Just stopped a teacher from applying medicated cream to a student's arm

[MHDNURSE]

I am getting so frustrated with this one teacher. I will start by saying she is LOVELY, super dedicated to our kiddos, most of who are low SES, significant issues at home, etc. She is only 23, very warm and loving with all of the kids and they love her. Having said this, I feel like she has crossed the line on many occasions where I just feel like she is trying to be a social worker and guidance counselor (and nurse), rather than their Kindergarten teacher. There have been occasions where she has come into my office, taken a temperature and then called the parent to pick the child up, all without my knowledge. I have found her going through my medical cabinet getting cough drops to give out to kids without asking if it was ok. Each time I have found her doing something beyond her scope of teacher position, I have nicely told her that my job is to be the nurse and her job is to be the teacher, etc.

Well just now, I was in my office with a student and I hear my cabinet being opened and can tell someone is messing with my stuff. I poke my head out into the hall and there she is with a K student, grabbing the hydrocortisone cream and a tongue depressor! I asked "Hi, can I help you with something"? She answered "Oh, she has an itchy rash all over her arms so I am putting cream on it". So I tell her "I need to evaluate her and see what is going on with her, I can't just have you put medication on her arms. Parents actually have to sign a consent form for any type of medication we give, and this might not even warrant this cream". She just stared at me and then said "Are you sure? I don't mind putting it on her" So I said "I am telling you NOT to put it on her, and NOT to give any child medication. Please send them to me. I am the nurse and that is why I am here". She just said OK and left.

I will have another conversation with her later, as well as my operations director. I am definitely going to do a lengthy in-service in August when we all come back to show the teachers the consent forms, tell them that even I can't just give an OTC without express consent from a parent. I seriously wonder what the heck has happened without my knowledge between 1:30 -4 every afternoon after I leave.

[tining, BSN, RN]

She is pretty bold. I would also emphasize to her that if she continues to "help" then she is legally liable and not you, especially when you are there. After 1:30 = wild, wild, west!

[MrNurse(x2), ADN]

Maybe a good time to attend a school board meeting with this information to prove the need for full time nurse for each school. Start saying things like liability, nurse practice act and such, maybe write a state delegate to make it a state law.

[pedi_nurse]

Oh I'd be so mad.

You've tried addressing this yourself. At this point, I'd have a conversation with her principal regarding this matter. After you leave, obvious the principal can delegate anyone to do these tasks, however, they still have to follow the law.

In our state, schools are not supposed to provide medications for the general student population, except in certain situations, like epipens. I'd look up your specific laws and use that as a resource to address this issue.

[JenTheSchoolRN, BSN, RN]

We used to have an admin that administered all kinds of OTCs when the nurse wasn't there. I talked this over with my boss and together we revised the policy and my boss helped police it. No OTCs given by anyone BUT the nurse. I will delegate schedule prescriptions (depending on what I can per state guidelines but mainly inhalers, ADHD medications, and Epi-pens for field trips) but nothing else.

Admin never did it again.

I think part of the issue is that people think OTC=Safe/no big deal. They don't think about the fact that kids have drug allergies, maybe the parents already gave something before sending them in, etc. I have one student who has LTA to ibuprofen, another kid who has parents who give NO medications at all and would freak out if we gave him something, etc. I have tried to impress upon the staff that just because something is OTC does not mean we can just freely give it.

[JenTheSchoolRN, BSN, RN]

I think part of the issue is that people think OTC=Safe/no big deal. They don't think about the fact that kids have drug allergies, maybe the parents already gave something before sending them in, etc. I have one student who has LTA to ibuprofen, another kid who has parents who give NO medications at all and would freak out if we gave him something, etc. I have tried to impress upon the staff that just because something is OTC does not mean we can just freely give it.

I think you just need support from your higher ups for no OTCs unless you are there. And that your office/office area is a no entry zone for teachers. But again, it really helps to have support from above I've learned.

[SchoolNurseTXstyle]

I think part of the issue is that people think OTC=Safe/no big deal. They don't think about the fact that kids have drug allergies, maybe the parents already gave something before sending them in, etc. I have one student who has LTA to ibuprofen, another kid who has parents who give NO medications at all and would freak out if we gave him something, etc. I have tried to impress upon the staff that just because something is OTC does not mean we can just freely give it.

YES!!! YES!!!! YES!!!!! They don't know what they don't know and that is scary. Just had a teacher give neosporin last week. I have been fighting that battle for years with no back up whatsoever so now I just document "ms. the rules don't apply to me applied neosporin to ................"

[tining, BSN, RN]

I'm glad we don't have to stock those OTC's. Parents have to bring in signed by MD. Deterrence enough to stop that crazy train.

[Glitternurse, LVN]

I'm glad we don't have to stock those OTC's. Parents have to bring in signed by MD. Deterrence enough to stop that crazy train.

Yes, we have to have signed doctor's order and signed consent from the parent. The only exception is if the telemedicine provider orders OTC meds, but the parents had to sign the consent for the kids to be seen and had to approve which meds were ok to give. These meds are kept locked and only the district RN and I have the combination to access these meds.

[Daisy Joyce]

Keep the cabinet locked.

You might have to go over her head to the principal if she won't stop

[NutmeggeRN, BSN]

I would say this....

I take no legal responsibility for any medical issues this may cause. I will follow up this conversation with an email to confirm (digital trail) and I would attach the laws and school policy as well.