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What are off-limit medications for school setting?

Updated | Posted

Specializes in School Nursing/Med-Surg. Has 2 years experience.

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I had a parent try to have me administer prednisolone to her child. The prescription was once a day for 5 days and the reason was for an asthma exacerbation. However, for several reasons, we decided that she should administer this medication at home. I'm still new to school nursing and so I have never considered what sorts of medications should be "off-limits." Would you ever administer a new medication such as prednisolone at school? And what are some other medications which you would not administer? 

NutmeggeRN, BSN

Specializes in kids. Has 25 years experience.

Daily's that can be taken at home, should be. If you feel that a child will not get the med for any number of reasons, (diversion, neglect or sometime just plain poor parenting), sometimes the wisest course is at school. Not the best choice usually, but on the occasion it needs to happen, it is best for the kiddo.

Most kids should not need narcs at school but sometimes they do, ie s/p post fracture or significant injury. But I have on a occasion had meds on hand and have procured an order to give 1/2 dose. Enough to help the pain, not enough so they cannot function (they don't drive obviously in that case).

Cattz, ADN

Specializes in School Nurse. Having conversations with littles.. Has 35 years experience.

As far as giving a new medicine at school- The rule of thumb is to not ever give any medication for the first time to a student at school. Unless, of course, it is an emergency medication.

Unless there is a very specific reason why medications that are ordered 1-3 times a day, that need to be given during school hours. My schools do not give them at school. The exceptions would be for instance: ADHD medicine that the student won't take at home--whether it be because of lack of parental supervision or just because the kid won't take it at home for the parent.

If it is ordered 2 times a day- Unless the label says specifically different- the child can take it at home before school and when he/she gets home. For Meds ordered 3 times a day- the same schedule, except to take it at bedtime also.

As long as it is FDA approved and it cannot be given at home (not during school hours)- I don't know that I would really refuse any medicine as long as it seems appropriate.

Those dang Essential Oils have caused quite a stir over the years- since they are not FDA approved- I will not administer them or allow them to be diffused.

I hope this is helpful. If you need more clarification, please reach out. Good luck.

 

 

pineappleupsidedowncake, BSN, RN

Specializes in School Nursing/Med-Surg. Has 2 years experience.

2 hours ago, Cattz said:

As long as it is FDA approved and it cannot be given at home (not during school hours)- I don't know that I would really refuse any medicine as long as it seems appropriate.

This is very helpful, thank you! I'm not sure why I have never heard of that rule of thumb, but it makes sense. 

Cattz, ADN

Specializes in School Nurse. Having conversations with littles.. Has 35 years experience.

17 minutes ago, pineappleupsidedowncake said:

This is very helpful, thank you! I'm not sure why I have never heard of that rule of thumb, but it makes sense. 

You are very welcome. Glad we are all in this crazy boat together. 

LikeTheDeadSea, BSN, RN

Specializes in School Nursing. Has 6 years experience.

Friendly reminder that medical cannabis products are 'certified' and not 'prescribed' so from a nursing perspective can't be administered.

I know many districts that even if a parent is coming to administer it (ie: managing seizure disorder), they have to step foot off of campus and administer it off the premises, otherwise it violates the Drug Policy.

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

23 hours ago, LikeTheDeadSea said:

Friendly reminder that medical cannabis products are 'certified' and not 'prescribed' so from a nursing perspective can't be administered.

I know many districts that even if a parent is coming to administer it (ie: managing seizure disorder), they have to step foot off of campus and administer it off the premises, otherwise it violates the Drug Policy.

There was a whole big legal battle in my state about this.  I think at the end of the day it could be administered, but with a big laundry list of restrictions.  

I generally won't give opiates. I'd have to be given a really compelling reason to do so.  

A big negative to anything not FDA approved.  This is a NO to essential oils, however if a parent wanted to use them at home and then send the child it, they may.  This is also a no to supplements such as lactaid. 

I will allow pancreatic enzymes for CF patients, but only the FDA approved ones ordered by a doctor.  

BrisketRN, BSN, RN

Has 4 years experience.

2 hours ago, Flare said:

There was a whole big legal battle in my state about this.  I think at the end of the day it could be administered, but with a big laundry list of restrictions.   

Illinois too.  I believe the consensus now is that it can be given but doesn't have to be given.  I was advised that if it comes up and administration OK's it, then have them give it.  No one has tried to get me to administer marijuana yet, so I honestly haven't looked into it.

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

Same here - I'll look further into it if someone pushes the issue.  Marijuana was just legalized here in my state yesterday AND the governor lessened the penalties for underage drinking and mj possession.  So , yeah... there's that.  

 I am not upset that mj was legalized.  It's not my thing and actually, I wonder if the increased revenue will help fund the pension programs, which have been repeatedly "borrowed" from.  It's the underage stuff that has me smdh.