RN, School Nurse

[Melmel75]

I'm a school nurse.

We have many kids with chronic conditions that require medication. Parents can be very lackadaisical when it comes to bringing in their children's life saving meds (Epi-Pen, Diazepam, Albuterol, etc) and Emergency Action Plans (signed by Dr with specific instructions).

I'm curious how other schools handle non-cooperative parents that find one excuse after another, and simple not bring in emergency medication.

Who is liable in case of an emergency and no medication on hand? School? Parent?

How much time do you give the parent to provide emergency medication before you take the next step? What is your next step?

Thanks

[whain, BSN]

You can't control the parent's decision so the best way to keep your sanity is to let that fight go.

Next step: documentation (document the parent refused, multiple times), education (explain to parent the importance, see if there's a reason such as cost for them not bringing it, offer solutions, educate student (age appropriate) and teachers (what to do if seizure happens, etc.), then document all of that), create your own ECP/provide that to teachers (and document that), call 911 when emergency happens/don't mess with trying to stabilize the student yourself.

Community nursing is about being creative with limited resources. Cover yourself with documentation, educate your populus on how to handle emergencies, remember that any student can have an undiagnosed asthma attack/anaphylaxis/seizure -- you wouldn't have medication on hand in that situation either -- so your actions aren't really all that different.

I know people want to call CPS when they can't get medication that they feel is needed for the student. However, I have never seen that course of action result in the parent bringing medication to school. Usually that just pushes the parent further from being cooperative OR they withdraw the student/take them to another school.

If you do your job well and have the documentation to back up every single effort you put into keeping that student safe, liability should never be a concern.

[LikeTheDeadSea, MSN, RN]

Welcome to the school nursing forum!

One of us! One of us! One of us!

Documentation and a generic emergency plan feel like "doing nothing" since you're still left without emergency supplies, but it's a big CYA. I agree with Whain about calling 911 if things start looking dicey, just like you would with a kid having an unknown reaction/episode.

I never hope it comes to that, but I'm sure Inhalers will magically appear once parents realize their ER trip could have been avoided.

[MrNurse(x2), ADN]

I work private, not sure how this would fly in public school. I send emails citing EMS response time to our location, approximately 20 minutes. I state that brain death occurs in 4 minutes without oxygen and it would be very frustrating to know what to do yet not have the tools necessary to treat their child. This is almost 100% effective. Be prepared for some frantic calls because too many parents are FB readers, meaning they scan for some words and don't really read it.