Morning meds

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For those of you that are lucky (like myself) and give the prescription meds at school what is your take on giving ADHD meds at 8AM. My position is that unless it is ordered by Dr. or DHS has order it has to be given at school then it should be given at home before 8AM. At this time I am giving 5 students meds at 8AM. But I am being told I have to give these because their parents wont give at home. Now I dont mind giving the meds that is not the problem. The problem is the teachers are of course saying the students are not being able to focus until about 10 and they are having to test later for that student. Or students behavior is awful until the meds kick in. Well yeah if it was given at 6:30-7AM like it should then by the time they got to school it would be in their system. There is only one student that DHS has ordered for his meds to be given at school the others are just parents not wanting to have to get up and give it. These kids k-3 are getting themselves up in the mornings and getting on the bus! I cant get my admin to understand that a BID order for ADHD meds means the first is given in the morning before school and the other is given at lunch which would be where I come in. You know dont listen to the one medical person on staff. I am asking for a policy change next year but I wanted to know if any of you might have some insight.

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Sounds like a meeting with both you and the teacher addressing this with the parents would be a good idea. The teacher sees the change as the meds kick in and can give that insight.

A few years ago I had a student who came in the morning and I couldn't figure out why. I finally asked him and it was because he went to before school care for an hour and a half and his parents did not want to give it so early so it wouldn't wear off before the lunch dose. Made sense to me! I had another junior high kiddo who wanted to take it after first period PE because it made his HR too fast combined with running so we changed that for him.

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Specializes in Home Health,Dialysis, MDS, School Nurse.

I have 4 that I give in the AM, and 3 of those come back at noon for a 2nd dose. In an ideal world, they would take them earlier at home, but for a variety of reasons, this wasn't happening. Our staff here decided its better for the kids to consistently get their meds, even if they didn't start working until 9 or so, than to not get them or get them sporadically. Trying to change the home life environment hardly every works, or works for a very short time, then reverts to old behaviors.

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Specializes in ICU/community health/school nursing.

Depends on the medication.

We have kids on antidepressents and antipsychotics, and I often offer to keep a dose or two for the days they forget. If it's a consistent "I forgot", then I look at the issue holistically. A lot of our kids leave at o'dark thirty and parent is unable/unwilling to supervise. Is the student better off taking the med supervised by me when s/he comes to school? Will that get more consistent results? Then yes, I will administer, happily.

It's the morning BSG checks that grate on me. Come on, kid. You got here at 0700 and ate breakfast. 0800 (30 minutes into class) is NOT the right time to check.

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Specializes in Pediatrics Retired.
I have 4 that I give in the AM, and 3 of those come back at noon for a 2nd dose. In an ideal world, they would take them earlier at home, but for a variety of reasons, this wasn't happening. Our staff here decided its better for the kids to consistently get their meds, even if they didn't start working until 9 or so, than to not get them or get them sporadically. Trying to change the home life environment hardly every works, or works for a very short time, then reverts to old behaviors.

I currently give 6 every morning; for the student and teacher benefit.

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Specializes in School nursing.

I had a few. But my office is open at 7:30 and school starts at 8. So the plan I tried was having students take it at 7:30, as some students were at school as early as 7 AM (the earliest we allow drop off). Sometimes this is the only way I can ensure a student gets a consistent morning dose. But I also work with older students and try to have them seek me out vs. the other way around to help them with a routine they can continue at college. (Sometimes this doesn't work and I'm seeking them out, even their senior year.)

When morning meds aren't consistent, however, it shows. I just had one parent try me giving the med at 730 (more consistent way because of student's morning schedule), but it just wasn't working by the time the school day started. So we've moved back to giving the med at home - mom is waking the student up 15 minutes earlier to give the medication. Mom is completely on board. I've very open to helping with morning routine if there are orders and communication.

I also have a few "just in case" morning meds - basically one or two tablets of the ADHD medication a student takes at home as a back-up if they forget their morning dose. Yes, it was be given delayed, but it will still be given. I have parents get me a doctor's order for these and they still must be submitted in the original prescription bottle.

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I have a few that I give in the morning. Parent(s) leave for work early and they want to make sure it's given. I'd rather that than have them only take it sporadically. Who would ever think that Jr. High kids would forget????:roflmao:

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I also have a few "just in case" morning meds - basically one or two tablets of the ADHD medication a student takes at home as a back-up if they forget their morning dose. Yes, it was be given delayed, but it will still be given. I have parents get me a doctor's order for these and they still must be submitted in the original prescription bottle.

I had a few students do this too. And I have left a few of my son's pills at his school for just such an occasion.

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I have 5 kids that come in the morning. Ideally they would take it at home, but for whatever reason they weren't getting it consistently. Now they are.

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I would rather give it daily in the morning than to get those "I don't think he had his meds today" calls and e-mails ALL.DAY. LONG!!

This year I have one that mom brings to school in her car every day (usually 15-40 minutes late) and wants me to give it because he refuses to take it from her. Now, he also refuses to get up in time for school and refuses to put away his ipad and go to sleep nightly because mom lets him run her over. I don't have any problem with him taking his meds from me. I am firm and do not give him a choice!!!

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Specializes in LTC.

Usually ADHD meds are given first thing in the morning- like when you wake up, and usually there is a booster med given in the afternoon if you need it. I only know from personal experience though, as I've taken ADHD meds since 5th grade.

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Specializes in Emergency Medicine, Women's Health,School Nursing.

I give quite a few morning ADHD meds too...unfortunately they are kids that have the type of parents who dont get up with them to get them out the door in the morning so in their case its better they just get it from me and have a delayed response to it kicking in then not having it at all.

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