Peanut allergy issue

  1. So typically I try to do my own digging around and research before posting here but in a bit of a dilemma as I am currently hospitalized with preterm labor, doing research on my iPhone is not so easy and don't you know the unexpected circumstances has the health office in a huge mess right now.
    i got a call from my health room aid that our local private school (who utilizes us as their school nurse for inquiries) is having an issue. They have a student with a severe peanut allergy (not just consumption but contact as well). They wrote up a letter and sent it home to all the parents indicating the school is peanut free now and asked that parents return the paper signed and ONE parent is down right refusing saying she will continue sending pbj sandwiches every day for her child. This child is also in the same grade as the child with the peanut allergy (they are a VERY small school of k-5 with 15-25 children per grade)

    any insight on how this should be handled?
  2. Visit Csn2016 profile page

    About Csn2016, BSN, RN

    Joined: May '16; Posts: 47; Likes: 103

    45 Comments

  3. by   MrNurse(x2)
    I realize that I am the minority on this, and will probably be blasted as narrow minded, but hear me out. There is NO WAY you can guarantee a peanut free environment. Despite what some school boards think, they can not control individual homes and the practices there, therefore latent peanut contact can still happen. You can make the space safer, and a peanut free table is more than enough control on this matter. We had an issue last year where a parent wanted this same demand, however we have at least a dozen (10% of students) that only eat PBJ every day. Should those students suffer when a safe alternative with the table exists? We had students in the class with the allergic student wash hands after lunch. The real world isn't peanut free and giving a false sense of security is detrimental in the long run. I understand the fear the parents of these highly allergic children must feel on a daily basis. It isn't fair that humans have devolved to the point of anaphylaxis, but it also isn't fair that someone else should go hungry when there is a safe alternative.
  4. by   ABRN2012
    Quote from MrNurse(x2)
    I realize that I am the minority on this, and will probably be blasted as narrow minded, but hear me out. There is NO WAY you can guarantee a peanut free environment. Despite what some school boards think, they can not control individual homes and the practices there, therefore latent peanut contact can still happen. You can make the space safer, and a peanut free table is more than enough control on this matter. We had an issue last year where a parent wanted this same demand, however we have at least a dozen (10% of students) that only eat PBJ every day. Should those students suffer when a safe alternative with the table exists? We had students in the class with the allergic student wash hands after lunch. The real world isn't peanut free and giving a false sense of security is detrimental in the long run. I understand the fear the parents of these highly allergic children must feel on a daily basis. It isn't fair that humans have devolved to the point of anaphylaxis, but it also isn't fair that someone else should go hungry when there is a safe alternative.
    I agree with all of this. There is no way to say "peanut free". I had to explain this to a church friend of mine whose child is severely allergic and decided to home school because the school district told her they could not promise peanut free but that the allergy would be taken very seriously and they would do all in their power to make it safe for her. I told her there is just no way to control what everyone else does. For example my own child had eaten a PB and toast for breakfast at home (as we rush out the door) many times. So once he gets to school and sits next to someone with PB allergies then there goes the idea of a peanut free school. She still didnt get my point.
  5. by   OldDude
    Quote from MrNurse(x2)
    I realize that I am the minority on this, and will probably be blasted as narrow minded, but hear me out. There is NO WAY you can guarantee a peanut free environment. Despite what some school boards think, they can not control individual homes and the practices there, therefore latent peanut contact can still happen. You can make the space safer, and a peanut free table is more than enough control on this matter. We had an issue last year where a parent wanted this same demand, however we have at least a dozen (10% of students) that only eat PBJ every day. Should those students suffer when a safe alternative with the table exists? We had students in the class with the allergic student wash hands after lunch. The real world isn't peanut free and giving a false sense of security is detrimental in the long run. I understand the fear the parents of these highly allergic children must feel on a daily basis. It isn't fair that humans have devolved to the point of anaphylaxis, but it also isn't fair that someone else should go hungry when there is a safe alternative.
    AYE!! A peanut free school is a fantasy and a "feel good" environment which invites disaster. The data is starting to come in confirming that. But, specifically regarding your situation, considering your school is "where it is," unless administration is prepared to remove the "violating" students from enrollment and not allow them on the property there isn't anything to be done other than live with it. Another reason "peanut free" is a bad idea.
  6. by   OldDude
    Oh yea, good luck on cooking that little one!!
  7. by   Cattz
    Yes I agree "Peanut Free" is impossible and I have made sure all my schools never refer to us as being such. (Even so much as explaining this AGAIN to one of my Principals, who had already put "Peanut Free signs all over the school. She changed her signs to Peanut Aware.) But, on a personal note, my 1st grade grandson loves PB and J more than any other food on earth. One of his best little friends is allergic to peanuts. We no longer serve peanut butter in that school and we have a Peanut safe table We still choose not to send PB and J for our Grandsons lunch, just because we don't want to take a chance. There are other things he can take for lunch and he is ok with that. We used it as a learning experience, that sometimes we have to think about what someone else needs over our own wants.
  8. by   BiscuitRN
    I agree with MrNurse. I work at a "nut aware" school. The policy is not and has never been my choice. It's a main selling point of our (private) school. Our cafeteria serves no nuts, nuts are BANNED from campus (which is laughable as the teachers bring a box of pb cookies to share in the breakroom and children are eating those single serve Nutella with dipping sticks as they wait for their parents after school). Then last year some of our high school kids took a field trip to Whole Foods for a cooking class. One of the children with allergies ate a nut. A 16 year old. In Whole Foods. Ate a whole walnut.

    I actually disagree with the idea of a nut-free table. I have two cousins with severe peanut/tree nut allergies, and they said sitting at a nut-free table felt like sitting at the freaks table. They preferred to just wash their area and not touch other people's food. They also have made the point that there are no nut-free tables in adult life so it's better to get used to making your own accommodations as a kid.

    Solutions: the student should be assisted in wiping their eating surface off with a Clorox or Wet Wipe. Don gloves if needed. This will likely become something they have to do in life if they are truly this allergic. With the permission of the student's parents, have the school nurse/health aid give an age-appropriate presentation on allergies. Teach the children to wash their hands after eating and to keep their hands to themselves when eating ESPECIALLY when eating food their friend might be allergic to. Send a note home to parents explaining that a student in the class has a life-threatening peanut allergy and to please label any class snacks (those to be shared for celebrations) with ingredients. Let the allergic student's parents know when a celebration will be taking place so they can send their child with a nut-free snack.
  9. by   kidzcare
    Agree that the phrase "peanut free" should not be used. "Peanut/nut aware" is better. No one can guarantee a peanut/nut free environment and you don't want to create a false sense of security.

    This parent, however, is being selfish. A child could die next to hers and she is assuming a "not my problem" mentality. A completely safe environment cannot be guaranteed, but reasonable adults should make efforts to make things safe. Not to mention that this parent is sending a message to their child that their desire for a PB&J is more important than another student's safety. Talk about creating a sense of entitlement.

    I have a student in preschool with 6cm of working small intestine (Hirschsprung's disease) and, as a result, she is highly susceptible to infections which can turn life-threatening quickly. So we ask that the kids wash their hands more frequently. Would this parent refuse to have their child wash their hands because it makes their skin dry? Send their kid in with a fever because they don't want to take the day off work to stay home with a sick child?

    ETA: this is a private school? They should be able to deny admittance to anyone. If this parent does not want to follow a simple guideline, they can be asked not to return. Alternately, the allergic child could be asked not to return.
  10. by   LikeTheDeadSea
    Fun research:

    Impact of school peanut-free policies on epinephrine administration. - PubMed - NCBI

    Peanut-"free" zones don't change rate of Epi being administered. Peanut free tables do.

    We just do our best.

    ALSO SENDING YOU GOOD VIBES FOR YOU AND BABY!
  11. by   Csn2016
    Quote from OldDude
    AYE!! A peanut free school is a fantasy and a "feel good" environment which invites disaster. The data is starting to come in confirming that. But, specifically regarding your situation, considering your school is "where it is," unless administration is prepared to remove the "violating" students from enrollment and not allow them on the property there isn't anything to be done other than live with it. Another reason "peanut free" is a bad idea.
    Okay so this was how I was feeling too since it is such a small school I'd think it'd be even easier to keep an eye out. Maybe enforce hand washing when returning from lunch back to the classroom and no homemade food products for special occasions (so ingredients are clearly labeled on packages)
    My brain can't really process too much right now so yeah sorting this out in my head I needed some back up reassurance lol
  12. by   KeeperOfTheIceRN
    Quote from MrNurse(x2)
    I realize that I am the minority on this, and will probably be blasted as narrow minded, but hear me out. There is NO WAY you can guarantee a peanut free environment. Despite what some school boards think, they can not control individual homes and the practices there, therefore latent peanut contact can still happen. You can make the space safer, and a peanut free table is more than enough control on this matter. We had an issue last year where a parent wanted this same demand, however we have at least a dozen (10% of students) that only eat PBJ every day. Should those students suffer when a safe alternative with the table exists? We had students in the class with the allergic student wash hands after lunch. The real world isn't peanut free and giving a false sense of security is detrimental in the long run. I understand the fear the parents of these highly allergic children must feel on a daily basis. It isn't fair that humans have devolved to the point of anaphylaxis, but it also isn't fair that someone else should go hungry when there is a safe alternative.
    DILLY DILLY!! Like the others have said, there is no way to guarantee a peanut free campus. All we can control are the actions that physically happen in the school where we can help minimize their exposure, like a peanut free table and frequent hand washing.

    I like to think the one parent refusing to sign the agreement isn't doing so out of malice, but rather out of concern for their own child having to go hungry. I know my son would be in a world of trouble if his school ever banned lunchables due to an allergy risk because that is literally the only thing he will bring if he's not buying a hot lunch at school. So, from that perspective, I can understand a slight reservation. But I definitely wouldn't flat out refuse. That's a bit extreme. I'm sure there are other things the parent can pack for a lunch that isn't potentially going to kill someone. Sheesh.

    Good luck with you delivery! I hope all settles down and you and baby are healthy and happy!
  13. by   UrbanHealthRN
    My work is with the littles, and in that age group it can be tricky to manage food allergies when all you're doing is herding cats all day (or so it feels like!).

    We serve breakfast, lunch, and snack on site (no food brought in from home), and we use sunflower butter instead of peanut butter (which, btw, is a very tasty substitute.)

    But! Even with these pretty hefty attempts to limit peanut exposure, we still make our food allergy kids bring in epi-pens to school, and we have zero control over who touches a jar of peanut butter/eats a peanut butter cracker/etc. before the start of the school day. And our food allergy families thankfully know and understand this. I agree with the above posters about trying to create smaller, nut-free zones at school, like a lunch table, instead of claiming that the entire building has nary a greasy trace or odor of peanuts.
  14. by   JenTheSchoolRN
    My school is peanut/tree nut "free." No peanuts or tree nuts in the building.

    However, we don't have a cafeteria currently and students eat lunch in home rooms and teachers have students clean up after, to varying degrees of actual cleanliness. Therefore a student could eat a PB sandwich at a desk at lunch, not clean it properly and a student with an allergy could end up sitting at desk next period.

    Yeah, imagine how fun that is for me .

    I had a student have a reaction sitting next to another student eating peanut butter. The student wasn't upset about the other student eating it, nor was the parent, but we had to think about getting the allergic student a safer space. So if student's normal lunch spot might have exposure, student is allowed to eat elsewhere and take a friend. But this student is in HS and both Mom and I realize the world isn't allergen free and how we can get student to have practical, safe practices. This includes my teaching student how to give a Epipen to themselves if needed.

    I feel like it is more my place to teach a student how to manage their allergy in both school and the world outside of school then spend my entire day policing the policy. It is there. We make sure any food we provide, including the school lunches we get delivered, are tree nut and peanut free. What else can one do?
    Last edit by JenTheSchoolRN on Sep 25

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