What OTC meds do you keep in your clinic?

Posted

I am a school nurse for a small community school district. Therefore I have an entire school, prek throught 12th grade. I have tried a million different ways to tell parents that if they want their child to recieve medications (otc) they must bring it from home to keep on hand at the school. I do keep medicine such as tylenol, ibuprofen, tylenol cold, tums, throat losenges, and glucose tabs. But I feel that these things I have bought should be used in emergency situations or as I see needed. I do not have the funds to supply the entire school medications because parents won't bring it it. But I feel terrible denying a child tylenol when they have a headache. How do you handle this situation and what medications do you provide the students?

Keepstanding, ASN, RN

Specializes in School Nursing. Has 10 years experience. 1,600 Posts

i am a school nurse for a small community school district. therefore i have an entire school, prek throught 12th grade. i have tried a million different ways to tell parents that if they want their child to recieve medications (otc) they must bring it from home to keep on hand at the school. i do keep medicine such as tylenol, ibuprofen, tylenol cold, tums, throat losenges, and glucose tabs. but i feel that these things i have bought should be used in emergency situations or as i see needed. i do not have the funds to supply the entire school medications because parents won't bring it it. but i feel terrible denying a child tylenol when they have a headache. how do you handle this situation and what medications do you provide the students?

my school system supplies none of the above. if parent didn't bring it in with a written permission note, then nothing else i can do.

Aneroo

Aneroo, LPN

Specializes in Cath Lab, OR, CPHN/SN, ER. 1 Article; 1,518 Posts

I am at the high school level. I am allowed to give 650mg po tylenol, 400mg po ibuprofen, or two bismuth tabs.

These are ordered by our MD at the health dept (who I work through), and we have criteria we have to meet before we can give it. We have to assess certain things depending on the complaint. I sent home slips at the beginning of the year- the front half is their emergency form, the back side is the medication info and log. The parents can choose all three, or only some of those meds. They can also request I call them before administering any medications. If I don't have a signed form, we will call home once to get parental permission via phone, but that's it. If the student is over 18 and has ID to prove it, I will also give them medication.

I also keep 500mg po tylenol for the staff. The person who purchased the meds wasn't aware of the doses I can give and bought two huge bottles of extra strength that I obviously cannot use for the kids. If staff wants it, I give them the bottle and they pour it themselves. I don't keep it up front in the office, b/c someone would decide to start giving kids tylenol instead.

ETA- I am the only one at the school who gives those meds, unlike if it's a daily or prn med brought in from home that someone here at school is trained to give. I lock up these meds when I leave, and I am the ONLY person with a key to that filing cabinet.

pattylpn54

pattylpn54, LPN

Specializes in Psych/Substance Abuse & School Clinics. 1 Article; 141 Posts

i am a school nurse for a small community school district. therefore i have an entire school, prek throught 12th grade. i have tried a million different ways to tell parents that if they want their child to recieve medications (otc) they must bring it from home to keep on hand at the school. i do keep medicine such as tylenol, ibuprofen, tylenol cold, tums, throat losenges, and glucose tabs. but i feel that these things i have bought should be used in emergency situations or as i see needed. i do not have the funds to supply the entire school medications because parents won't bring it it. but i feel terrible denying a child tylenol when they have a headache. how do you handle this situation and what medications do you provide the students?

i am a clinic sub (lpn) and have worked in clinics full-time/full-year, so i've worked in all grade settings and we are not allowed to give any medications of any type (otc or other), unless brought in by a parent or guardian with a filled out & signed permission slip. preferrably bottle to be unopened. at end of school year all meds must be picked up by an adult or they are to be discarded --- meaning they can not be kept/carried over from year to year (no matter what grade the student is in or what the med is). each new school year a new medication release form (permission form) must be filled out for the new bottle of med to be dispensed. these are rules mandated by our county health dept. and local school board.

any otc meds that parents don't come pick up or that call & tell you to just "throw them out", --- otc's, we will sometimes keep for staff/teacher use only; i.e. tylenol, motrin, pepto, etc. --- rather than the clinic purchase them. we don't ever use our small, meager budget on any otc's for anyone. even teachers/staff must supply their own if we don't have left-overs that we saved from prior year. we are a school clinic, not a free-clinic!!!

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma. 5 Articles; 4,427 Posts

in my state I can't even give a cough drop without an order from an MD and parental permossion. We have a few blanket orders for things like caladryl, bacitracin, bactine, ect... but beyond that I need a doctor's order.

The real kicker, though... the daycare in my building can give anything as long as the parents sign off on it. So apparently the assessment skills of a 22 year old are more accurate in determining if a cough should be treated with Dimetapp while my professional training needs endorsement by a physician. sigh......

raidermom

raidermom

Specializes in med surg, geriatrics, peds. Has 19 years experience. 88 Posts

I am only allowed to give OTC if parent signs permission form and brings meds from home. We do not stock any meds for student or teacher use. Our state board has adopted this policy 6 years ago. No alcohol or peroxide, or antibiotic ointment either. We can use water, soap, saline solution, sterile water to clean cuts.

kidsnurse1969

kidsnurse1969

Specializes in Coronary Care, School Nurse. Has 15 years experience. 86 Posts

I am in Illinois. I do not have a MD to prescribe routine meds for my district so I do not give anything that is not brought from home with a completed Medication Authorization form signed by the doctor. I do not use/give cough drops, antibiotic ointment, antihistamine creams, ect. I do not want to risk being charged with prescribing/dispensing medication without a license.

I clean cuts with soap and water. I put petroleum jelly on itches and dry hands. Kids with sore throat get to gargle with warm salt water. Honey and warm water soothes an annoying cough (but not very well). Occasionally, I give peppermint candies or crackers to settle an upset stomach. Headaches get 8 oz of water for rehydration.

I would love to hear about any other "non-medicinal" treatments for my arsenal. What do you do?

Aneroo

Aneroo, LPN

Specializes in Cath Lab, OR, CPHN/SN, ER. 1 Article; 1,518 Posts

I am in Illinois. I do not have a MD to prescribe routine meds for my district so I do not give anything that is not brought from home with a completed Medication Authorization form signed by the doctor. I do not use/give cough drops, antibiotic ointment, antihistamine creams, ect. I do not want to risk being charged with prescribing/dispensing medication without a license.

I clean cuts with soap and water. I put petroleum jelly on itches and dry hands. Kids with sore throat get to gargle with warm salt water. Honey and warm water soothes an annoying cough (but not very well). Occasionally, I give peppermint candies or crackers to settle an upset stomach. Headaches get 8 oz of water for rehydration.

I would love to hear about any other "non-medicinal" treatments for my arsenal. What do you do?

I'm taking notes- those are some good suggestions!

I hate it when it's warmer and I get a TON of bug bites and I feel helpless! Sugar free candy works well for supressing a cough also.

luvschoolnursing, LPN

Specializes in School Nursing. Has 23 years experience. 651 Posts

Our district physician writes standing orders for TUMS, hydrocortisone cream, antibiotic ointment, orajel, caladryl and artificial tears.

Anything else weather OTC or prescription has to have a physician form and a parent form filled out. I'm in high school and I do pass out Hall's type cough drops if I think the kid really needs it, but technically, I don't think I am allowed.

I also keep orange juice and glucose tabs for the kids with diabetes, even though they are supposed to have their own.

And yeah, the parents give me a VERY hard time when I tell them they have to bring their kid tylenol if they want them to have it.

Aneroo

Aneroo, LPN

Specializes in Cath Lab, OR, CPHN/SN, ER. 1 Article; 1,518 Posts

Our district physician writes standing orders for TUMS, hydrocortisone cream, antibiotic ointment, orajel, caladryl and artificial tears.

Anything else weather OTC or prescription has to have a physician form and a parent form filled out. I'm in high school and I do pass out Hall's type cough drops if I think the kid really needs it, but technically, I don't think I am allowed.

I also keep orange juice and glucose tabs for the kids with diabetes, even though they are supposed to have their own.

And yeah, the parents give me a VERY hard time when I tell them they have to bring their kid tylenol if they want them to have it.

I wish I had orders for the hydrcocortisone cream and ab. ointment. I see a lot of kids with bug bites (hydrocortisone cream) and a lot with scrapes or "I got my belly button pierced and need some cream to put on it". GAH.

SchoolNurseBSN

SchoolNurseBSN

Specializes in school nursing. Has 4 years experience. 381 Posts

We keep absolutely nothing. We can only give OTC med with parent signature, physician order, and parent supplies product in brand new unopened container.

It is frustrating to not even be able to apply neosporin!!

Sometimes, I feel useless.

Purple_Scrubs

Purple_Scrubs, BSN, RN

Specializes in School Nursing. Has 8 years experience. 2 Articles; 1,978 Posts

We were recently told that even salt water gargles are a no-no for my district. I have confiscated cough drops and ointments brought from home because the kids can't carry them and I can't adminster ANYTHING without a Med Permit signed by physician and parent. I have on occasion offered an OTC from my own purse to a staff member, but only ones I am friends with, and I let them know it is being given as a friend as not as the nurse.

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