Students under the influence at school

[NurseVal93]

Hi Fellow School Nurses,

How do you deal with a student that is brought in by Admin to "check to see if they are under the influence"?

I've had this happen 3 times in the past 2 weeks. I do my head to toe nursing assessment and interview the student and report my findings to admin.

What I don't understand is that they look at me for a definitive answer whether YES or NO they are under the influence, and get irate if I'm unable to provide that definite answer. Only 1 time was I able to confirm via my findings and the Student openly admitting to drinking and being drunk.

I do not have any special tools (eg brethalyzer), and am not trained to give a field sobriety test... Sometimes I tell them, "This is not the TV show COPS, I can only use my nursing assessment and nursing skills".

How do y'all handle this?

Help..

[Farawyn]

Yes.

I do an assessment including vitals and eye checks, balance, slurred speech, etc. I report those findings to the AP/Principal in front of the student.

In a serious tone.

Usually the kid will confess then and there.

Half the time, I have no idea. You can't say, "I've known the kid since they are 2 and they SEEM high."

I also ask them about other meds, vitamins, etc.

[ruby_jane, BSN, RN]

What I don't understand is that they look at me for a definitive answer whether YES or NO they are under the influence, and get irate if I'm unable to provide that definite answer. Only 1 time was I able to confirm via my findings and the Student openly admitting to drinking and being drunk.

I do not have any special tools (eg brethalyzer), and am not trained to give a field sobriety test... Sometimes I tell them, "This is not the TV show COPS, I can only use my nursing assessment and nursing skills"..

^That's awesome^ About once a year I have a conversation with one of the upper admin about how I can't do anything like a breathalyzer and any pee test result (if that was even an option, which it isn't)wouldn't stand up because of things like chain of custody.

We have a ridiculously long form that asks us to assess nystagmus 5 different ways. I do a set of vitals, document LOC by asking about what they had for breakfast, last meal, how they got to school , things like whether eyes are bloodshot, anything I see or smell (fresh cigarette smoke is easy), and we do Romberg balance test and alternate leg stand.

And write it all up. None of that does much to prove anything but it gives the AP or police officer the gist of whether the student is alert and oriented or seems impaired. I also provide a list of places where a parent can take a kid for a drug test if asked.

Next to the BMI, it's my second least favorite thing to do.

[LikeTheDeadSea, MSN, RN]

For ortho stuff: "I don't have x-ray vision."

For drug stuff: "I don't have a lab."

I'm always flattered that people think my office has a trap door to all these fun diagnostic tools.

If I say there isn't anything in my assessment evidencing drug use, but admin still thinks so d/t an event or history or something that was said, they're still following-up with authorities and parents anyway. I'd say the nursing assessment is more-so a "is it safe for us to have him here or does he need medical attention before we figure out the story," and once they're ruled stable, the discipline side can do its thing without worry.

[ruby_jane, BSN, RN]

For ortho stuff: "I don't have x-ray vision."

For drug stuff: "I don't have a lab."

I'm always flattered that people think my office has a trap door to all these fun diagnostic tools.

First belly laugh of the morning!!! Thank you.

[SaltineQueen]

Is it safe to assume your school doesn't have an SRO? If you do, that would be the go to person for these issues, seeing as how they ARE trained in field sobriety type tests. If not, I think you're doing the best you can with what you're given.

[JenTheSchoolRN, BSN, RN]

All the YES. I love your response NurseVal.

I'll see if they will admit it and do a basic head-to-toe assessment and report my findings. I tell my Dean of Students that nope, I am not a lab and cannot fully determine if a student is under the influence, I can just assess if my findings may impact their ability to learn at the moment. But I also have a great relationship with my Dean so he gets it.

[Amethya]

I had to do that last year, and I was honestly lost because I was never taught how to tell the difference in kids under the influence. I know by experience (Not me! Never did drugs in my life) but friends, and I can tell when people are high or drunk, but with vitals? I'm not certain in that sense, but I just collected vitals and gave it to my AP and hopefully she can make heads or tails of it, because when I did it, the kid had good vitals, nothing abnormal.

[BeckyESRN]

I had to do that last year, and I was honestly lost because I was never taught how to tell the difference in kids under the influence. I know by experience (Not me! Never did drugs in my life) but friends, and I can tell when people are high or drunk, but with vitals? I'm not certain in that sense, but I just collected vitals and gave it to my AP and hopefully she can make heads or tails of it, because when I did it, the kid had good vitals, nothing abnormal.

I think I've offered this up before, but we have a pretty through assessment tool that we use in my district. I'd be happy to share if anyone wants it!

[JenTheSchoolRN, BSN, RN]

I think I've offered this up before, but we have a pretty through assessment tool that we use in my district. I'd be happy to share if anyone wants it!

Yes please! I would love any additional resources - I can PM you if that easier.

[Amethya]

Yes please! I would love any additional resources - I can PM you if that easier.

Same here!

[BeckyESRN]

I'm trying to attach it as a file, we'll see!

Intox exam, no name.docx