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Y'ALL.

Teacher got me all riled up this morning! Good grief!

Had a student come to my office asking if I had something for asthma. Told the student I didn't. Called home. Mom brought inhaler and went home with paperwork for medication on campus. NBD.

BUT! While we were waiting for mom to arrive, this student tells me their teacher offered them their PERSONAL inhaler but told the student they needed to ask their mom first. :eek::eek::eek: I told the student this is never, ever, EVER ok and to always come to me or the front office if they need something. Student agreed, we went about our conversation waiting for mom to arrive.

During our wait, the teacher in question came to check on the student. Teacher then states "yeah, I offered them my inhaler but I told them they needed to ask their mom first" :bored: I informed said teacher that this is never ok and teachers, staff, non-custodial adults, pigeons, WHOEVER cannot offer students medications. EVER. Teacher responds with "well I just figured it was ok because when I was in school, several friends and I had the same inhaler so our school nurse and my parents said it was ok if I used their inhalers". :banghead: Again, told teacher this isn't an option; even inhalers have different dosages and there are different types and not everyone needs the same treatment. Her response?? "yeah, I know. I've had asthma since I was 5."

Y'all. At this point it is taking every ounce of my being to not come across my desk and scream in this teacher's face WE CANNOT OFFER PERSONAL MEDICATION TO ANY STUDENT!!!!!

I quickly calm my inner rage and, AGAIN, reiterate that this is not an option. EVER. Teacher then asks "but, what about in an emergent situation?" :mad::mad::mad::mad:

My first thought? I'm about to SHOW you an emergent situation!!!!

My actual response? "NO. Students who are experiencing any kind of emergency need to be assessed by me. If they can walk, they need to be assisted to my office. If they're unable to walk, I need to be called so that I can come to them. At that point, I will notify 911 if I feel the situation warrants it."

I'm now in the process of making a video that will be posted to the online faculty meeting next week to discuss WHY WE CAN'T GIVE PERSONAL MEDICATION TO A STUDENT.

Specializes in Pediatrics Retired.
Here's a thought:

If you were waiting for 911 for an asthmatic who (had no inhaler) and was going rapidly downhill, would you dose them from another student's MDI? (Mind you, you know it's the same med and strength.)

Honestly, if the kid was turning blue before my eyes, I probably would...

You bet! I wouldn't care what strength or who it belonged to if I thought it would help; then I'd sort the legalities out later...but I answer to a higher authority than the BON.

Specializes in kids.
That's one aggressive inhaler. "I will bronchodilate you!!!!"

#WhatTheFocalin

#Thattoo

Specializes in School Nurse, past Med Surge.
Here's a thought:

If you were waiting for 911 for an asthmatic who (had no inhaler) and was going rapidly downhill, would you dose them from another student's MDI? (Mind you, you know it's the same med and strength.)

Honestly, if the kid was turning blue before my eyes, I probably would...

This is why every school needs an albuterol protocol, just like an epi protocol. And tack a narcan one on to boot. We have all three in my district.

Here's a thought:

If you were waiting for 911 for an asthmatic who (had no inhaler) and was going rapidly downhill, would you dose them from another student's MDI? (Mind you, you know it's the same med and strength.)

Honestly, if the kid was turning blue before my eyes, I probably would...

I think, as NURSES, we all would too. But that's assuming the student is in our clinic, has been evaluated by us, and an action plan is already in play. However, this teacher is not (nor was she ever) a nurse or doctor or any other medical professional. This medication was offered to the student before I even knew the student needed help. The teacher made a medical assessment of her own and implemented a treatment plan of her own. All without the training we all went through as nurses.

So yes. As a NURSE, if I saw a student actively turning blue before my eyes, I would absolutely administer a medication if I thought the student would benefit from it. I feel I have that knowledge and authority to do so. This teacher does not.

Student was stable. Capable of speaking in full sentences. AAOX3. Vitals relatively normal (HR was a tad elevated). No wheezing. Able to walk. There is no reason for this teacher to assume this student was in such a crisis situation that she needed to immediately administer her own personal medication.

Specializes in kids.
I think, as NURSES, we all would too. But that's assuming the student is in our clinic, has been evaluated by us, and an action plan is already in play. However, this teacher is not (nor was she ever) a nurse or doctor or any other medical professional. This medication was offered to the student before I even knew the student needed help. The teacher made a medical assessment of her own and implemented a treatment plan of her own. All without the training we all went through as nurses.

So yes. As a NURSE, if I saw a student actively turning blue before my eyes, I would absolutely administer a medication if I thought the student would benefit from it. I feel I have that knowledge and authority to do so. This teacher does not.

Student was stable. Capable of speaking in full sentences. AAOX3. Vitals relatively normal (HR was a tad elevated). No wheezing. Able to walk. There is no reason for this teacher to assume this student was in such a crisis situation that she needed to immediately administer her own personal medication.

And as stated above, we would know about the risk of giving albuterol to a child who it could endanger.

Best case scenario is that the teacher's albuterol would have helped and parents would be satisfied- but the NURSE is still out of the loop of a child having an acute need and you would have not known to give mom the paperwork and request the inhaler for next time. Worse scenarios- many and we can imagine them all.

Specializes in School Nursing, Ambulatory Care, etc..
Here's a thought:

If you were waiting for 911 for an asthmatic who (had no inhaler) and was going rapidly downhill, would you dose them from another student's MDI? (Mind you, you know it's the same med and strength.)

Honestly, if the kid was turning blue before my eyes, I probably would...

Why not give them epi? (assuming you have stock epi-pens)

Specializes in school nurse.
Why not give them epi? (assuming you have stock epi-pens)

Good point. Although, in my scenario the child has inhaler orders, just no med. Our district epi-orders wouldn't cover giving one for asthma emergencies. On the other hand, if it was life or death...

That's why I hope this remains an intellectual exercise only.

Several years (and school districts ago), the receptionist shared hers with a student who was not in any distress at all!!

I also had a school nurse friend who found out that her athletic coaches had taken up an assortment of inhalers and made a communal basket for anyone to self service themselves during practice / games. Her admin barely gave a slap on the wrist. She also had to call 911 on a student and didn't know his name. he was in respiratory distress and was just sent walking out of classroom by himself with no note, no phone call, no follow up to see if he made it to her. Another barely slap on a wrist. She passed away about 2 months after retiring from that hell hole.

These are the ones shaping and molding the future of America...It was a funny story to read Keeper cuz I think we all can relate, thank you!

Future, yeah. They can barely spell, punctuate, or use proper grammar.

However, while working nights in a long term facility, a doctor told me to give Albuterol to a pt. Pt. had never had an inhaler before. Sup said there were none in the emergency closet, which I knew was not so. There was definitely a new inhaler she could have provided.

Called doc back, before the jerk turned his phone off altogether, told him the situation. He said to get someone else's inhaler and wipe it off with alcohol for the pt who needed it.

That or send him to the ER.

Best case scenario is that the teacher's albuterol would have helped and parents would be satisfied- but the NURSE is still out of the loop of a child having an acute need and you would have not known to give mom the paperwork and request the inhaler for next time. Worse scenarios- many and we can imagine them all.

Of course, the parent should have provided the inhaler long before now. I am really beginning to think parents like this should be reported to CPS for child endangerment.

Specializes in Pediatric Critical Care.
Best Oprah Voice:

YOU GET A PUFF, YOU GET A PUFF, AND YOU GET A PUFF

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