I am new as a high school nurse. Our district has a standard form used for impairment evals - basically vitals, pupils, orientation, nystagmus, stand-and-turn and Romberg, and some questions....but I seriously question the value of these assessments. Or at least I'm frustrated by them, because typically what the principal or teacher wants is "proof."
Our form is basically an adapted police field assessment, which was intended to screen for impairment and legally support a decision to detain the person and require they provide evidence - a breathalyzer or blood test. But since in a school we don't do laboratory tests to confirm or rule out substance use, and since we're not building a court case, what's the point? Some of the kids referred to me are surely high as kites (on marijuana or occasionally something else), but if they're regular smokers who aren't dumb enough to do it in front of witnesses in the parking lot and breeze in reeking of weed, there is not any definitive exam to "prove" it. Even if they smell like pot, I'll note that but it doesn't prove anything.
If a kid has pinpoint pupils and respirations of 4/minute, or if they're agitated and hallucinating, I'm calling 911 regardless of whether it's from drugs or something else. If the kid is upright, walkie-talkie and doing math problems, denying any use, denying any physical complaint, they're probably going back to class; staff can still call parents if they're aware of some concern. I'm basically just figuring out if they're safe and stable; I don't have secret drug-detection powers!
Personally I fill out the form, noting my observations, I'll document whether the kid admits to any use, and I'll provide education to the kid about risks - but I tell the teacher or principal every time AND document on the form, "Substance use cannot be confirmed or ruled out without laboratory testing, which is not available in this setting."