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School Aide Jailed For Stealing And Replacing Students' Medication

Posted

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

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

Specializes in School nursing.

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

Specializes in school nursing. Has 6 years experience.

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"

Edited by CanIcallmymom

GdBSN, RN

Specializes in School Nurse. Has 6 years experience.

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

Specializes in ICU/community health/school nursing. Has 12 years experience.

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

Specializes in school nursing, ortho, trauma.

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.

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, BSN, RN

Specializes in School Nursing. Has 6 years experience.

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.

Edited by LikeTheDeadSea
grammar/flow of sentence

ruby_jane, BSN, RN

Specializes in ICU/community health/school nursing. Has 12 years experience.

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

Specializes in school nursing. Has 6 years experience.

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"

Edited by CanIcallmymom
Edited to add: I'm not sure that counting it daily is actually LAW but it pulls up in a medication guide for schools that's distributed by DHS, so I go by it.

CanIcallmymom, BSN, RN

Specializes in school nursing. Has 6 years experience.

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

Specializes in School nursing.

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.

BrisketRN, BSN, RN

Has 4 years experience.

Just wondering--has anyone else ever dealt with liquid controlled substances? When I worked in home health we would do the math and put a piece of masking tape on the side marking where the medication level was at the end of each shift and wrote what it would be based on the math (35ml-5ml=30ml). Is there a better way? Weighing it on a small scale?

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

In the 90's, my youngest needed noontime Ritalin. RN covered 3 schools, so the secretary administered from prefilled weekly mediplanner that I sent in on Monday and arrived home via backpack Friday; did have empty RX bottle kept at school along with doctors note. Resolved when longer lasting Concerta came on market, given at breakfast. No medication count record kept. In today's "I'll sue" mindset, can see that med count record needed for controlled substances to CYA and help curb/catch early stealing meds.

k1p1ssk, BSN, RN

Specializes in pediatrics. Has 10 years experience.

1 hour ago, BrisketRN said:

Just wondering--has anyone else ever dealt with liquid controlled substances? When I worked in home health we would do the math and put a piece of masking tape on the side marking where the medication level was at the end of each shift and wrote what it would be based on the math (35ml-5ml=30ml). Is there a better way? Weighing it on a small scale?

I would insist that the pharmacy place it in a bottle that has measurements on the side in mLs OR that they use pre-measured syringes; Mark down the beginning measurement and count by mLs each day... maybe even mark down coloration and consistency to make sure that liquid isn't being removed and replaced with water or something. This is how it was handled in a nursing home I worked at.

BrisketRN, BSN, RN

Has 4 years experience.

6 minutes ago, k1p1ssk said:

I would insist that the pharmacy place it in a bottle that has measurements on the side in mLs OR that they use pre-measured syringes; Mark down the beginning measurement and count by mLs each day... maybe even mark down coloration and consistency to make sure that liquid isn't being removed and replaced with water or something. This is how it was handled in a nursing home I worked at.

Yes--I forgot to add the bottles are always marked with measurements! Those bottles have measurements in 5ml increments and the dose is 4ml so the tape is just to mark exactly.

SandIsMyGlitterRN, BSN, RN

Specializes in School Nursing. Has 21 years experience.

1 hour ago, NRSKarenRN said:

In the 90's, my youngest needed noontime Ritalin. RN covered 3 schools, so the secretary administered from prefilled weekly mediplanner that I sent in on Monday and arrived home via backpack Friday; did have empty RX bottle kept at school along with doctors note. Resolved when longer lasting Concerta came on market, given at breakfast. No medication count record kept. In today's "I'll sue" mindset, can see that med count record needed for controlled substances to CYA and help curb/catch early stealing meds.

They let students bring in their own meds in backpacks!??? Now that is trust. Would never fly now.

Bulldogs, CNA, EMT-B

Has 4 years experience.

21 hours ago, JenTheSchoolRN said:

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.

Tell me More about your system . YOu refill a personal pill box for each student for the week on Fridays??? Are you placing labels on theses with names dob medication type???? I* am very curious about this as I am the District nurse but this could help our my secretaries at my other campuses and I would be the only one counting pills.