I have a 1st grade student who gets ADHD meds in the morning at home, and a lunch dose here at school. Frequently, the parent "forgets" to give the morning dose, and it is very apparent with the child's behavior. He tends to settle down after his lunch dose, so it is pretty apparent to everyone what is going on. The mother is notoriously hard to get a hold of by phone as well.
The teacher is wanting me to give the morning meds in addition to the noon dose. I told her I needed a new permit signed by the doctor and the parent to do so, so the teacher got a permit completed by the parent...all it is lacking is the doctor's signature. She wants me to just fax it over and get the signature. I have a couple problems with this:
1) The meds really need to already be in his system for a while before he gets to school in order to maximize the effectiveness
2) Our med policy states that we will give meds at school that are necessary for the student to take in order to remain in school...it even describes giving meds that are required three times daily in the morning before school, when the child gets home, and at bedtime (the point being to minimize the number of meds given at school)
3) I feel like this is the parent's responsibility! If we cater to this, we are setting a precedent, and I guarantee that when this child gets to middle school they are NOT going to cater to them in this way!
I think the child's behavior issues should be handled as discipline issues to force the parent realize the extent of the problem. Part if the issue is that the teacher does not handle the child'e behavior as a disciplinary issue because "he can't help it because he hasn't had his medicine"...that is ridiculous to me! Students should be held accountable for their behavior regardless, and parents should be accountable for seeing that the child is getting the meds. I think if the teacher started doing office referrals when the behavior is our of control (example yesterday, screaming, cussing, basic temper tantrum). The student would probably be suspended and sent home...forcing mom to realize what an issue this is. This happens enough and I guarantee she is going to get tired of coming to pick him up and will be more likely to remember his meds! Is this fair to the student? Maybe not, but catering to a neglectful parent is not helping him out either. Administration is not even aware of the extent of the behavior problems because the teacher shields the student from reprimand because "he can't help it".
So, at this point I have a call into the nurse at the doctor's office and I'm waiting for a call back. I'm going to ask how the doc feels about the meds being given at school and express my concern about it not having time to take effect. I'm hoping they say no, it needs to be given at home :) I'm also going to have a talk with the principal when she is back in town next week. How would you all handle this? Thanks, :heartbeat y'all!
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
I agree Martha. I feel that giving that morning med is my way of supporting the educational process of the child, which just so happens to be my job! I would rather give the med that have the student walked down to the clinic daily at 10:AM by an exasperated teacher.
I work in a pretty small school...about 240 kids pre-k-6 and 160 in Jr-Sr High. I am not only the nurse but the elementarty secretary (budget cuts and all) I give (5) 8:00 am meds, (5) noon meds, (1) 2 pm med, and (1) 3 pm med. I agree with all the posts...yes, parents need to be responsible but as nurses, if we can help the child learn we must do out part also. It can get frustrating at times but I guess I would rather give the med here at school just so it is consistant.
I realize this is an older post so I apologize for giving it wings again. But....we are dealing hard and heavy with this issue in our district. Right now we have the same policy as most....we only give meds that are needed to keep the child in school. I am totally against giving AM meds when the parents/guardians can/should be responsible. The schools already transport, feed, cloth, teach, discipline, give medical care, health screenings, dental care, after care......all this care because many parents "just don't care". Now, I KNOW some parents are just not capable of parenting effectively so I'm not trying to make this a blanket statement.
If our district was to agree to giving AM meds....then we can not "pick and choose" who we give it too. Once we agree we open Pandora's box and they will come out of the wood works. We have one school that has 79 children who take some type of behavioral medication at home in the mornings. Can you imagine if ONE nurse (the district will NOT pay for help) taking up her valuable time to pop pills all day? She would NEVER be able to take care of the other students who require attention such as diabetics, asthmatics, tube feeders etc. Who is going to clinically judge "who" needs AM meds at school? You truly can't pick and choose one child over another....you will have angry parents and a whole lot of trouble knocking on the door. Our district has already said they will not allow staff to be trained to give medication like this. As nurses we worry about the safety factor also. What if the parent decided to give their child meds for the morning and then you give them another dose? We all know that you can have orders or an agreement and some parents will NOT follow them nor communicate with the Nurse as to what has or has not been done. Are we suppose to call each parent every morning to verify if they have given meds? Nope. This won't work. We all know half the time we can't find a working number just to call and let them know little Johnny has a fever. Our district only looks at the educational side of things and they can not see the nursing perspective. Their motto is: We educated them, you medicate them. As far as I'm concerned I feel that doctors are quick to diagnose children (younger and younger) with behavioral issues and medications. I feel there has to be alternatives in some cases (not all). I know this is a totally different thread when we start discussing children and diagnosis so I will stop there. Just my opinion on the whole AM med issue.
SchoolNurseBSN
381 Posts
I agree Martha. I feel that giving that morning med is my way of supporting the educational process of the child, which just so happens to be my job! I would rather give the med that have the student walked down to the clinic daily at 10:AM by an exasperated teacher.