School Aide Jailed For Stealing And Replacing Students' Medication

[NRSKarenRN, BSN, RN]

Will spend 5 years in prison

What advice do AN's school nurses offer to minimize this issue? Especially with district having one RN covering multiple schools using nursing aide in each school in place professional RN/LPN. Karen

March 4, 2020 from I Heart Radio:

School Aide Jailed For Stealing And Replacing Students' Medication

https://www.iheart.com/content/2020-03-04-school-aide-jailed-for-stealing-and-replacing-students-medication/

Quote

,,, The school's nurse began to suspect something was amiss last year when she noticed that pill bottles were not in their usual locations. She believed that her aide,... was tampering with the medications.

As the nurse began to look into the matter, she found that the pill count logs had been altered. While the nurse was trying to figure out what was going on, the police received a report from a parent that her child's Adderall had been replaced with Benadryl.

During an investigation, school officials discovered two other cases in which a child's medication had been stolen and replaced. Police arrested Poytress, and she told investigators she had been battling an "opium problem" for five years....

[JenTheSchoolRN, BSN, RN]

Easy answer: every school building should have its own nurse. (For many reason besides the above.)

Less expensive option: have the RN in charge do a medication count/reconcile at least once a week at each campus they oversee. (I do this in my own office for myself.)

[CanIcallmymom, BSN, RN]

1 hour ago, JenTheSchoolRN said:

Easy answer: every school building should have its own nurse. (For many reason besides the above.)

Less expensive option: have the RN in charge do a medication count/reconcile at least once a week at each campus they oversee. (I do this in my own office for myself.)

I reconcile my meds for controlled substances daily. I don't trust people.

Edited to add: Our state's medication guidelines actually state to do so as well: "Extra precautions should be taken when handling controlled substances (drugs). Controlled drugs (such as Ritalin and Adderall) are substances that have potential for abuse, physical dependence, psychological dependence, with varying degrees of medical acceptance and restrictions on usage.3 Controlled drugs should be counted on arrival to the school, daily by the individual administering the medication, and at least weekly with a witness.4 All counts should be recorded in the student’s medication record by all present witnesses.5"

[GdBSN, RN]

10 minutes ago, CanIcallmymom said:

I reconcile my meds for controlled substances daily. I don't trust people.

Edited to add: Our state's medication guidelines actually state to do so as well: "Extra precautions should be taken when handling controlled substances (drugs). Controlled drugs (such as Ritalin and Adderall) are substances that have potential for abuse, physical dependence, psychological dependence, with varying degrees of medical acceptance and restrictions on usage.3 Controlled drugs should be counted on arrival to the school, daily by the individual administering the medication, and at least weekly with a witness.4 All counts should be recorded in the student’s medication record by all present witnesses.5"

What state are you in? This is interesting.

I count my controlled meds once a week, and after returning to the clinic when someone else gave meds when I wasn't on campus.

[ruby_jane, BSN, RN]

26 minutes ago, CanIcallmymom said:

I reconcile my meds for controlled substances daily. I don't trust people.

DADGUM. I salute you - I really only counted in beginning and ending but our district makes it easy for me by allowing only a week's worth of med to be brought at a time. My last district allowed whatever to be brought whenever. Good on you.

[Flare, ASN, BSN]

I count weekly (honestly, probably more - I tend to tell the kids how many they have left regularly) and when I return after being covered by a sub.

My controlled meds are in my double-locked cabinet with the keys being kept in my desk. I am not sure why this aide would have access to the meds unless in that state the UAP can admin meds. Here, it must be an RN.

[ihavealltheice]

I manage 2 schools and I trust my health aid, but hearing stuff like this makes me nervous. The way that we work it in my district is that I am housed in 1 school while my health aid takes care of the other school. I am labeled as the "district nurse" so I do everything but take care of the daily/emergent needs over there. Trouble is that I rarely have the ability to go over there because there is no one to sit in my office here. This leaves me responsible for something that I have no control over.

I have been fighting for a second nurse since day one, but since it is not law to have a nurse in every building nor is it no longer law for a nurse to have to dispense meds (which didn't matter to them even before it changed), it's just "not in the budget."

[LikeTheDeadSea, MSN, RN]

I'm not a huge fan on the focus being the person is unlicensed and that changing this is the key to prevent medication diversion in the school settings. The state they're in allows for it, so we should assume they were trained per protocols. RN/CSNs can also do this, being licensed doesn't make people unable to make these decisions. Any office that has multiple staff members makes it easier for diversion to happen if protocols aren't in place.

Having routine checks and paper trails is important. I've worked in many school districts in the last decade, especially early in my career, and most did not have a formal way of tracking or counting, which is asking for trouble, especially with multiple people dispensing through the week.

[ruby_jane, BSN, RN]

52 minutes ago, ihavealltheice said:

I manage 2 schools and I trust my health aid, but hearing stuff like this makes me nervous. The way that we work it in my district is that I am housed in 1 school while my health aid takes care of the other school. I am labeled as the "district nurse" so I do everything but take care of the daily/emergent needs over there. Trouble is that I rarely have the ability to go over there because there is no one to sit in my office here. This leaves me responsible for something that I have no control over.

I have been fighting for a second nurse since day one, but since it is not law to have a nurse in every building nor is it no longer law for a nurse to have to dispense meds (which didn't matter to them even before it changed), it's just "not in the budget."

"With so many people who have keys it's going to be difficult to accurately perform a count of the medications."

Consider going to a week's worth of meds at a time...parents hate it but that's a solution to the count/recount issue.

[CanIcallmymom, BSN, RN]

3 hours ago, GdBSN said:

What state are you in? This is interesting.

I count my controlled meds once a week, and after returning to the clinic when someone else gave meds when I wasn't on campus.

Texas.

https://www.dshs.texas.gov/schoolhealth/tgshs/sclhealthservices/

And then click "Guide to Medication Administration in the School Setting"

[CanIcallmymom, BSN, RN]

2 hours ago, ruby_jane said:

DADGUM. I salute you - I really only counted in beginning and ending but our district makes it easy for me by allowing only a week's worth of med to be brought at a time. My last district allowed whatever to be brought whenever. Good on you.

Only my controlled substances! There's no way I could count ALL meds daily, I have about 60 prescriptions in my clinic. I think only 8 or 9 controlled meds. It drives me nuts, and I'm not perfect so I've missed days here and there, and also when I've been out. But too many people have master keys.

I agree that bringing in weekly is the best. I have one student who does this, I wish they all did. It makes it so much easier.

[JenTheSchoolRN, BSN, RN]

19 minutes ago, CanIcallmymom said:

I agree that bringing in weekly is the best. I have one student who does this, I wish they all did. It makes it so much easier.

If I did weekly, I would have kids going days without ADHD meds.

I do count my controlled at least 2 times a week. I actually do pill boxes for each student and refill them on Fridays. I do a bottle count each Monday when I start the week and Friday when I refill the boxes. Boxes also let me track the week and also whether or not student received a med or not (especially when I get uber busy during a med pass time).

However, there are only two keys to the locked cabinet in my office that contains meds and they don't circulate beyond myself, my boss, the nurse from our other campus, or given to sub if they cover me so that helps.