Stocking Albuterol in Schools

allnurses Guide · Aug 28, 2016

My concerns here on the West Coast where there isn't a full-time school nurse on every campus is that we are turning schools into mini-health clinics run by school secretaries or . . .if you can manage to convince a teacher to volunteer . . . teachers.

It was a huge mess here when the epi-pen law was passed without a lot of forethought into how we were going to find a physician who would write an order for a school district that had no school nurse on every campus and laypeople would be trained to give epi.

I was the only school nurse for 11 campuses and they were 20 miles apart in some instances. My job was part-time as well; 3 days a week.

There was also a law passed about rectal valium for seizures but NO teacher would step forward to be trained on each campus - with all the focus on teachers not touching a child because of concerns about abuse, there was no way they'd volunteer. So, we have no trained lay-people to do this.

We have AED's on all campuses and training has to be done for school staff and they are all supposed to have current CPR cards, which many don't.

Teachers, secretaries, janitors, school aides are asking, why are WE being asked to be the medical authority on campus? Teachers ask "Don't we have enough mandates regarding teaching children?".

So, I don't think we should stock asthma meds for use on kids without an Rx.

Kids who do have an Rx can certainly bring their asthma meds to school; many can keep their inhalers with them if they are old enough. We also have student with diabetes who bring their insulin to school and staff have to be trained to give insulin as well.

There is a huge malpractice concern for school as well.

A full-time school nurse on every campus would help but that isn't going to happen here in my state.

Schools require emergency allergy medicine, but doctors balk | EdSource
Dr. Brett Curtis, a consulting physician for the Oakland Unified School District, is all for it. The standard is to prescribe on the basis of a good-faith exam,â€ he said. But the law asks doctors to write a prescription naming the school district as the patient, with the injectors to be used to treat a student or adult as needed â€“ which means a patient I've never seen,â€ Curtis said.
The law indemnified everybody except the doctor,â€ he said.

Cattz, ADN · Aug 29, 2016

My thoughts exactly Spidey's mom- I have been pretty successful in making this a non-issue in my schools. I go to 4 different buildings in 3 districts. Even with training, unlicensed personnel don't need to be making these decisions. If there was a nurse in every building everyday, then I would love to talk about it.

ohiobobcat · Aug 30, 2016

I have a stock albuterol inhaler at my school with standing orders for me to use it if appropriate for resp distress. I am lucky, because I AM in my school full time, so an RN assessment always precedes administration of the inhaler. I use it maybe 5-6 times per year.

(P.S. My computer wants to spell check albuterol to butterball. :yes: )

AdobeRN · Aug 31, 2016

We stock it in my district - started last year. I love having it here - I think I had to use it about 5 times last year.

offlabel · Aug 31, 2016

Indeed, without professional oversight, ie an RN vs layman, even a standing protocol for inhaler use is pretty dangerous. A false sense of security can develop in a situation where transport to the hospital is necessary. Goofing around with an inhaler when someone should be calling 911 should be avoided.

OldDude · Aug 31, 2016

I'd like to have it in stock for me to administer, however.