Admin just not getting it

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We have went over and over how we need to revise the medication administration policy before next year. In my state the RNs can not dispense OTC meds without a Dr. order. But of course we are asked to do it everyday. The current policy is "Prescription meds in pharmacy bottle with label and authorization note from parent." Which that is fine. The OTC part is stupid and redundant "The parent must give consent for their child to have OTC meds such as Tylenol or IBU that they will supply to the school. The school does will not supply OTC meds." Well hello if I provide a bottle of Tylenol for my child then yes I am giving permission for them to have it. But the teachers do not want to give any meds. The expect me or the other nurse to give it all. We cant give OTCs I have screamed this till I am blue in the face. No we have no medical director and no standing orders either. And after asking for a meeting to review policies and getting no response to that I get an email asking me to read this and see if I agree with it. Um NO it addresses nothing! And NO the students may NOT bring any medication to school! I am about to curse! And of course it says nothing new about OTC meds.

Student Medication

Students who need to take medication during the school day should bring their medications with a note that is dated and signed by the parent with instructions as to how the medication should be given to the school office. The medication must be in the student's name if prescribed by a doctor. If the medication is over the counter, the medication must be in the original packaging with dispensing information. Each school should have a designated person to administer the medication to students. That individual shall be trained by the district nurse on the proper procedures to be followed when administering medication to students. Refer to full policy in the student handbook.

"Nursing tasks commonly performed in the home setting by a parent/guardian or caregiver take on a more complex dimension in the school setting. Often parents/guardians and school administrators are confused about why what appears to be a simple task is held to a much different and higher standard at school. One of the challenges to delegation in the school setting is that parents/guardians and school administrators may not recognize that there is a requirement for medical orders for any health-related procedures in the school setting and that nurses are held to a higher protocol standard than a parent/guardian would be when delivering the same procedure at home. The school nurse practices in the educational setting where nurses support the primary purpose of providing education and must comply with state and federal mandates, nursing licensure standards and meet the expectations of parents/guardians, while working to ensure the health and safety of all students."

From the National Association of School Nurses position statement on delegating tasks: Delegation, Nursing Delegation to Unlicensed Assistive Personnel in the School Setting - National Association of School Nurses

Here is the position statement on Medication Administration as well: Medication Administration in the School Setting - National Association of School Nurses

It's so frustrating to me that we are the only medical professionals in the building and even when we conclusively show what the law and/or best practice is, we are overruled. Why hire a medical professional if not to utilize their expertise?

Maybe tell them that as much as you know they would never hire a person without the appropriate qualifications to teach just because the parents wanted that person hired, you expect them not to put the school and your license at risk because the parents want you to give OTC meds without an order.

Good call.

"Nursing tasks commonly performed in the home setting by a parent/guardian or caregiver take on a more complex dimension in the school setting. Often parents/guardians and school administrators are confused about why what appears to be a simple task is held to a much different and higher standard at school. One of the challenges to delegation in the school setting is that parents/guardians and school administrators may not recognize that there is a requirement for medical orders for any health-related procedures in the school setting and that nurses are held to a higher protocol standard than a parent/guardian would be when delivering the same procedure at home. The school nurse practices in the educational setting where nurses support the primary purpose of providing education and must comply with state and federal mandates, nursing licensure standards and meet the expectations of parents/guardians, while working to ensure the health and safety of all students."

From the National Association of School Nurses position statement on delegating tasks: Delegation, Nursing Delegation to Unlicensed Assistive Personnel in the School Setting - National Association of School Nurses

Here is the position statement on Medication Administration as well: Medication Administration in the School Setting - National Association of School Nurses

It's so frustrating to me that we are the only medical professionals in the building and even when we conclusively show what the law and/or best practice is, we are overruled. Why hire a medical professional if not to utilize their expertise?

Thank you! I am printing this out now!

Specializes in IMC, school nursing.

Could you partner with your health department to come up with protocols that cover instances for OTC that are signed off by a physician? That is how I am able to give OTC medications. After all, our primary goal is to keep aes in classes, right?

It is so frustrating trying to explain things like this to "non medical" people. They just don't get it.

My principal sent home OTC permission forms to ALL STUDENTS for this school year and told parents that we would supply to medication. (Totally not true, and she's been principal for 20+ years here, she knows better!) So I have 200 permission forms for students for every med under the sun. So when little Susie starts vomiting and I call home Mom is livid because I can't just give her some pepto because she signed a form for it. :rolleyes:

We have went over and over how we need to revise the medication administration policy before next year. In my state the RNs can not dispense OTC meds without a Dr. order. But of course we are asked to do it everyday. The current policy is "Prescription meds in pharmacy bottle with label and authorization note from parent." Which that is fine. The OTC part is stupid and redundant "The parent must give consent for their child to have OTC meds such as Tylenol or IBU that they will supply to the school. The school does will not supply OTC meds." Well hello if I provide a bottle of Tylenol for my child then yes I am giving permission for them to have it. But the teachers do not want to give any meds. The expect me or the other nurse to give it all. We cant give OTCs I have screamed this till I am blue in the face. No we have no medical director and no standing orders either. And after asking for a meeting to review policies and getting no response to that I get an email asking me to read this and see if I agree with it. Um NO it addresses nothing! And NO the students may NOT bring any medication to school! I am about to curse! And of course it says nothing new about OTC meds.

Student Medication

Students who need to take medication during the school day should bring their medications with a note that is dated and signed by the parent with instructions as to how the medication should be given to the school office. The medication must be in the student's name if prescribed by a doctor. If the medication is over the counter, the medication must be in the original packaging with dispensing information. Each school should have a designated person to administer the medication to students. That individual shall be trained by the district nurse on the proper procedures to be followed when administering medication to students. Refer to full policy in the student handbook.

Sorry, I don't think the teachers should be administering meds, even OTC.

Specializes in School Nursing.

One of our district nurses asks parents, "If we were in a hospital and you brought me a baggie of pills and asked me to give it to the patient would you understand why I would have to say no? Yes? This is no different. In the hospital I even need an order for Tylenol."

One of our district nurses asks parents, "If we were in a hospital and you brought me a baggie of pills and asked me to give it to the patient would you understand why I would have to say no? Yes? This is no different. In the hospital I even need an order for Tylenol."

Yes! Thats good! But sadly where i live people are so backwoods they would think nothing of it. I hate to even say this but my own mother doesnt understand why she can't just take her home meds while in the hospital. Im like mom you cant do that. There is a policy and procedure for things.

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