Good afternoon my SN friends. I'm curious how many of you have issues getting order clarification from MDs (or suspect a parent may have faked orders). Here is the history.
I have a 1st grader with a hx of migraines, ADHD and behavior issues. In the beginning of the school year, I had to call mom for fevers (2-3x) and migraine (1-2 times). One of the times she had a migraine mom asked if I could give her Tylenol. I explained not without a doctor's orders. Well, about 5 weeks ago, mom comes in first thing in the morning (while I was busy) and dropped off the filled out orders and pharmacy labeled ibuprofen (go give q6 -8hrs for fever). I didn't look at the orders until she left. The orders called for ibuprofen every 4 hours "if has fever". (This parent speaks Spainish only) So, I call the doctor's office on the order to clarify the order AND to ask for the order to read for headache because the way I see it, if a student has a fever, they need to go home, not get medicated and sent back to class. I was placed on hold for 20 minutes. I hang up and call back the next day, again put on hold. I have since sent three faxes for order clarification (since when do we give ibuprofen q4?)... anyway, I can not get the doctor to call back or fax back clarification.
Fast forward to this week. Student throws up in classroom, gets sent to clinic and has temp of 99.4. No, not a fever but student says she's been vomiting since last night and mom gave me medicine when she woke up. We call mom, who says, "she has orders for medication, I gave it to the nurse myself".... I go on to explain that the orders have never been verified by the MD and that while I am happy to medicate a headache (with PROPER orders) I will not medicate a fever (and vomiting) and send the child back to class. I also explained (through my translator) that a child with a fever needs to be picked up because of risk of child being contagious. Mom was peeved she had to pick up her kid.
Did I handle this wrong? What doctor orders medication for fever to be given at school? The mom also lied to the teacher and told her I had orders to give ADHD medications at school-- as far as I can tell (mom hasn't provided me any documentation or meds for anything other than "if has fever"), the child does not take ADHD medications..
Do y'all have trouble getting doctor's to respond to clarification or did mom fake the orders? I'm beginning to think she did.
You all took the words right our of my mouth; enough said, considering the source. Thank you. I'm so fortunate, blessed really, to be allowed to be a part of this group and you guys put up with me. Love you all.
You all took the words right our of my mouth; enough said, considering the source. Thank you. I'm so fortunate, blessed really, to be allowed to be a part of this group and you guys put up with me. Love you all.
I've never been a groupie before. I like it!! [emoji8]
You all should be ashamed your first duty is to your patient, advocacy is our goal here Q4 ibuprofen is not an order "five rights unavailable" invalid prescription...As far as dosing goes Q4 at 100mg po ibuprofen is rather common for someone suffering migraines. It is your duty now to get the prescription or turn over for prosecution the person that gave it to you. You DO NOT start with the patient or the family the doctors name is on the prescription and your state AG would dance a jig should you send it to him/her federal law imposes that a fax number must be made available to you if not now it is your school districts issue and you turn it over to the principal. However in the mean time a child is suffering and her relief is in your hands.
Again, I am amazed at your level of expertise! Like a zit that just keeps oozing all over every thread. I can only imagine what knowledge you'll possess when you're actually a nurse. (Still stalking...such fun.)
Can I just ask a question here, and excuse me for my ignorance, but here where I live, school nurses do not need prescriptions for OTC medications, so I'm wondering why so many on here do? Parents here sign a slip at the beginning of the year allowing the school nurse to administer OTC meds without involving parents or a doctor. They can give Tylenol, Ibuprofen, Benadryl........ Those kinds of items. Then when my child goes to the nurse and he has a headache, they can medicate him. My son does get migraines that are alleviated by ibuprofen. When he has a headache he goes and gets one. He also has acid reflux and I know they have treated that at the school nurse also, but I'm not sure exactly what was given.
I also worked as a pharmacy tech years ago and I have seen scripts written for fever before. If a doctor writes a script for ibuprofen and say medicaid will pay for it, they do write them that way. I've seen them written q 4-6 and q 6-8 before depending on the dosage.
Maybe it's just my state or my school district but my son has been in the same district since kindergarten and he is in fourth and it's been the same thing every year, that we just sign a form.
With being put on hold at the clinic, are you sure you are calling a clinic? When I was a pharmacy tech in retail, I saw some pretty crazy things occur. I'm thinking maybe there could be something shady going on in that aspect. I'll never forget the guy who impersonated a doctor's office from a pay phone along the freeway trying to fake a new vicodin script. I laughed so hard thinking what doctor's office has the sound of the interstate behind them? The police were waiting on that guy when he came in to our store trying to pick up his new vicodin script.
In my district, We can not give any med, OTC nor prescription without a written MD order, and a signed parent permission form.
I have heard of schools with standing order OTC meds that parents sign off on, but our school physician does not allow it. The only med we have a SO for is epinephrine.
And why in the world would a student stay in school with fever? Any order to medicate for fever is pretty useless to us. And child with a temp of 100 or higher is sent home, per policy.
In my district, We can not give any med, OTC nor prescription without a written MD order, and a signed parent permission form.
I have heard of schools with standing order OTC meds that parents sign off on, but our school physician does not allow it. The only med we have a SO for is epinephrine.
And why in the world would a student stay in school with fever? Any order to medicate for fever is pretty useless to us. And child with a temp of 100 or higher is sent home, per policy.
OldDude
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You all took the words right our of my mouth; enough said, considering the source. Thank you. I'm so fortunate, blessed really, to be allowed to be a part of this group and you guys put up with me. Love you all.