Would you call an ambulance?

[halohg]

Scenario:

First grader lower function ASD student found during snack time by his one on one with two over the counter pain meds in his snack bag. No acute distress. Would you call an ambulance immediately?

yes or no

[kidzcare]

history of another like student whom was found to have a pill cut in half shoved into each side of a Twinkie.

What the focalin????

[Twinmom06, ASN, APN]

Wow! That Principal is over the top nuts. Why have a nurse in the building if you aren't going to respect their professional judgement? That poor family has now been cast into a hell of his making.

CYOA - not saying I agree

[OyWithThePoodles, RN]

If principals are just going to override professional decisions, why bother having a school nurse?

This. At our nurse staff meeting this week another nurse was telling our boss lady that the principal and secretaries keep sending kids home after she's evaluated them and sent back to class. Boss lady said "sounds like they aren't needing a nurse next year!" Let us do our job. I don't give the kids a random spelling test or mad minutes while they are in my office, and then call home if they get them wrong. C'mon now!

[FolksBtrippin, BSN, RN]

yeah but I'm the idiot nurse who has to report to personal and rebut my formal write up for "poor medical judgement", they will get that and a lot more. Including the results of this poll.

How dare they!?

Outrageous!

[kidzcare]

I was thinking about this and it reminded me of a sentiment that a previous superintendent kept repeating when we were discussing a privacy issue.

"It is our job, as school professionals, to act on behalf of a rational parent"

The key word is rational. If you were at home and found your child holding unidentified medication and were not sure if he/she had taken any, would step one be to call 911? Let's say it's a toddler who cannot tell you whether or not they took any (as this student with ASD cannot)? Would a rational parent call 911 in this situation if the child was in no distress?

[Dizzyblue415]

The school should have a policy to follow.

Unless he's in distress, I'd contact the parents.

If the kid had filched them himself, they'd more likely to be stuffed in a pocket, not all nice in a ziplock baggie.

[JustbeRN]

No as long as the student was hemodynamically stable- I would call parent and recommend medical f/u.

As far as principal goes- its their school- so if they want to override the nurse- that is their choice to make. I just make a note in my office visit on the outcome. Once EMS arrives care is transferred to them and they can make the call. Parent can sign refusal to transport and take the student home at that point.

[3ringnursing, BSN]

Was there any evidence he had already take any unauthorized meds (as in unauthorized by you, the designated authority in the school setting)?

I work in telephone triage and speak to multiple nervous parents who call daily about "really high fever" (but most use their hand as a gauge, not an actual thermometer). These are the parents who are needlessly alternating apap and ibuprofen every 4 hr's for what we consider a therapeutic fever due to viral illness. Most of these parents view the fever as a primary problem instead of a symptom of an illness much the same way a cough, or nasal congestion is also a symptom. Most of the kiddos do not have a H/O febrile seizures, and many of these "really high fevers" are actually a T-max of 101.0° F or less.

These parents all get the talk that the fever is helpful, and an example of the child's immune system kicking in to the heat up the body and kill the virus - 99% don't listen, then want to schedule an appointment to get a Rx for an antibiotic … sigh …

I'm thinking it's probably this line of thought that lead mom or dad to believe that (2) different OCT pain relievers slipped into junior's bag is okay to do in the first place, instead of coming in to talk directly with you.

[audreysmagic, RN]

What the focalin????

This is going to be my favorite new kid-friendly curse...along with "son of a banana-pants" that I got from a coworker recently...

[marylou5]

Logic,

1.No sign/symptoms of any distress

2.Two otc pills found in bag

3.Parents KNOW not to send pills with child, since in most schools,

"in school medication" is always dispensed by nurse.

4.Your professional judgement.... contact parents for explanation i.e. number of pills sent

5. Principal, with no medical credentials, overrides your professional decision, accusing you of poor judgement.

6. Principal orders Ambulance and CPS contacted

7. Child transported to hospital

Principal CAN override your decision.... depending on school policy regarding medication.

BUT that doesn't make your judgement "poor" and allow her to write you up!

BUT I'd get my own lawyer and have that expunged.

Principal overreacted because they always do ....CYA..by assigning blame to others to assure parents that THEY acted properly ...which means you get thrown under the bus!!!

Wish you well....when any incident occurs with children, in the future..CYA.... overreact.

PS. The person who put the pills in the bag should be re-educated!

That was a very stupid thing to do..and she/he knew it when they did it..not the first time!

[tch1920, BSN, RN]

No. With no S/S of distress I would have called the parents. Principal overreacted by calling an ambulance. Who traveled with the student in the ambulance? If the parent was notified and came to the school they could have refused treatment and transport to hospital. The ambulance driver had to treat the situation as an emergency and calling CPS would have been required if the child is being transported to hospital for drug related issue and the student is considered vulnerable and underage.

[Farawyn]

Complete overkill.