No Insulin Orders

[joy09]

We must have doctor's orders to administer insulin (state nurse practice act) or any other medication. We had a student come to school with verbal orders from Mom, handwritten orders by the school nurse and prefilled syringes (by mom) in the fridge. Mom is new to the area and has no doctor.

What happens in your school if a student like this doesn't have physician orders? How do you respond? First, as the school nurse? Then, as the float nurse (me).

[K8schoolnurse]

:bluecry1:Ihad a student who came to school with just a note. He went to a BS of 21!! I told the parents that he could not come back to school until I had a doctor's orders. It was so scary! This is my first year of school nursing and is it sure an eye opener!!

[guest83140]

Can the student not afford to see the doctor. Most doctors won't refill insulin orders unless they have been seen recently in the office. Also some people borrow insulin from friends/family and have no real orders/instructions and make up their own scale, which is scary. I would see if they are not making enough to qualify for assistance and is low on money or if the parent just doesn't want to take off and go to the doctor. But no, you can't even accept prescription anytime without a doctor's signature for the current year. Insulin is so dangerous to administer without orders and anybody giving it without orders is practicing as a physician and could lose their license.

I would tell mom I couldn't administer, she can, I can't. If he is high but not showing signs, I would call her to come administer the insulin, I would record the incident and let the principal know. If he was showing signs of serious problems, I would call her and 911 and tell her that would be more expensive and that she needs to fix the problem.

[SchoolNurseBSN]

You just can't do it! I would help mom find resources. In the meantime - until you have a Dr. order - tell her that she will have to administer it. Document, document, document on this one!!

[joy09]

We did tell Mom that she would have to come in to administer the insulin. She has already withdrawn the child for personal reasons. I know nurses are compassionate but let's not be stupid by being kind and being dangerous. I don't think this boy should have been allowed to start school without doctor's orders. In the last district I worked, he would not have. In the district I work now, I was called to cover when the nurse left for an emergency. This is what I had to work with.

Guess what? The new admin found our med policy and it states if you give a med without an order and something bad happens, you will not be backed by the school district. I don't understand why nurses can't say no but I have learned to say it and it is helpful to hear other school nurses say this is the right thing to do. Thanks!