Ok, I wanted to find out what others say about this. I don't think it's legal, but just wanted to make sure. My best friends son has asthma. Until today, she has been able to do all his treatments at home. This changed today. She went to the school, to talk to them and give the instrutions for his neb treatments and all that. The school secretary was who she talked to, who said she would pass everything on to the nurse. My friend had to actually go get the meds, so when she went back the secretary was out to lunch. She asked to speak directly to the nurse, at which point she found out there is no nurse, and that the secretary is the one who administers ALL the meds to any kid who needs it.
First off, the secretary flat out lied to her about saying the "nurse" would be the one doing it. This person has NO medical training, or instruction or training of any kind to be administering meds. My friend is livid. She called the county school board, and was told because it is a charter school they can't do anything. She is getting ready to call and speak with the principal, and is going to find out who else she needs to contact.
But I just wanted opinions. This is not legal right?
ETA: They are giving insulin and all as well. She's not just mad about a nebulizer.
My understanding is that is legal in every state but California, my state has very specific legal parameters to define the process for unlicensed personal to administer meds but it can be done.
A basic premise of Nursing is to facilitate a patient's ability to care for themselves and/or facilitate their support structure's ability to care for the patient which may include parents, friends, etc.
The ANA sued the State of California over non-licensed personal administering meds based on the premise that only Nurses can administer meds. This is obviously not a position we truly believe because we teach a patient's caregivers such as family members how to administer meds all the time. As an endocrinologist opposed to the ANA put it:
"The very foundation of modern diabetes care is the training of lay people to safely administer insulin," said Dr. Kaufman. "Parents, caregivers and other unlicensed volunteers routinely administer insulin every day. Nothing about this is new; it has become the standard of care of diabetes treatment world over."
The difference here appears to be that we are trying to expand our territory for financial/job security gain. Should we also be arguing that parents shouldn't be allowed administer insulin to their kids and need to hire a nurse to come by 3-4 times a day? Seems sort of ridiculous but it's the exact same premise. The ANA's position is that it's not for securing more jobs, but for patient safety, and I'd feel less embarrassed by the ANA's actions if they had even a small amount of evidence to back that up, but they don't.
It would be preferable for public schools to have more nurses, it would also be nice if they still had music, art, smaller class size, more special ed teachers, etc. California has one of the best nurse to student ratios in the country at 2,150 students to each nurse. Obviously, that one nurse can't cover every diabetic kids insulin, so the result is that a large number of diabetic kids in the California school system receive no coverage at all or any other meds during the day.
I'm all for protecting the territory of nursing, but using a kid's health as a bargaining chip isn't acceptable and directly contradicts basic nursing ethics. So how do we advocate for nursing when doing so harms patients? It's a difficult question but there has to be a better answer than this.
In my county, they do not have the budget for a nurse at every school...secretaries are given training on how to give diabetic injections and test for blood sugar by the school nurses as well as how to handle epi-pens.
Here, if you send an OTC medication, the parents have to fill out a form on how it is to be given and how often.
All prescription meds have to be in the original container with a form filled out by the physician on how it is to be dispensed...however, the joke is that they have one small line for adverse reactions...anyone who is a nurse, knows how LONG the list really is!
My understanding is that is legal in every state but California, my state has very specific legal parameters to define the process for unlicensed personal to administer meds but it can be done.
A basic premise of Nursing is to facilitate a patient's ability to care for themselves and/or facilitate their support structure's ability to care for the patient which may include parents, friends, etc.
The ANA sued the State of California over non-licensed personal administering meds based on the premise that only Nurses can administer meds. This is obviously not a position we truly believe because we teach a patient's caregivers such as family members how to administer meds all the time. As an endocrinologist opposed to the ANA put it:
"The very foundation of modern diabetes care is the training of lay people to safely administer insulin," said Dr. Kaufman. "Parents, caregivers and other unlicensed volunteers routinely administer insulin every day. Nothing about this is new; it has become the standard of care of diabetes treatment world over."
The difference here appears to be that we are trying to expand our territory for financial/job security gain. Should we also be arguing that parents shouldn't be allowed administer insulin to their kids and need to hire a nurse to come by 3-4 times a day? Seems sort of ridiculous but it's the exact same premise. The ANA's position is that it's not for securing more jobs, but for patient safety, and I'd feel less embarrassed by the ANA's actions if they had even a small amount of evidence to back that up, but they don't.
It would be preferable for public schools to have more nurses, it would also be nice if they still had music, art, smaller class size, more special ed teachers, etc. California has one of the best nurse to student ratios in the country at 2,150 students to each nurse. Obviously, that one nurse can't cover every diabetic kids insulin, so the result is that a large number of diabetic kids in the California school system receive no coverage at all or any other meds during the day.
I'm all for protecting the territory of nursing, but using a kid's health as a bargaining chip isn't acceptable and directly contradicts basic nursing ethics. So how do we advocate for nursing when doing so harms patients? It's a difficult question but there has to be a better answer than this.[/QUOTE]
A very interesting thread topic. You seem very knowledgeable, would you be interested in starting a new thread?
i don't see why he would need a treatment during school every day unless the parent just didn't want to do it. whoever said it's not rocket science is correct - my 1-2 year old pretty much gave them to himself once i got it going. lol. the daycare he went to COULD give them (not a nurse there either) but i didn't see any reason to put that burden on them (it's time consuming) when i could do it in the morning before dropping off and again when we got home. her other option would be going to the school and doing it herself. contrary to popular belief, "i have to work" is not a good reason for not doing so - they aren't there to babysit.
i don't see why he would need a treatment during school every day unless the parent just didn't want to do it. whoever said it's not rocket science is correct - my 1-2 year old pretty much gave them to himself once i got it going. lol. the daycare he went to COULD give them (not a nurse there either) but i didn't see any reason to put that burden on them (it's time consuming) when i could do it in the morning before dropping off and again when we got home. her other option would be going to the school and doing it herself. contrary to popular belief, "i have to work" is not a good reason for not doing so - they aren't there to babysit.
Are you kidding me? I take it you have no children.
If you have a diabetic kid that requires daily injections...you show me a job where you can leave anytime you want, to drive across town (which can be as much as a 30 or 45 minute commute, one-way in some cities)..just drop everything and go...leave work to co-workers, walk out of a meeting, leave the hospital, whatever the profession...and use the "Oh, I have to drive to the school to give my kid his insulin shot."
You show me ONE employer that allows that and allows you to keep the job.
Schools are obligated to provide reasonable accomodations for kids with disabilities/chronic illnesses...if a medical assistant can be trained to give injections so can the school secretary.
LIFE GOES ON for kids that need daily medication and to expect every parent to run to the school everytime something changes....seriously...where is the quality of life in that for the family????
Actually I do have children, but I'm not the one complaining about needing a professional to give a neb treatment. If she's not satisfied with the reasonable accomidation they HAVE made then yes she can go do it herself.
The child we're talking about doesn't need insulin so that's not what my comment was about, but I do know a first grader who's a diabetic that takes care of herself at school but she goes to the nurses office to do it. Anyhow, I've never heard of a kid who needs more than 2-3 neb treatments a day and they can be done at home which of course takes effort.
My understanding is that is legal in every state but California, my state has very specific legal parameters to define the process for unlicensed personal to administer meds but it can be done.
Correct me if I am wrong but the ANA went for the "injection" of insulin and did not challenge the asthma meds since that is a Federal law that states have had to complay with for access to these meds. Although it specifically states a child can carry their own meds, many states have also placed "designated person trained to administer" in their statutes. I also believe the insuln injection is also still okay for an unlicensed staff member to administer in an emergency. The Epi-Pen is also still okay since that too is for an emergent situation. I also believe in the state of California a Paramedic can not administer insulin.
Anyhow, I've never heard of a kid who needs more than 2-3 neb treatments a day and they can be done at home which of course takes effort.
You probably have not been to the Central Valley of California or know that controlling and treating pedi asthma is a difficult process. The etiology for the reactive airways can also be complex due to a history of premature lungs. Long acting inhalers that adults might get may also not be recommended for many of these children. So a q4 hour neb might not be to unrealistic especially if the child is participating in sports. Some may have a neb or inhaler prescribed to be administered a few minutes prior to sports participation. Proper monitor and administration of the medication will prevent a trip to the ED. You can't always predict when the child's environment will give rise to a breathing problem or create the potential for one but it does not always need to mean a trip to the ED.
LIFE GOES ON for kids that need daily medication and to expect every parent to run to the school everytime something changes....seriously...where is the quality of life in that for the family????
Quality of life should be at the center of this. We don't want kids to be restricted to only certain schools that may not fulfill their academic needs nor do we want them to be denied access to participate in sports. We do not want them to be labeled as "special" or "sickly" with limitations as what was done in this country for decades in the modern school systems.
We also want a safe environment fo the kids and that realistically means not relying on just one RN for over 2000 students to be there at all times for an emergency or to prevent one. The AHA wants all school children to learn CPR which I believe is a fantastic idea. I also believe a first aid course similar to what EMTs get or what is offered by the ARC would not be that bad of an idea either.
I was a school nurse for a while, and I can assure you that there were times when the admin personnel gave meds.
.
This was my experience as well, a school administrator, not secretary would administer the
medication when a nurse was not available.
No school secretary in my opinion should be expected to give meds.
It is a nursing function, or administrator function. A secretary can not monitor for
side effects/or changes in patient status. Often the administrator would recheck on the student when giving meds, but the secretary has her own school tasks that often prevent a followup to see if the student is ok. That said, state laws differ.
The issue to me is if this administrator/staff giving meds occurs on a consistent and regular basis.
If so, consider the average school has more than one known student who could have a health emergency and a licensed nurse should be present.
In my experience, administrators who were giving meds were quick to call in a school nurse sub.
If so, consider the average school has more than one known student who could have a health emergency and a licensed nurse should be present.
Let me give you some stats just for asthma in Californa.
In California, school-aged children miss approximately 1.9 million school days each year due to asthma, a rate of nearly 2.5 days per child with asthma per year.
More than one third (35%) of all school-age children in California with current asthma miss at least one day of school during the year due to asthma and more than half (51%) of younger children (ages 5-11) miss school due to asthma.
In California, 809,000 children with asthma experience asthma symptoms every year, including 89,000 who experience symptoms every week.
More than 350,000 California children take medication to control their asthma every day.
Diabetes is one of the most common chronic diseases in school-aged children, affecting about 151,000 young people in the United States, or about 1 in every 400 to 500 young people under 20 years of age. Each year, more than 13,000 youths are diagnosed with type 1 diabetes.
Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
i don't see why he would need a treatment during school every day unless the parent just didn't want to do it. whoever said it's not rocket science is correct - my 1-2 year old pretty much gave them to himself once i got it going. lol. the daycare he went to COULD give them (not a nurse there either) but i didn't see any reason to put that burden on them (it's time consuming) when i could do it in the morning before dropping off and again when we got home. her other option would be going to the school and doing it herself. contrary to popular belief, "i have to work" is not a good reason for not doing so - they aren't there to babysit.
His doctor had just switched him to where he needs a treatment everyday before any strenous activity. So he now has to have a treatment before recess each day, and any other activity of the sort.
Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
Actually I do have children, but I'm not the one complaining about needing a professional to give a neb treatment. If she's not satisfied with the reasonable accomidation they HAVE made then yes she can go do it herself.
The child we're talking about doesn't need insulin so that's not what my comment was about, but I do know a first grader who's a diabetic that takes care of herself at school but she goes to the nurses office to do it. Anyhow, I've never heard of a kid who needs more than 2-3 neb treatments a day and they can be done at home which of course takes effort.
First of all, I wasn't "complaining" about it. It's not even me, I was just asking to clarify for a friend. She was not complaining about making reasonable accomodations. She was mad that they LIED TO HER about it. Also, if you had read the posts, you would see that the doctor had just changed the order, and he needed the treatments while at school. She has other young kids at home that she takes care of, as well as goes to school herself, so it has absolutely nothing to do with her being lazy and not wanting to do it. It's very rude of you to even say that. Considering that she can't predict every time he will need a treatment, as he has to have them prior to any strenous activity... It is not reasonable to expect her to come to the school every time he needs a treatment.
As I have already said, she has another child who has Tourettes Syndrome as well as many other issues. It has absolutely nothing to do with making the effort. She spends half her time going from doctor to doctor for medical issues. She takes care of her child when he is home. I don't see anything wrong with making sure her son is adequately cared for while at school.
As I don't have a child in school, I stated I don't know anything about school nursing. Hence why I came here to ask. Now I know, and so does she. The "lazy" thing to do would have been to just send her kid to school with no regard to making sure proper accomodations were made.
MunoRN, RN
8,058 Posts
My understanding is that is legal in every state but California, my state has very specific legal parameters to define the process for unlicensed personal to administer meds but it can be done.
A basic premise of Nursing is to facilitate a patient's ability to care for themselves and/or facilitate their support structure's ability to care for the patient which may include parents, friends, etc.
The ANA sued the State of California over non-licensed personal administering meds based on the premise that only Nurses can administer meds. This is obviously not a position we truly believe because we teach a patient's caregivers such as family members how to administer meds all the time. As an endocrinologist opposed to the ANA put it:
"The very foundation of modern diabetes care is the training of lay people to safely administer insulin," said Dr. Kaufman. "Parents, caregivers and other unlicensed volunteers routinely administer insulin every day. Nothing about this is new; it has become the standard of care of diabetes treatment world over."
The difference here appears to be that we are trying to expand our territory for financial/job security gain. Should we also be arguing that parents shouldn't be allowed administer insulin to their kids and need to hire a nurse to come by 3-4 times a day? Seems sort of ridiculous but it's the exact same premise. The ANA's position is that it's not for securing more jobs, but for patient safety, and I'd feel less embarrassed by the ANA's actions if they had even a small amount of evidence to back that up, but they don't.
It would be preferable for public schools to have more nurses, it would also be nice if they still had music, art, smaller class size, more special ed teachers, etc. California has one of the best nurse to student ratios in the country at 2,150 students to each nurse. Obviously, that one nurse can't cover every diabetic kids insulin, so the result is that a large number of diabetic kids in the California school system receive no coverage at all or any other meds during the day.
I'm all for protecting the territory of nursing, but using a kid's health as a bargaining chip isn't acceptable and directly contradicts basic nursing ethics. So how do we advocate for nursing when doing so harms patients? It's a difficult question but there has to be a better answer than this.