I had mailed asthma care plan to this particular parent who's daughter has asthma.
This is the care plan that the physician is to fill out and return to the clinic. Parents are supposed to bring an inhaler in so that we have it while kid is in school.
This care plan came in about a month ago, but no inhaler.
I just got off of the phone with the Mother. I told her that the order is here, and we are just awaiting the inhaler.
Mother states: Oh.... I thought the doctor would send you the inhaler too. What ???
Easy, I'm on the provider side of things and often insurance only covers enough for 1 inhaler.... I have seen it denied multiple times ...... So I think the op response is kind of jerky without further exploring the parents hesitation to provide one.... Not everyone has a few hundred to spare.
Secondly an inhaler belongs with the patient at all times, that should be reinforced at a young age. The nurse should not be the gate-keeper.
Many elementary school students cannot appropriately self administer. There is a technique to inhalers, and I've taught many adults (who've been using inhalers for YEARS) how to appropriately self administer. Also, I see a danger when other students become curious about said inhaler and decide to "share" with their friends. This is not an uncommon practice. I've had experiences where kids come to school with OTCs and pass them out to all their friends - NOT okay.
I am in an Elementary School PK-6. I have 4th-6th graders who self carry and administer their inhalers, after it has been signed off by their parent, their physician and me. They have to be able to clearly demonstrate they know how and when to use their inhaler in order to get this sign off. There's not a single 4 yr old in this building I would sign off on carrying their own inhaler so it stays with me. For the kids who self carry I always get a backup for my office. I've had inhalers malfunction, get lost, get left on a bus, you name it. I have yet to have a parent have an insurance problem getting one to me, and if they did I would try to find a way to help them get one at a reduced cost through a local pharmacy, etc.
On the topic of OTC medications. I agree we should treat them differently BUT the law in my state requires that all meds (OTC or prescription) be given in school ONLY with both parental and physician signoff. Whether it's a cough drop or Adderall you can't have it in a school here unless your Dr and your parents fill out paperwork and bring it to my office. Not my call on that-talk to the state.
I think these are some of the nuances of being a School Nurse that are not easily understood by those not in it.
I have a kid allergic to bees. We have an allergy action plan in place for him, just no epi-pen. I, and the previous nurse, have called multiple times to ask her to send one to school. We have "stock" pens to use, but I can't send those on a field trip with him. Parents don't seem concerned.
Easy, I'm on the provider side of things and often insurance only covers enough for 1 inhaler.... I have seen it denied multiple times ...... So I think the op response is kind of jerky without further exploring the parents hesitation to provide one.... Not everyone has a few hundred to spare.
Secondly an inhaler belongs with the patient at all times, that should be reinforced at a young age. The nurse should not be the gate-keeper.
Easy?? In addition to the above posts, which I agree with, I will add that I have NEVER been given a provider authorization for an elementary schooler to self carry an inhaler... so we're back to having an inhaler at school. And yes, it is possible, and I agree to let the child bring me the inhaler in the morning upon arrival at school and I'll give it back to the child at dismissal to take home - I'm OK with that; but that lasts about 2 days and I never see the inhaler again until the child needs it and I'm on the phone trying to get a parent to bring it to school.
Also, we're not talking about people who live in their car. These people have cell phones, satellite TV, flat screens, high speed internet, home computers, I-pads, pets, tattoos, elaborate manicuring, body piercings, Coach purses, and other luxuries that they freely spend their money on but you suggesting, unless someone else pays for the school inhaler, they are excused from that portion of medical care for their child. And an Albuterol HFA is not $200.00 - $70.00 cash price with free coupons to lower the price more.
Parent education, or the lack thereof, that starts in the provider's office, however is a huge element in the parent's appreciation of the potential severity of asthma and EIB and is reflected in their interest and participation in their child's asthma control plan but that's a tennis match for another time.
I do, however, agree with you about zero tolerance - a policy which arose from zero, or very little, critical thought or reason.
Easy?? In addition to the above posts, which I agree with, I will add that I have NEVER been given a provider authorization for an elementary schooler to self carry an inhaler... so we're back to having an inhaler at school. And yes, it is possible, and I agree to let the child bring me the inhaler in the morning upon arrival at school and I'll give it back to the child at dismissal to take home - I'm OK with that; but that lasts about 2 days and I never see the inhaler again until the child needs it and I'm on the phone trying to get a parent to bring it to school.
Also, we're not talking about people who live in their car. These people have cell phones, satellite TV, flat screens, high speed internet, home computers, I-pads, pets, tattoos, elaborate manicuring, body piercings, Coach purses, and other luxuries that they freely spend their money on but you suggesting, unless someone else pays for the school inhaler, they are excused from that portion of medical care for their child. And an Albuterol HFA is not $200.00 - $70.00 cash price with free coupons to lower the price more.
Parent education, or the lack thereof, that starts in the provider's office, however is a huge element in the parent's appreciation of the potential severity of asthma and EIB and is reflected in their interest and participation in their child's asthma control plan but that's a tennis match for another time.
I do, however, agree with you about zero tolerance - a policy which arose from zero, or very little, critical thought or reason.
Specializes in School Nurse. Having conversations with littles..
I also disagree with this zero tolerance for any drugs in school. I think we, as adults, need to differentiate Motrin and cocaine. How will children ever learn to take medication responsibly if adults treat OTC meds like illegal drugs?
I also disagree with this zero tolerance for any drugs in school. I think we, as adults, need to differentiate Motrin and cocaine. How will children ever learn to take medication responsibly if adults treat OTC meds like illegal drugs?
Easy?? In addition to the above posts, which I agree with, I will add that I have NEVER been given a provider authorization for an elementary schooler to self carry an inhaler... so we're back to having an inhaler at school. And yes, it is possible, and I agree to let the child bring me the inhaler in the morning upon arrival at school and I'll give it back to the child at dismissal to take home - I'm OK with that; but that lasts about 2 days and I never see the inhaler again until the child needs it and I'm on the phone trying to get a parent to bring it to school.
Also, we're not talking about people who live in their car. These people have cell phones, satellite TV, flat screens, high speed internet, home computers, I-pads, pets, tattoos, elaborate manicuring, body piercings, Coach purses, and other luxuries that they freely spend their money on but you suggesting, unless someone else pays for the school inhaler, they are excused from that portion of medical care for their child. And an Albuterol HFA is not $200.00 - $70.00 cash price with free coupons to lower the price more.
Parent education, or the lack thereof, that starts in the provider's office, however is a huge element in the parent's appreciation of the potential severity of asthma and EIB and is reflected in their interest and participation in their child's asthma control plan but that's a tennis match for another time.
I do, however, agree with you about zero tolerance - a policy which arose from zero, or very little, critical thought or reason.
I think we're all swooning, OldDude.
I can't add anything expect anecdotal evidence. 4th grade boy with permission to self carry from his doctor, couldn't demonstrate proper use to me and had no idea when it would be appropriate to use. Called the parents, they wanted the inhaler sent home, no problem. Teacher called me 2 weeks later, he had seen said 4th grader using the inhaler in the hallway. Teacher brought it to me; albuterol inhaler that had been filled just over 2 weeks ago, had 5 puffs left- that's 197 puffs gone. Wonder why we worry about them self carrying?
Specializes in School Nurse. Having conversations with littles..
Oh...woops. MY 'puter messed up. Didn't know that posted. I was just going to say that not on my watch. sorry. not gonna happen. The little whippersnappers (some of them) can't be trusted to be smart with meds.
Farawyn
12,646 Posts
Yes, Beachy. I misread PP and took my "like" back.