Parents won't send inhaler to school

BunnyBunnyBSNRN, ASN, BSN · Nov 30, 2010

We don't have a form like that, the only advice I can give you is DOCUMENT DOCUMENT DOCUMENT!!!!

Flare, ASN, BSN · Nov 30, 2010

Are they Christian Scientists or some religion that would possibly frown on medication use? How is the asthma treated at home?

i don't have a waiver that i'm aware of but i would make sure the parent was well aware that if i felt the child was having an asthma attack that i would not hesitate to call for an ambulance. (which i would do in any case where a child were having difficulty breathing and I couldn't manage it in my office.) Bet it would only take one time doing that for them to meet him in the ER for them to think differently.

pvtschoolnurse · Nov 30, 2010

This child was diagnosed last year (after repeated phone calls to the parents requesting that he be seen, it took around 3 months). They finally did send the inhaler to school last year. I know that he has had all of his immunizations, and we do not have a religious waiver on file for him.

rdsxfnrn · Nov 30, 2010

I had same problem, and had to call 911 for student. Oddly enough, inhaler came in pronto. :)

Jolie, BSN · Nov 30, 2010

I was new to my grade school last year and noted that a 5th grade student who had previously had an inhaler @ school did not have one last year. I contacted the mom and expressed my concern, but mom reassured me that her daughter's asthma had improved and an inhaler was no longer necessary. I was skeptical, but all I could do was document.

Needlss to say the student had an episode of breathing difficulty at school one day during PE and neither parent was answering their phones. Our state has an asthma/anaphylaxis protocol that I considered implementing, but held off because she remained pink, was improving in her ability to speak, and the protocol states that the student must receive an epinephrine injection first, then a nebulizer treatment if necessary. I was concerned that injecting the student would trigger such a fearful reaction that she would decline.

She recovered by the time the parents could be reached and arrived at school. The principal backed me up and insisted that the student be evaluated by a healthcare provider before returning to school. Mom very grudgingly took her daughter to the doctor. Later that afternoon, I got a phone call from the doctor's office nurse asking me to describe the child's episode. Apparently, mom had downplayed it and told the doctor that she was only there because the school wanted her daughter to have an inhaler.

Fortunately, I was able to describe the episode to the nurse and the physician agreed that an inhaler was warranted.

I truly think that mom was just sick and tired of dealing with her daughter's asthma and other health issues, and was in denial. This turned out to be a wake up call. In a way, I'm grateful it happened at school. If the girl had been on a soccer field in the middle of nowhere, things could have gone badly.

SchoolNurseBSN · Nov 30, 2010

Are they Christian Scientists or some religion that would possibly frown on medication use? How is the asthma treated at home?
i don't have a waiver that i'm aware of but i would make sure the parent was well aware that if i felt the child was having an asthma attack that i would not hesitate to call for an ambulance. (which i would do in any case where a child were having difficulty breathing and I couldn't manage it in my office.) Bet it would only take one time doing that for them to meet him in the ER for them to think differently.

Flare,

You took the words right out of my mouth! I have had this situation occur and parents were pretty upset when they got the $800 ambulance bill in addition to the hospital bill. Had an inhaler (and working phone numbers) in my med cabinet the day the kid returned to school

I think you don't need a waiver as long as your documentation is good.

safarirn · Dec 1, 2010

Document. Document. Document.

I send a letter that states, 'upon review of your child's health record, you're child, -insert full name here- has been diagnosed with asthma in the past. And then it goes on asking for an inhaler... etc.

I then sign it, make a copy for the health record & I mail it home. If parents are going to be noncompliant, you need to be sure YOU CYA big time!!!!

Long Term Care Columnist / Guide · Dec 1, 2010

Has anyone asked the parents if they have health insurance, or if they can afford medication for the child? As we all know, many families do not, and they don't necessarily want to advertise that fact---it's embarrassing! This could be the reason the OP's student doesn't have an inhaler; do you know how expensive those things are nowadays? Before the environmentalists got a stranglehold on aerosols, you could get a basic 200-dose albuterol MDI for less than $20; now they run $40-$50 for 100-150 inhalations.

Let's not judge the parents until we know their circumstances. Just sayin......

Neveranurseagain, RN · Dec 1, 2010

I just call the parents every time the child shows up in my office with asthma and have them bring the inhaler. After 4 trips in a week the student had an extra one sent to my office.

Purple_Scrubs, BSN, RN · Dec 1, 2010

This is a huge problem at my school. I have at least 3 known asthmatics right now with no inhalers and one of them lives at the homeless shelter so mom is impossible to get ahold of. And there is really no excuse in her case because they set them up with medical care at the shelter, so she only has to keep him out of school one day and take him to the free clinic to get the permit and extra inhaler.

If/when it gets bad enough and I cannot manage an attack with rest and calming/breathing techniques, I will call 911 without hesitation. So far I and the kids have been lucky, but I am afraid it will take a near trajedy to remedy the situation.

Purple_Scrubs, BSN, RN · Dec 1, 2010

I also have a student with a known insect sting allergy that mom has repeatedly refused to provide an epi pen.