Medication Mishap

[Amethya]

Got a student who has ADHD badly and she tends not want to take her medication and I was told in the beginning that she's a liar and that we need to keep an eye on her to take her medication. I wanted to trust her and help her, but sadly it didn't work out.

Today she came to take her medication. I gave it to her like always, and she proceded to go to the water fountain to take her meds. The secretary called out to me and told me she threw away the medication. I then proceded to give her another one, which this time I saw her take it.

My AP called me and asked me if she took her medication or not, and I told her she threw away the first pill and I gave her another one. She got upset because she said we didn't see her take the medication and gave her one, and the child told her she took it, but opened the capsule and took the contents. She never has done that with me, she always took the pill whole. Then the child changed the story to that she didn't take it.

My AP was upset with me because she said that I'm not doing my end of the bargain which was watching her take her medication and that yesterday was the second time I didn't give it to her on time.

I explained to her that yes, it was my mistake I didn't check before I gave her another dose, but I can't do anything if she doesn't take her medication.

She is upset, and wants to talk to my principal, which I did before her, explaining that I'm not sure how we can do this with this child, she is difficult and I now know why we can't trust her.

I wanted to give her trust but obviously she can't be trusted. It was my mistake and I am trying to fix this situation by finding a solution, but I'm not sure how I can defend myself when I talk to my AP.

I know this will be another written warning and I will write a rebuttal but I'm not sure how I can defend myself on this.

Yes, it was my fault, and I made a mistake and I'm willing to fix the situation, but what I do I tell her.

[ruby_jane, BSN, RN]

I will never, ever let any medication with street value out of my office unless it's been swallowed in my office. Change your policy immediately and you will then lose the she said/she said about whether the student took the med or not.

As far as re-administering...do you have anyone with a nursing degree in your district whom you could ask that question?

Child no longer has your trust. You've changed the way you do business. End of story.

[Amethya]

I'm not sure if I can even ask without getting pushed under a bus for this mistake. I was told to let parent know but I'm not sure if should too.

I just don't know what to do at this point, because I know it will not forbade good.

[OhioBPH]

I suppose you could state that you were trying to build rapport, I'm not sure how much value there would be in that. If it had happened to me I would have dug through the trash to find the pill before giving another.

Regarding changes in your clinic, if it were me I would likely change to a cheek checking policy where ALL students have to show you they've taken meds before they can leave the clinic. Tell them all that the policy change came from above you, and that everyone has to comply.

[OhioBPH]

I'm not sure if I can even ask without getting pushed under a bus for this mistake. I was told to let parent know but I'm not sure if should too.

I just don't know what to do at this point, because I know it will not forbade good.

Yes tell the parent! Tell them everything! What happened, what you were told, what the student told you. I likely would have made that call before giving the second capsule.

[WineRN]

This was an unfortunate mistake.

Medication should never leave the office. I do understand that noncompliant students are tough to deal with, but ensuring the student takes the medication is a part of the job. Especially if there is a history of this student not taking medications.

And as RubyJane mentioned above, re-administering judgement may need to fall to the RN who is above you. Especially since the student is unclear on if they took it or not. You would never want to be responsible for overdosing a little one who lied about not taking it.

I don't think you can rebuttal this one, just be honest and own the mistake.

[Flare, ASN, BSN]

absolutely agree with Ruby. Pills are swallowed in front of my eyes, in my office - no distractions. Invest in a dollar store pitcher and a box of dixie cups if you don't have a sink in there.

[OhioBPH]

Invest in a dollar store pitcher and a box of dixie cups if you don't have a sink in there.

In my clinic the sink is in my bathroom, and usually the students get water there. if the bathroom is occupied, they take their cup and get water from the drinking fountain and come back for their pill. I have thought of getting a pitcher to keep on the med cart so they do not have to leave at all, to minimize the time they are out of class.

[tining, BSN, RN]

This is not a medication "mishap." This is a medication error.

I have stated this several times in nicer ways.

You are in over your head.

As I stated on November 30 under your thread - "Secretary Issues":

I am concerned about your position as well. Posts like: "Been thought of as the bad guy?;"I did something wrong. Help!;" "Going over me to go home;" "I feel like I'm losing." "I did something bad..." "Today is not a good day for me." "I am so disappointed" "Got scolded by parent today"

I see a pattern. Just an observation.

[Amethya]

So what I should tell my school health manager? Because I want to be careful how I word this.

[Amethya]

I know this, but until I can find another job, I am not leaving from this one.

[tining, BSN, RN]

I know this, but until I can find another job, I am not leaving from this one.

So you would rather risk over and or under medicating a child . . .

What will the next mishap (error) be? I shudder.