Inhalers?

[Supernrse01]

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.

[Flare, ASN, BSN]

Like i said earlier -I will take a child's word for it if they say they need it. Even if I don't hear wheezing - i don't live in their lungs - so if a kid comes looking for their inhaler, i will give it with no protest 99% of the time. But - there comes that tipping point when that child starts coming every single day and it's not prompted by something like PE or recess or they come in at one of those times with their horde or friends putting on an oscar worthy performance with crystal clear lungs only to use their inhaler and then Oh Lord Mercy!! It's a Miracle! That albuterol takes effect instantaneously! Be sure to catch the repeat performance tomorrow...

I shut that nonsense down toot sweet. There are calls to be made to parents about discussing asthma control, which often lead to discussions about coming to the nurses's office only when necessary. Fortunately - I really don't run into this too often. My asthmatics really do all seem to udserstand and respect their condition.

[100kids, BSN, RN]

I always give the inhaler. If I notice a pattern of increased use I always call home to talk to the parents about what is going on at home as well and suggest they may need to call their physician and let them know that their child is using their rescue inhaler often.

[Spidey's mom, ADN, BSN, RN]

I always give the inhaler. If I notice a pattern of increased use I always call home to talk to the parents about what is going on at home as well and suggest they may need to call their physician and let them know that their child is using their rescue inhaler often.

Me too. Things can turn on a dime with those pesky lungs.

And the truth is, we are being asked to be the equivalent of a medical clinic with all the new rules and regs that the Feds and the State government pass.

In CA . . . they passed an epi-pen law, mandatory on each campus, two volunteers have to be willing to learn to recognize anaphylaxis and give epi-pen. You cannot make them do it but if they don't, you can make the admins of each campus learn. However, it is next to impossible to get a physician to give us an Rx for epi. California school nurses are having a hard time with this not-very-well-thought-out law. And the AMA is not happy with it either.

However, in CA, there is rarely a full-time nurse on each campus. So we are training lay people to be medical authorities along with the regular job of being a teacher or principal. (The teacher's union is not thrilled with any of this - at least here in CA).

Supposedly the liability laws keep the lay people safe but I've not been able to get one person to volunteer to to learn to give a suppository to a student having a seizure. No one is volunteering to give insulin either since that law was passed a couple of years ago stating a lay person, trained, could give insulin.

We are lucky so far that there is only one elementary school aged kiddo who has an insulin pump and two high school aged kids who manage their own diabetes.

As you can see, I'm frustrated by the unfunded mandates given to me from the state of CA.

And I realize that many of you all over America have been doing this for years but the difference might be that from what I learned at the NASN convention in SF the first year I started doing this, back East, there IS a nurse on most campuses full time.