parent refuses to send prescribed meds at school..

[kam474]

New school nurse here at a private school. , any advice? We are in MA, and I have looked at the DPH / state website and it does not address this topic

-Child has a 2x daily rx order for g-tube feedings at school,

-Parent has refused to send med in because she feels child does not need medication

-MD has been contacted, will not discontinue med until he see's the patient

-Mom has yet to set up appt (7 days)

?At what point does this become medical neglect?

?Does your school have any policies you could refer me to? (Our school does not have a policy regarding this)

[schooldistrictnurse]

I would document "no med available--parent has been contacted" or "med held per parent request" until the issue is resolved.

[Flare, ASN, BSN]

is this for a supplement or for a primary form of nutrition? if it's primary then i'd be more inclined to start really making waves, but if it's a supplement and the child eats well beyond, then i'd go with schooldistrictnurse's suggestion

[kam474]

Thanks, This is a secondary, however the PO intake of food is minimal at school.

[BSNbeauty, BSN, RN]

At this point social worker needs to be involved. Not supplying the child with ordered gtube feedings is considered neglect. The is poor child could be starving.

What does your supervisor have to say about this?

[kam474]

They want a doc stating that it is state policy to report med neglect before I do so. I have since been able to convince the MD's office to contact family. Apt. is set up for next week.

Does anyone know of if it is a written policy in state health? MA's is about 1300 pages long, and I have yet to come across it.

[Jolie, BSN]

It would probably be quicker and easier to reiew mandatory reporting requirements for yourself (nurses), teachers and school administrators.

Alternatively, does your state have a school nurse liason to the BON or department of public health who might be able to advise you of your legal reporting requirements?

Given that this is a medical issue and not one of obvious physical neglect visible to teachers, this is undoubtedly going to fall into your lap. I applaud you for trying to encourage cooperation with the parents and the child's physician rather than jump headlong into mandatory reporting, which will put everyone on the defensive.

[Nurse ABC]

You say it's secondary and you notified the dr and the mom has an appt so that's good. I would document all that and start weighing the child weekly. Unless he/she is losing weight (which would give you a good reason to report it to CPS) I wouldn't worry too much. It may be considered medical neglect but unless it's really adversely affecting the child's health then CPS won't do much.