no! I did not intend to imply that you were Supernrse. Actually my comments were to address GrannyRRT concerns with the way School Nurses deal with asthma in the school. The school nurses that I know would never deny an inhaler either or make such demeaning comments to a student. I am not saying there are not a few bad apples out there.....but most school nurses would rather err on the side of caution than to have to squad a kiddo. IMHO I can see more unlicensed personnel or teachers making such comments, not a school registered nurse.

Completely agree! Please let me clarify that I did not deny this student the inhaler. Like you, I have a few students who often seem to be abusing the inhaler in order to get out of class. I'm not denying student's their medication and I won't speak to them they way some of the examples are written. I want them to trust me.
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Specializes in School Nurse.

Don't forget the parent who neglects to deliver an inhaler period, or provide a spare to keep in the clinic in case the student forgets! I had a student end up in the ICU last year due to a severe asthma attack. And this was over a month into the school year!

We as school nurses also have to deal with parents who:

1) neglect to advise us of a diagnosis

2) neglect to fill out paperwork when hand delivered, mailed or faxed, sent electronically or what have you

3) continue to smoke in he home and the kiddo comes in reeking of smoke on their clothes

4) acknowledge the child smokes but states "I have no control over her she is 17"

Please do not make broad assumptions about the care provided in the school setting.

This is the hardest part of taking care of the asthma kids....parents not working with the school nurses. Parents that don't share info, respond to request for info make me want to scream!!

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Specializes in Pediatrics Retired.

Thank you Nutmegge....at least you still love me!!! :)....

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Specializes in Telemetry, Gastroenterology, School Nrs.

I knew you didn't LicensedschoolRN! I didn't even think you meant those comments toward me! I think when I responded about your comment I just ended up going on a tangent :) I had read through some of the other comments and wanted to be sure I clarified my actions! I knew you understood what I was trying to say!!

Oh no! I did not intend to imply that you were Supernrse. Actually my comments were to address GrannyRRT concerns with the way School Nurses deal with asthma in the school. The school nurses that I know would never deny an inhaler either or make such demeaning comments to a student. I am not saying there are not a few bad apples out there.....but most school nurses would rather err on the side of caution than to have to squad a kiddo. IMHO I can see more unlicensed personnel or teachers making such comments, not a school registered nurse.
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Specializes in Telemetry, Gastroenterology, School Nrs.

I'm on your side OldDude and knew completely what you were saying. We do need those specific orders.

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Specializes in School nursing.
We as school nurses also have to deal with parents who:

1) neglect to advise us of a diagnosis

2) neglect to fill out paperwork when hand delivered, mailed or faxed, sent electronically or what have you

3) continue to smoke in he home and the kiddo comes in reeking of smoke on their clothes

4) acknowledge the child smokes but states "I have no control over her she is 17"

Please do not make broad assumptions about the care provided in the school setting.

This is the hardest part of taking care of the asthma kids....parents not working with the school nurses. Parents that don't share info, respond to request for info make me want to scream!!

YES. A thousand times, YES. Like I said above, when a parent does not think it is important enough, the child will think it isn't important enough. And that is just frustrating. :banghead:

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Specializes in kids.
Thank you Nutmegge....at least you still love me!!! :)....

Gotchyers and Supenrse01'S backs!!!!!!

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We as school nurses also have to deal with parents who:

1) neglect to advise us of a diagnosis

2) neglect to fill out paperwork when hand delivered, mailed or faxed, sent electronically or what have you

3) continue to smoke in he home and the kiddo comes in reeking of smoke on their clothes

4) acknowledge the child smokes but states "I have no control over her she is 17"

.

I know this has been quoted a couple of time but well worth doing it again.

Just one of my frustrations is lack of communication with the providers and an action plan. I rarely get any back.

We keep elementary school aged kids inhalers in the office in a locked area - this is mostly for Kindergarten aged or kids who lack the maturity to safely carry an inhaler. One mom refused to let her son have an inhaler on the bus because she was afraid he would simply play with it and he had an asthma attack on the way to school two weeks ago. The bus was almost to school so the school secretary ran the inhaler out to the bus as the bus driver had radioed ahead to the school.

I'm not on every campus (we have 11) and so the office staff has to be trained. This bus driver was a fill-in and just panicked and called it in instead of calling 911. Fortunately, the kiddo was ok. I did spend a lot of time on the phone with mom and finally got her to send an inhaler. He isn't getting his Singular every day because parents are divorced and Dad doesn't believe in Western Medicine and wants to use "natural" remedies.

I also went over to the bus garage and did some further training about what to do in that situation. The kiddo is remembering his inhaler but as stated, the mom was very concerned that at his age, he would just play around with it.

I appreciate the info from GrannyRRT but I do also have OldDude's back. :up:

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Our school still does not allow kids to carry their inhalers despite being allowed to by the state :banghead: Here are some handy items to help kids keep up with inhalers at school: Star Allergy Alerts - Asthma Kids – Asthma Cases & Inhaler Carrier| Asthma Inhaler Carrying Case & Cover

The lanyard!! Schools in our areas are requiring students to wear their student ID on a lanyard (not our school). They could hang their inhaler on it too with the case shown on the linked page.

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Our school still does not allow kids to carry their inhalers despite being allowed to by the state :banghead: Here are some handy items to help kids keep up with inhalers at school: Star Allergy Alerts - Asthma Kids – Asthma Cases & Inhaler Carrier| Asthma Inhaler Carrying Case & Cover

The lanyard!! Schools in our areas are requiring students to wear their student ID on a lanyard (not our school). They could hang their inhaler on it too with the case shown on the linked page.

The lanyard would be considered a choking risk.

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Specializes in school nursing, ortho, trauma.

I get Olddude's spirit behind his statement - parents will make the statement that "susie needs her inhaler everyday for the next two weeks for a cough." and after 4 days (and perhaps some antibiotics and or nebulizers or maybe just time - kids sometimes recover quickly) everything clears up. Well, I don't like to give an inhaler needlessly - so i'll make a courtesy call to a parent to find out A. is the child going back to the doctor for a recheck and B. do they still think it's necessary to get the inhaler every 4 hours (are they still doing this at home too? usually they are not and they have just forgotten to tell us not to). There are times too that that the student simply stops coming - I may check in the first day or so depending on the age of the student and then I'll take the student not coming as a sign that things have improved (mostly the older students)

I would never deny a child their inhaler. The fact is that I don't live in their lungs and I don't know what changes they are feeling that I can't necessarily hear yet when I auscultate. But on the flip side- there have been plenty of times that I have had to educate children that their albuterol is a medication and can cause serious side effects when not used properly.

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Specializes in Acute Care, CM, School Nursing.
Scheduled inhaler use makes me tired.....I'll put up with it for a couple of days and then I require a MD order to continue; if their condition requires scheduled bronchodilators every 4 hours for more than 48 hours they don't need to be at school. Most of the time these kids say they aren't using their inhaler at home anyway.

OldDude, can you please, please come to work with me?! I can't seem to make anyone here pay attention to common sense. Maybe if I had you to back me up, it would get better?? LOL

Your posts are always right to the point, and make perfect sense. Love it! :up:

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