Med Schedule

[MegWorth]

This is my first full year working at the school. The way the school has it set up is that the parents tell me what time to give their child med. I have found it to be a little crazy since I am leaving the office a lot throughout the day. I have to go to majority of the students because they do not want the kids to miss class time. The only students that come to me are JR/HS during their lunch hour. I do not mind going to the class, I like walking but I am away from the office too much. I am thinking about asking the head of school about having block time for parents to pick from. I was thinking either 9AM, 10:30AM, LS Lunch, US, Lunch, and 2PM or 10AM, LS Lunch, US Lunch, and 2PM.

What does your med schedule look like? Any recommendations?

[OldDude]

I am really liking the way all of you handle your medication policy. The medication policy at my school doesn't require a doctor note stating exact times to give medications during the day. I do have one student med direction is to take 1 tablet by mouth at 11:30, this med is for a heart condition. All the others are QD, BID, or TID. I feel several of the parents do not want to deal with giving their child medication, so they have me give it to them when the arrive to school and a few minutes before leaving school.

I get that too but I tell the parents, for instance, BID means every 12 hours, TID means every 8 hours. Many ADHD meds are written BID but meant to be given in the morning and at noon. So, you're within your nursing scope of practice to obtain clarification of actual times.

I have one ADD med I have to give at 3:00 pm - AHHHHHHH! Drives me crazy.

[Rubor]

Are your orders from doctors written as PRN? Albuterol obviously, but what of the other orders? Do the parents just call you and tell you that so and so got their PRN med at certain time? OR do they not follow some time for administration at home?

[AdobeRN]

I have one ADD med I have to give at 3:00 pm - AHHHHHHH! Drives me crazy.

I have one of those and one that I admin morning meds random dates thru the month - divorce situations where one of the parents is not compliant with administering.

[WineRN]

I have found it to be a little crazy since I am leaving the office a lot throughout the day. I have to go to majority of the students because they do not want the kids to miss class time.

Your school needs to realize that your students health comes before their classes. If they need to be medicated during the day, it's most likely because their condition affects their performance in school. Them missing at the most 5 minutes to come to your office and take the pill and return to class is nothing compared to you being out of your office for large chunks of time administering meds.

I give meds pretty much around the clock, there is a cluster at the start of the day and noon. In total I have 22 scheduled meds, plus any inhalers since it's now spring. Between them and my visits, I rarely leave my office. I feel like having them come to me helps them build up accountability for their own health and wellness.

[OyWithThePoodles, RN]

Every med I have a time is specified by the doctor on the order.

[MegWorth]

Are your orders from doctors written as PRN? Albuterol obviously, but what of the other orders? Do the parents just call you and tell you that so and so got their PRN med at certain time? OR do they not follow some time for administration at home?

In the medication policy (written before I worked here) we only require the pharmacy medication label on the bottle. We do not require any additional orders from the doctor for medications, I am wanting to change this. The PRN meds I have are inhalers, EpiPens, a couple anxiety medications, med for arthritis pain (I speak with dad before administering this med), and seizure medication. All the other meds are QD, BID, or TID - the parents tell me the time(s) to give their child their med. Most my students I give them QD, one is BID during school (early morning and late afternoon), TID is given here and at school though I have one family pushing me to give the med TID.

I am the first medical person to ever work at this school. I started towards the end of last school year, so this year I have notice several flaws in the medical policies. I have a meeting with the head of the school in a few weeks, I will address the issues at that time. I do not see my boss giving me any trouble wanting to change a few of the policies for next school year.

[SchoolNurseTXstyle]

The only student I go to the class to give medication to is autistic and non-verbal. His teacher or aid used to bring him to me, but he would knock things off my desk, rip things off my wall, etc so I started taking it to him.

Last year, I had 28 daily meds. Thank goodness this year only about half that. Still, no way can I leave the clinic that much and travel around my huge building. I see 40-50 kids a day on top of meds.

[LikeTheDeadSea, MSN, RN]

I would easily argue student privacy with having the nurse hand-delivering medication to a classroom.

I always like to view the bigger picture, too. The comment above me is a good example - this year you may have the ability in your schedule to do that, but it is definitely not guaranteed to be the same in the future. I believe in setting a standard while things are easier to move around (ie: less meds) then when you're suddenly slammed one year and trying to get everyone on board with changes.

[Amethya]

I go what it says on the bottle and the doctor's orders. As of now my schedule is:

TD1 student: glu check at 10:45 AM

TD1: student: glu check and carbs for lunch at 11:20 AM

Diabetic student: glu check at 11:45 AM

Medication for student: 12PM

ADD meds for student: 12 PM

TD1: Glu check at 2:40 PM

And some PRN inhalers at times during the day and TD1 I do a 1:30 to check him out if he's not feeling well earlier. but that's my basic med schedule

[LikeTheDeadSea, MSN, RN]

Everywhere I've worked has required doctor's order IN ADDITION to the RX on the bottle.

Pharmacy has made errors, public health nurses (school/camp) have caught them. Sometimes things get transcribed wrong from the original order and parents just take it and hand it over if it's something that is only given during school days (ADD meds, for instance). I've had parents also give me OLD RX bottles full of a medication that made the child too sleepy so they d/c'd it bet kept it in the handy misc-med-drawer. The phone call of "Uh, this is the wrong label and wrong pills...." is always a fun one, but only capable when an order is present. Also some fun phone calls people have commented about regarding parents asking to confirm what med their kid is on because they forget.

I don't think I'd ever just pour from a bottle.

[Windchaser22]

What everyone else said...also, adding to privacy, students are nosey and don't need to know that Susie or Mike needs a med. Bullying is a big problem. No reason to give them a reason.