OTC medications help

NutmeggeRN, BSN · Sep 14, 2012

Well my first question is to ask how much fluid have they had? did they eat breakfast or lunch? But, sometimes no matter what my thoughts are, they are convinced they need tyl/ibu..... hard to blame them as we have become a society that pushes medicine at everything. :banghead:

If it becomes the difference between staying in school and going home I am all for it. If I see a trend (same class) I will try to to get to the root cause....Not sure there is one good answer as each kid has a different need.

Flare, ASN, BSN · Sep 15, 2012

we discussed getting a standing order for otc pain meds in my old district. We decided in the end not to go through with it for similar reasons to what you are experiencing. Are you keeping a log on administrations? You could always put a cap on how many times a student can get an otc pain med before requiring a doctors note. If the students know they can only get the med 3 or 4 times before adding in a visit to a doctor or some other inconvenient step, it may dissuade them. In the mean time, it is well within your rights as a school nurse to tell a student that they have to get assessed or perhaps try increasing their fluid intake before going with the "chemical solution".

Jolie, BSN · Sep 16, 2012

Whether the students like it or not (and many high schoolers won't), it is our professional responsibility to assess them before administering prn medications, just as we would do in the hospital, clinic or home settings. Unless a student has prior approval to self carry and self administer, their medications are kept in the nurse's office precisely because there is a need for some degree of adult supervision in their use. That supervision involves more than just opening the bottle and handing over 2 tablets.

It is not likely that I would refuse to administer a dose of requested medication, but I do need to know why it's needed, how severe the symptoms are, what caused the symptoms, how long they've persisted, what (if anything) the student has tried to relieve the symptoms, and whether there may be a non-chemical treatment option. I might ask the student to consider other options first, with the understanding that they can come back for their Tylenol or Motrin.

Let me describe a few different scenarios: My daughter gets migraines. If she takes Motrin within a few minutes of feeling one start, she is fine. If medication is delayed, she becomes violently ill, vomits uncontrollably and needs an injection of medication at the doctor's office. When I submit her medication form every year, I make certain that the nurse, office staff and teachers understand the need for immediate treatment when she complains of a headache. I would have a serious tiger-mama moment if anyone delayed her medication.

Another student may come into the office wanting Tylenol for a headache. Upon questioning, it is revealed that the student overslept, had no breakfast, came in early for volleyball practice, and now at 10:00 has a headache. I would probably find something for the kid to eat and drink and ask her to come back in 1/2 hour if her head still hurts.

Another student may come in and want Tylenol for a headache. He's in a hurry and doesn't want to bother answering any questions. But when I insist on an assessment before giving medication, I find that he has a temp of 101 degrees, swollen cervical lymph nodes, a beefy red throat and white patches on his tonsils. He may need Tylenol, but he needs a ride to the doctor's office even more.

There is much about high school that students don't like. Giving up independence to the nurse is one of those things, but I believe that we owe it to the students to put professional standards before convenience. During the process we have the opportunty to teach these young adults important lessons about self care. Not to mention that the students who don't really need meds will stop coming.