Something for all you school nurses...

[caregiver1977]

First off, I am not a nurse. I am a caregiver for a diabetic relative who has mobility issues due to a stroke. I am also a teacher assistant for a first grade class in a school that has a large population of health-challenged students (mentally and physically).

There is a student in my classroom who has been just diagnosed with asthma. Her mother brought an asthma inhaler to the school nurse without the proper letter from the physician/documentation. The school nurse where I work (an RN) accepted the asthma inhaler from the mother because, as the nurse said, she would rather we have the inhaler there and explain it later than for it not to be there and the child have an attack and need it. The nurse one day called me to the door of my room and told me the child would be carrying it in her backpack (backpacks are kept in lockers during school hours). She said she had discussed it with the child's mother, and they had agreed to keep it in the child's backpack, but not let the child know that it was in there because she would be tempted to take it out and play with it (that was the red flag right there that she wasn't responsible enough to have it in her backpack). The nurse told me that if she needed the inhaler, to let the office know. The child has never been observed having any asthma symptoms at school.

It sounded like a bad idea to me, but I have only been in education for about 7 months (most of that time as a substitute teacher). However this RN is the one that approves how meds are handled in the school, so I didn't argue with her.

Well, the crap hits the fan yesterday! I find out the child is carrying the inhaler around in her pocket. I take it from her and remind her that she is not supposed to have it. Too late! While on the playground during an activity that where neither the teacher nor I was present, this child has let about 8 children take puff from the inhaler!! All of those parents had to be called, and there are parents that are still upset today.

I am not a nurse, and I am not trying to act like I am, but I think it was a bad idea to accept the inhaler from the parent without the proper documentation in the first place. If this had of been a different kind of medication, then this could have been much more serious. I mean, I am sorry if a child does not get the meds they need because their parents do not bring the proper documentation, but that is the parent(s) fault and not the school's. The other kids have to be protected too. If it is a medication a child really needs, and the parent goes through the right process to have it at the school, I can't see a school not working with that parent.

Just thought you all might find this helpful or interesting.

[caregiver1977]

First off, I am not a nurse. I am a caregiver for a diabetic relative who has mobility issues due to a stroke. I am also a teacher assistant for a first grade class in a school that has a large population of health-challenged students (mentally and physically).

There is a student in my classroom who has been just diagnosed with asthma. Her mother brought an asthma inhaler to the school nurse without the proper letter from the physician/documentation. The school nurse where I work (an RN) accepted the asthma inhaler from the mother because, as the nurse said, she would rather we have the inhaler there and explain it later than for it not to be there and the child have an attack and need it. The nurse one day called me to the door of my room and told me the child would be carrying it in her backpack (backpacks are kept in lockers during school hours). She said she had discussed it with the child's mother, and they had agreed to keep it in the child's backpack, but not let the child know that it was in there because she would be tempted to take it out and play with it (that was the red flag right there that she wasn't responsible enough to have it in her backpack). The nurse told me that if she needed the inhaler, to let the office know. The child has never been observed having any asthma symptoms at school.

It sounded like a bad idea to me, but I have only been in education for about 7 months (most of that time as a substitute teacher). However this RN is the one that approves how meds are handled in the school, so I didn't argue with her.

Well, the crap hits the fan yesterday! I find out the child is carrying the inhaler around in her pocket. I take it from her and remind her that she is not supposed to have it. Too late! While on the playground during an activity that where neither the teacher nor I was present, this child has let about 8 children take puff from the inhaler!! All of those parents had to be called, and there are parents that are still upset today.

I am not a nurse, and I am not trying to act like I am, but I think it was a bad idea to accept the inhaler from the parent without the proper documentation in the first place. If this had of been a different kind of medication, then this could have been much more serious. I mean, I am sorry if a child does not get the meds they need because their parents do not bring the proper documentation, but that is the parent(s) fault and not the school's. The other kids have to be protected too. If it is a medication a child really needs, and the parent goes through the right process to have it at the school, I can't see a school not working with that parent.

Just thought you all might find this helpful or interesting.

[DemonWings]

I agree that she needs the proper documentation from the doctor, but why would the nurse not keep it in her office? Im not a school nurse so I am just curious. My child has medical issues and they wouldnt touch her medication with a 10 foot pole without a note from both her pediatrician and allergist with the dose, frequency ect.

[caregiver1977]

From what I understand, this was what the mother wanted, and she was trying to do it as a favor to the mom. Our school nurse is not at this school full-time, so maybe she was trying to compensate for that?

[Flare, ASN, BSN]

yikes! What a bad situation. This is a first grade stdent?

In my school I have taken an inhaler in the past with the understanding that the med order best be in my hot hands in the next 24 hrs. In district here, only middle and high school students are permitted to carry inhalers. And that is only with is being signed off as acceptable by the md and parents.

I have said before - that i am positive that there is a handful of students that are asthmatic that are carrying inhalers without orders - if one of these students were in a true asthmatic crisis, then i would consider giving their inhaler - order or not- and that would be paired with a call for the parent to get me an order immediately and a notification to the principal that the student was carrying a medication without an order - which would lead to discipline for the student. But don't forget - mine are middle school students - that's in an entirely different arena than a first grader.

[Staragate, ADN, ASN, RN]

Inhalers can save the life of the child so when she needs it, she needs it THEN! That said, the nurse should have followed policy and had a med letter signed by the mother. At my son's school, he needs a special form signed each year to carry it. No big deal.

As far as the child is concerned, there should be an attempt at teaching the proper use of it. Even if she doesn't totally 'get it', at least there was an attempt. If she can't be trusted with it, her teacher, aide, 1:1 should have it with them just in case.... and not forget it when the kid goes outside. All this should be discussed at her IEP meeting.

I worked as a special ed aide for many years, so I know how the schools work. The nurse should have followed up with having mom sign the form....

[loriangel14, RN]

Keeping it in the office would not be acceptable. If a child has an asthma attack they need it right away.Time spent going to get it, unlock a door or a drawer could be the difference between life or death. A young man died in my area because he had left his in his locker.By the time someone managed to get it he was gone.

But I do agree that he proper documentation should be followed.

[ixchel]

If I were a betting gal, I would bet the nurse put it in the backpack to cover her butt for not having the proper documentation from the doctor. After all, it's not in her possession, right? Pretty dumb way of handling the situation, though. Look how it backfired!

I know a mom who frequently self medicated her child and shares her kids' meds. She's also one who stops abx early because, after all, the kid isn't sick anymore. She puts them in her cupboard for the next time the kids get the sniffles. That mom is what makes me say what I'm going to say next:

I understand that if a child needs their inhaler, they need it NOW, but if it were my @$$ on the line, that parent would have driven home or to the doctor's office or wherever she needs to go to get the doctor's note. I wouldn't accept a med without it. Not worth the insanity that this nurse is about to go through, and rightfully so. I'd be mad as hell if one of my kids was one who used that inhaler.

[caregiver1977]

Yes, this was a first grader. Not a very mature one at that. I found out a few minutes ago that the child was never told by the parents not to ever play with it or share it with other students. Since the child was not supposed to know that it was in her back pack, the nurse didn't do it either.

[caregiver1977]

If I were a betting gal, I would bet the nurse put it in the backpack to cover her butt for not having the proper documentation from the doctor. After all, it's not in her possession, right? Pretty dumb way of handling the situation, though. Look how it backfired!

I know a mom who frequently self medicated her child and shares her kids' meds. She's also one who stops abx early because, after all, the kid isn't sick anymore. She puts them in her cupboard for the next time the kids get the sniffles. That mom is what makes me say what I'm going to say next:

I understand that if a child needs their inhaler, they need it NOW, but if it were my @$$ on the line, that parent would have driven home or to the doctor's office or wherever she needs to go to get the doctor's note. I wouldn't accept a med without it. Not worth the insanity that this nurse is about to go through, and rightfully so. I'd be mad as hell if one of my kids was one who used that inhaler.

You hit the nail on the head when you said that part I put in bold. It was like you were here when it happened!

I found out today that the child was never taught not to play with the inhaler or to share it with other students. The child was not supposed to know that the inhaler was in her bookbag, therefore, they didn't teach her about it.

I understand that people can need insulin, inhalers, Epi-pens at a moment's notice. If it is that serious, then the parents should do EVERYTHING POSSIBLE to make sure that the medication can be kept where it needs to be at school and get the required documentation, etc. If this student had of had the proper documentation, we could have kept it in the classroom with no problem and it could have been taken out to recess, or wherever else it is needed. Question: can't you get the proper documentation at the time the medication is prescribed (I don't know, never had to do this for any of my children)?

ixchel, I couldn't agree more!

Some of you have spoken about students who died because they didn't have proper access to their meds. What about students who die or get sick because they took some other child's meds? We have to protect the student with a health issue and the students who don't.

This child does not have an IEP. The whole asthma thing just came up about a week ago.

[rdsxfnrn]

If it were me, I would have accepted the inhaler, kept it in my office. If mom is not timely about getting doc note, I get doc phone number and call for it myself. Then they can fax right to me. I have done this multiple times. Rather have it here than not. Whether I would give w/o note, nother thread.

[caregiver1977]

The nurse says she has learned her lesson and next time in a situation like this she will keep it in her office. This is still a pretty hot issue at the school, so people are still discussing it.