Parents not giving ADHD meds...how far should we go?

Flare, ASN, BSN · Jan 20, 2011

well, on one hand in you are giving it in school you are assured that the child gets what he needs, at least 5 days/ week, True this doesn't help the parent become any more responsible, but let's be realistic - there are many many parents that are permanently out to lunch and it is the child that ends up suffering because their parent is a real dingbat! Sigh... if onlly we could just solve all the world's problems.

I tend to agree with the idea that the behavioral aspect should guide repeat disciplinary episodes to foster an environment where the parent feels compelled to be diligent with medicating her child. In a perfect world a few calls from the principal would have just this effect and the pill bottle would be put on the sink next to his toothbrush and it would be given every day.

I think reaching out to th doctor was a smart move - perhaps there is a once a day medication that could realistically be given under your watch. Perhaps the doctor wasn't aware that the child was missing so many doses and s/he would put more pressure on the parent to comply.

Keep us posted.

Purple_Scrubs, BSN, RN · Jan 20, 2011

Well, I just talked to the nurse at the MD office and they are of the opinion that they would rather him take it late (i.e. at school) than not at all :) So, I'm faxing the permit over and I suppose I'll be giving the meds in the am also. It's not that I mind giving the meds, I just hate that we're playing into the lack of accountability on the part of the parent. Oh well, que sera sera!

Flare, ASN, BSN · Jan 20, 2011

yeah - that's the face of our job anymore. The school is responsible for everything...

LACA, BSN, LPN, RN · Jan 20, 2011

I have a very similar situation with a K kiddo here. He's supposed to take it in the morning, but never gets it--and will tell you he never gets it. He takes it here at lunchtime. His problem isn't behavioral when he doesn't have it--he's a well behaved kid. He just can't focus, concentrate, and get his work done because he hasn't had his medicine. His grades have dropped dramatically in the last little while. By the time he takes his med at lunch, it kicks in close to the end of the day and does him no good. The teacher has suggested to the guardian that perhaps he could take it at school first thing in the morning but the guardian completely ignores the suggestion. I'm at a loss for what to do.

luvapug · Jan 20, 2011

I completely understand where you're coming from but there are just some parents that will never "get it" no matter how many times you send their child home-they'll just blame the school for making things hard. We have had a few requests over the years from dr's to please start giving the med at school first thing in the am just to make sure the kid will get it regularly. There's also the issues we've had where the parent is selling the drugs instead of giving them to their child. We always go along and just give it because it's better than not at all which then creates a disruption in the teacher's/kid's/nurses'/parents day. I agree that it SHOULD be a parental responsibility but it all comes down to what is best for the student and sometimes that ends up being the nurse.

Purple_Scrubs, BSN, RN · Jan 20, 2011

Very true, actually to all of the above, lol. I just worry about what is going to happen with this family when they get to middle school. I know the MS nurses will NOT take to this without a fight. They have more kids, busier days, and sometimes no FT nurse. Like I said, I don't mind doing it, it's really not that big a deal to give a couple meds after his breakfast. I just wish the parents would feel *some* kind of consequences...as of now it is the student and the school staff bearing the brunt of it all

bergren · Jan 21, 2011

If we argue school nurses are needed because we impact the health and LEARNING of students, it is difficult to argue that administering medication for ADHD is not our job just because it COULD be given at home. Our obligation is to the student and the school and if the parents are willing to let the school administer the medication, it certianly seems appropriate to do so. The school benefits from a properly medicated child more than the parents do.

" I just hate that we're playing into the lack of accountability on the part of the parent. "

" I just wish the parents would feel *some* kind of consequences"

See this website:

Parents with ADHD probably suffer from impairments in executive functions creates challenges in the treatment of their children. This article discusses some of the specific challenges that I have observed in regard to parents with ADHD and executive function impairments

http://www.psychiatrictimes.com/adhd/content/article/10168/53746

Purple_Scrubs, BSN, RN · Jan 21, 2011

I never said it wasn't my job, but in my district our policy is very specific that any meds that CAN be given at home SHOULD. If we did not enforce this policy, I would do nothing but pass meds and then the rest of the school would miss out of the health promotion, screenings, and millions of other things we do. Like I said, I don't mind doing it, but at some point these parents are going to have to take responsibility for making sure the child gets his medicine. We are already raising a generation that believes that all their problems are somone else's responsibility to fix. I am tired of the learned helplessness thing. Mom can't remember to give his meds, oh well, make the school handle it. There should be a partnership between school and family, not passing the buck.

bergren · Jan 21, 2011

Agree on the partnership.

But many children with ADHD have parents with ADHD.

And the parents don't suffer if the child does not get the medication. The child and the teacher and the other children in the classroom do.

There are solutions that might work before the medication needs to be administered in the school. The cheap watches that have timers. The child's watch could be set to go off for the morning medication before he leaves home. That could be experimented with before bringing the meds to school.

But if other strategies have been tried and failed, the bottom line is school nurses are more valuable to the school if we raise test scores. This is one of the school nurse interventions that is directly tied to LEARNING. Our salaries are paid for the most part by the education system and this is one of those interventions that directly benefits "the hand that feeds us."

tencat · Jan 21, 2011

I just wish the parents would feel *some* kind of consequences...as of now it is the student and the school staff bearing the brunt of it all

And that is reason #153 as to why I left teaching.........no accountability for kids or parents with schools being left to be responsible for everything, even things they obviously have no control over.

Jolie, BSN · Jan 22, 2011

I had a grade school student who came in to my office near the end of the school year last spring with an authorization from Mom and doctor to receive a critical med on his way into school on 2 set mornings per week. The authorization made no sense to me, since he didn't participate in early am daycare at school and also since this was med that had to be given daily in order to be effective.

I called Mom and learned that those were the 2 days that his dad brought him to school, following overnight visitation, and that Dad was so unreliable and un-cooperative that the child had been missing his essential medications on those days. Mom really wanted to take him to court to argue for no overnight visitation, but didn't have the money to do so and was advised that it was unlikely that a judge would rule that way, even though the dad's neglect of his son's meds was impacting the child's health.

I was deeply saddened to learn that this mom, who was a lovely lady, had to deal with handing her child over to a "parent" who cared so little about the child's very real health needs. I would literally go insane with worry in such a situation. Never having dealt with divorce (thank heavens) it is humbling to see what some children and estranged spouses are put thru at the hands of someone who should have the child's best interests at heart.