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It's just anaphylaxis

School   (4,428 Views 26 Comments)
by it'snotatumor it'snotatumor (New) New

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I have ONE student's Epi-pen in my office, yet I have around 30 students with life-threatening allergies at my school, and I'm wondering how the rest of you get non-compliant parents to bring in critical medication or even just return paperwork.

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454 Posts; 7,576 Profile Views

I apparently call 911 to get parents to bring in inhalers! :roflmao:

But, when you find a reasonable way, please let me know! Most of the time, I don't even know the kid has an allergy until someone else lets it slip. Then I call home, talk to the parents, send the kid home with the permission paperwork, and wait and wait and wait.

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MrNurse(x2) has 28 years experience as a ADN and specializes in IMC, school nursing.

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My standard text to parents....

Dear Ms. ______, your darling child is noted as having ________ by her emergency card. EMS time to the school is ten minutes, brain death occurs after four. The best chance of a desirable outcome should 911 be called is for me to have proper tools to save your child and that must be provided by you. Thank you, MrNurse(x2)

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1,211 Posts; 7,893 Profile Views

My standard text to parents....

Dear Ms. ______, your darling child is noted as having ________ by her emergency card. EMS time to the school is ten minutes, brain death occurs after four. The best chance of a desirable outcome should 911 be called is for me to have proper tools to save your child and that must be provided by you. Thank you, MrNurse(x2)

I love you!:inlove: Seriously, this is the best!

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2 Followers; 5 Articles; 4,098 Posts; 35,076 Profile Views

I send letters and follow up with a call. If they still don't send it, I document it.

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Amethya has 5 years experience and specializes in Cardiology, School Nursing, General.

1,808 Posts; 12,484 Profile Views

Thankfully lots of the parents in my school actually brought the paperwork like they are suppose to, but some of the students brought inhalers with no paperwork. The ones that rarely use it, I told them to sign the papers, or no inhalers. I hate doing that, but it's the school policy and I have to follow it. Now unless the student needs it real badly, I give them benefit of the doubt and keep giving their medications, but I will keep bothering parents to get a note signed from the doctor and their signature as well.

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Windchaser22 has 5 years experience and specializes in School nurse.

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After asking, writing, and asking again...No meds=no field trips. 99% compliance.

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ohiobobcat specializes in ED, School Nurse.

871 Posts; 13,713 Profile Views

I probably sent 50-75 (I should have counted) letters yesterday asking parents to complete paperwork so that I can have the proper documentation on file for Epi-pens and inhalers. Some I have partial paperwork completed, some I have nothing at all. My stock Epi-pens expired- new ones are on order but not here. I have 4 student Epi-pens in my office and not one batch of completed paperwork on any of them. This and concussions are the most frustrating part of my job.

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JerseyTomatoMDCrab has 7 years experience as a BSN and specializes in med-surg, IMC, school nursing, NICU.

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But guess what? Heaven forbid a child actually has a reaction, all eyes are going to be on the nurse, asking why there wasn't medication or a plan in place! It's so frustrating.

I had a kiddo last year who transferred in mid-year and the health file from his previous school was full of letters from the nurse, begging mom to bring something in for his multiple allergies. Apparently, mom was medicating him with hydroxyzine every morning before school "in case he reacted to something" and was falling asleep every day! The previous nurse tried to explain to her that it would make more sense to have emergency epi at school for accidental exposure instead of medicating him into a stupor every morning but to no avail.

When I called mom to explain our medication policy and ask her to please bring an epi-pen, she said "Don't you keep spare ones there?"

Uh, yeah. For mystery allergies that nobody is aware of and pop up out of nowhere! Not for parents who don't want to bring them in!

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Kristiernbsn has 5 years experience and specializes in Psych, Addiction.

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Admittedly, I'm naive. I'm not a school nurse, and I haven't quite finished my RN, although I'm a mother and grandmother of kids who have allergies. Isn't there a budget with which you can buy an emergency EpiPen to keep in your office to save a life? I agree some parents are the worst at sending necessary supplies for their kids, but if you make the case to your district, couldn't this be accomplished? I worked as a LPN at a summer camp and we had several EpiPens and Benadryl we sent on every trip off-site, along with the campers' own pens from home, in case we had an anaphylactic camper who didn't have a history or whose parents didn't send a Pen. We didn't have enough nurses to send one on every trip, so all staff were trained in proper use of the Pens. I know public school funding is very different, which is why I am asking.

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3 Posts; 179 Profile Views

I imagine school nurse discretionary funding varies widely by state and school district. The few schools I have worked at have minimal school nurse funding which would not support the purchase of EpiPens, and I would hazard a guess that this is the norm rather than the exception. Nonetheless, Mylan has an "EpiPen4Schools® program" in which they offer up to four free EpiPens per school. See link for details: https://www.epipen.com/en/hcp/for-health-care-partners/for-school-nurses

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2 Posts; 187 Profile Views

Hi,

Just commenting from Australia so wish to acknowledge that my take on this may be different.

We have the same issue here but a few ways to address this with families.

If we have a documented student with anaphylaxis we expect all paperwork completed and epipens provided within one month of enrolling at the start of each year or within a month of diagnosis. If this doesn't occur it means no excursions- especially if it's a food or insect allergy, no purchases from the canteen if a food allergy, no participation in food technology (cooking) class if it's a food allergy, and sometimes kids have to sit outside my office to eat their lunch if they are potentially at risk. This is not to punish the kids but to make it as safe for them as possible. They often bring a friend with them so they aren't ostracised or isolated. The focus is on student safety and not punishment. These limitations often wear thin very quickly for the students and they seem to assist the parents to step up and provide documentation/ epipens really quickly..... Parents may choose to ignore me but they don't often get to ignore their child if they're missing out on something they want to do...

I also often scan/ email or fax the required paperwork directly to their doctor with a friendly cover letter requesting completion within a week. I resend this fortnightly until it's returned..... it seems to come back quite quickly. At times I've also let parents and doctors know I'm documenting how many times I've requested this information in case something happens and i need to provide evidence for a Coroners Case....

Compliance with providing required documents/ epipens/ inhalers at my school is around 90+%

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