58 replies to this topic

[road2freedom]

Logic has little to do with the law.

You said it all right there...

Prescriptions are between a doctor and a patient. A school nurse is required to have written permission from the parent to administer said medication. The parent can choose to personally medicate the child, medicate the child outside of school hours, or have the nurse do it for them with written permission.

She didn't have to administer it... the principal could have simply returned what was his, and legally prescribed by his physician. If you say they are looking at it from a liability perspective, I would think there is more liability for the prescribing physician than the school employee. What's the worst that could happen by giving a child a prescription inhaler with his name and doctor's name on it? He breathes again? It's not like they were loose hydrocodone pills in a ibuprofen bottle. Plus, you and I both know schools keep a running file on students and that this medical condition was noted, probably multiple times throughout his file. In an emergency, call the 911... call the parents... call the doctor... call the pharmacist. Watching him choke out does not seem like a valid medical response.

I know and understand that part of the problem is that parents are so litigation-happy these days and will sue for anything. Part of mitigating that is making a decision of lesser evils. Will the parent be more pissed if their kid is dead or given a prescription which he is legally prescribed? I'd choose the latter.

Edit: This post was edited by the redundancy department of redundancy.

Edited by road2freedom, 26 May 2012 - 09:50 AM.

[dingaling]

I should keep my mouth shut, but I can't. School nurses are like teachers - they are blamed for everything that goes wrong. They have no discretion in anything, only a set of rules they must follow without exception or they will be fired. Imagine working in an environment where almost every sentence from an administrator starts with "you will be fired if.....". Rules must be followed 100% of the time or you will be out on the street.

[beli]

I should keep my mouth shut, but I can't. School nurses are like teachers - they are blamed for everything that goes wrong. They have no discretion in anything, only a set of rules they must follow without exception or they will be fired. Imagine working in an environment where almost every sentence from an administrator starts with "you will be fired if.....". Rules must be followed 100% of the time or you will be out on the street.

I highly doubt the nurse would have been fired in this instance. However by doing nothing not even calling 911 before calling the parents, she may be fired anyway, and possibly loose her nursing license and the school will more than likely have a lawsuit on their hands. From my understanding medical professions regardless of whether working for a school/and or hospital have ethics they must follow, I fail to see how this falls under that, now she'll more than likely have to answer to the medical board who issue their license, and I'm sorry I doubt the medical board will accept that "Well he didn't have a signed medical release on file with the school so I could administer his own medicine that has his doctors name on it as well as his." will suffice as an answer.

Edited by beli, 26 May 2012 - 10:53 AM.

[Credit Please]

If it is FL law that medication can't be administered without prescription and "all of the above" excuses are in play, no student should be allowed to step foot in a school without the form being signed. How about they follow that policy, therefore no student would have to suffer the way this one did.

I believe the nurse and principle didn't call 911, because 911 would have told them to give the boy the inhaler, and that would have been to much like the right thing to do.

[Bad Doctor Frost]

This is why, if I ever have children, they will never be in this country's public school system, and would be thrilled if I could stop paying for it. Were I this kid's parent, and something tragic happened, you bet your ass there would be a lawsuit filed naming the nurse, the principal, and the school. I don't care about releases forms. I care about having a prescription (you know, given by a doctor, the ones with the medical degrees, not the ones who play with crayons all day) and having a need for that prescription. Zero tolerance = zero brains.

[iH8cra]

BDF, you said you care about the physician's prescription but the fact remains that if you want your child to have access to the medicine while in school, you must sign a release. Saying that prescriptions are from people with medical degrees not people who play with crayons doesn't change anything. I totally agree about zero tolerance laws but the fact remains that this is the law and the nurse and the school are required to follow them. Don't like it? Take up issues with the law with the responsible party - the legislator.

There are all kinds of laws that are stupid. A DNR is a do-not-resuscitate, i.e. if you heart stops then do not perform chest compressions, shock, that kind of stuff. In Texas, you can have a DNR signed, notarized, and witnessed personally by the governor and a team of doctors but when you get admitted to a hospital it disappears legally - congrats, you're now a full code. In my line of work, we have patients who are DNRs come in all the time who then get coded because of this. It's awful and I hate having to be the one to code someone who obviously doesn't want it, but that's the law and I'm required to follow it. Say a patient who is a DNR comes in who is 100 years old, has the acronym DNR tattooed on his chest, and has some awful, intractable disease. The family and physician have not executed a new DNR yet. The patient's heart stops. If I fail to code this "DNR everywhere except a hospital" patient and even if the family thanks me for not coding him and sends me a thank you card and a box of chocolates, I would be professionally negligent and would almost certainly be disciplined by the board of nurses. I could easily lose my license. If the family wanted to, they could sue me and the hospital and win a tidy sum. It would be an open-and-shut case because the law is clear.

Edited by iH8cra, 26 May 2012 - 12:55 PM.

[beli]

BDF, you said you care about the physician's prescription but the fact remains that if you want your child to have access to the medicine while in school, you must sign a release. Saying that prescriptions are from people with medical degrees not people who play with crayons doesn't change anything. I totally agree about zero tolerance laws but the fact remains that this is the law and the nurse and the school are required to follow them. Don't like it? Take up issues with the law with the responsible party - the legislator.

Again.. the only reason the nurse had the prescription in the first place was because of a random drug check. Anyone with a brain would know that the medicine belonged to the child and would not have confiscated it. I have yet to hear of any issue like this where a school administrator has taken a legally prescribed drug (other than OTC crap such as midol etc) away from a child during random drug checks.

[Pam]

BDF, you said you care about the physician's prescription but the fact remains that if you want your child to have access to the medicine while in school, you must sign a release. Saying that prescriptions are from people with medical degrees not people who play with crayons doesn't change anything. I totally agree about zero tolerance laws but the fact remains that this is the law and the nurse and the school are required to follow them. Don't like it? Take up issues with the law with the responsible party - the legislator.

Again.. the only reason the nurse had the prescription in the first place was because of a random drug check.

Which has nothing to do with the fact that there was still no release on file. The random drug check was not illegal, hence the drugs are not "fruit of the poisonous tree", so to speak.

Anyone with a brain would know that the medicine belonged to the child and would not have confiscated it.

No one is disputing that zero tolerance laws can be stupid. However, if common sense were common, zero-tolerance laws wouldn't be necessary.

I have yet to hear of any issue like this where a school administrator has taken a legally prescribed drug (other than OTC crap such as midol etc) away from a child during random drug checks.

Just because you haven't heard of it, doesn't mean it hasn't happened. That particular policy is part of my kid's school handbook (not in FL) and according to the 19 seconds I just spent using Google, part of thousands of school handbooks nationwide.

[beli]

BDF, you said you care about the physician's prescription but the fact remains that if you want your child to have access to the medicine while in school, you must sign a release. Saying that prescriptions are from people with medical degrees not people who play with crayons doesn't change anything. I totally agree about zero tolerance laws but the fact remains that this is the law and the nurse and the school are required to follow them. Don't like it? Take up issues with the law with the responsible party - the legislator.

Again.. the only reason the nurse had the prescription in the first place was because of a random drug check.

Which has nothing to do with the fact that there was still no release on file. The random drug check was not illegal, hence the drugs are not "fruit of the poisonous tree", so to speak.

Anyone with a brain would know that the medicine belonged to the child and would not have confiscated it.

No one is disputing that zero tolerance laws can be stupid. However, if common sense were common, zero-tolerance laws wouldn't be necessary.

I have yet to hear of any issue like this where a school administrator has taken a legally prescribed drug (other than OTC crap such as midol etc) away from a child during random drug checks.

Just because you haven't heard of it, doesn't mean it hasn't happened. That particular policy is part of my kid's school handbook (not in FL) and according to the 19 seconds I just spent using Google, part of thousands of school handbooks nationwide.

I never said the drug checks weren't illegal. Of course the school has every right to randomly check students lockers for illegal drugs.

So what your saying is basically you would have done the same thing? I'm sorry but I can't have that on my conscious, plus not to mention I'm pretty sure the medical broad that issued my licensed would have backed me up.

[Pam]

BDF, you said you care about the physician's prescription but the fact remains that if you want your child to have access to the medicine while in school, you must sign a release. Saying that prescriptions are from people with medical degrees not people who play with crayons doesn't change anything. I totally agree about zero tolerance laws but the fact remains that this is the law and the nurse and the school are required to follow them. Don't like it? Take up issues with the law with the responsible party - the legislator.

Again.. the only reason the nurse had the prescription in the first place was because of a random drug check.

Which has nothing to do with the fact that there was still no release on file. The random drug check was not illegal, hence the drugs are not "fruit of the poisonous tree", so to speak.

Anyone with a brain would know that the medicine belonged to the child and would not have confiscated it.

No one is disputing that zero tolerance laws can be stupid. However, if common sense were common, zero-tolerance laws wouldn't be necessary.

I have yet to hear of any issue like this where a school administrator has taken a legally prescribed drug (other than OTC crap such as midol etc) away from a child during random drug checks.

Just because you haven't heard of it, doesn't mean it hasn't happened. That particular policy is part of my kid's school handbook (not in FL) and according to the 19 seconds I just spent using Google, part of thousands of school handbooks nationwide.

I never said the drug checks weren't illegal. Of course the school has every right to randomly check students lockers for illegal drugs.

So what your saying is basically you would have done the same thing? I'm sorry but I can't have that on my conscious, plus not to mention I'm pretty sure the medical broad that issued my licensed would have backed me up.

You aren't using logic to back your argument.

1. Your response was "but the school confiscated a prescription drug during a random drug search!!!" So? There are monkeys flying out of BDF's butt, too, but that's not a valid argument, either.
2. The medical broad (ahem) or even that board, would NOT back you up in this case. The nurse did not have authorization from the parent to administer the drug. That's the LAW that the nurse is required to follow and following the law is a required to keep your license. Even in a medical setting such as a hospital, parental consent is required to administer a drug to a minor - why should the school setting be any different?

I don't know what I would have done in this case. If the kid was as severely symptomatic as the parent would have you believe, I'd have called 911. If the kid was as mildly symptomatic as the school nurse and principal claim, I'd have done what they apparently did - which was to call the kid's parent and ask them to come on down and handle the situation.

But then again, you know, I get sidelined by them there things those city slickers call facts.

[beli]

BDF, you said you care about the physician's prescription but the fact remains that if you want your child to have access to the medicine while in school, you must sign a release. Saying that prescriptions are from people with medical degrees not people who play with crayons doesn't change anything. I totally agree about zero tolerance laws but the fact remains that this is the law and the nurse and the school are required to follow them. Don't like it? Take up issues with the law with the responsible party - the legislator.

Again.. the only reason the nurse had the prescription in the first place was because of a random drug check.

Which has nothing to do with the fact that there was still no release on file. The random drug check was not illegal, hence the drugs are not "fruit of the poisonous tree", so to speak.

Anyone with a brain would know that the medicine belonged to the child and would not have confiscated it.

No one is disputing that zero tolerance laws can be stupid. However, if common sense were common, zero-tolerance laws wouldn't be necessary.

I have yet to hear of any issue like this where a school administrator has taken a legally prescribed drug (other than OTC crap such as midol etc) away from a child during random drug checks.

Just because you haven't heard of it, doesn't mean it hasn't happened. That particular policy is part of my kid's school handbook (not in FL) and according to the 19 seconds I just spent using Google, part of thousands of school handbooks nationwide.

I never said the drug checks weren't illegal. Of course the school has every right to randomly check students lockers for illegal drugs.

So what your saying is basically you would have done the same thing? I'm sorry but I can't have that on my conscious, plus not to mention I'm pretty sure the medical broad that issued my licensed would have backed me up.

You aren't using logic to back your argument.

1. Your response was "but the school confiscated a prescription drug during a random drug search!!!" So? There are monkeys flying out of BDF's butt, too, but that's not a valid argument, either.
2. The medical broad (ahem) or even that board, would NOT back you up in this case. The nurse did not have authorization from the parent to administer the drug. That's the LAW that the nurse is required to follow and following the law is a required to keep your license. Even in a medical setting such as a hospital, parental consent is required to administer a drug to a minor - why should the school setting be any different?

I don't know what I would have done in this case. If the kid was as severely symptomatic as the parent would have you believe, I'd have called 911. If the kid was as mildly symptomatic as the school nurse and principal claim, I'd have done what they apparently did - which was to call the kid's parent and ask them to come on down and handle the situation.

But then again, you know, I get sidelined by them there things those city slickers call facts.

Okay, but what about medical ethics? Doesn't a nurse have to swear that she will help someone in need to the best of their ability? By doing nothing (only calling the parent, and not even calling 911) I still don't see how she fulfilled that requirement?

And in the interim.. what would have happened if the kid died while his medication was sitting right there on the counter?

Edited by beli, 26 May 2012 - 09:22 PM.

[iH8cra]

There are monkeys flying out of BDF's butt

This is true.

Okay, but what about medical ethics? Doesn't a nurse have to swear that she will help someone in need to the best of their ability? By doing nothing (only calling the parent, and not even calling 911) I still don't see how she fulfilled that requirement?

And in the interim.. what would have happened if the kid died while his medication was sitting right there on the counter?

What I think you're not seeing is that a nurse has a duty to her patient but was prohibited by that same duty from administering the medication. There is no wiggle room and if the nurse tries to make wiggle room, she is committing malpractice.

A separate issue is the nurse's handling of the asthma attack. She may be found guilty of negligence.

What would have happened if the kid had died with his inhaler right there? He would have rec'd CPR and EMS would be called but he would not get any medication that is not authorized and that includes the inhaler. When EMS arrived, he would be given epi to attempt to open his airway. I'm not a paramedic so I'm not sure what their rules are (maybe a paramedic on here can chime in) but it's possible the paramedic may be able to give the kid his inhaler. I doubt it though since they have better stuff, like the epi.

[Bad Doctor Frost]

And in the interim.. what would have happened if the kid died while his medication was sitting right there on the counter?

As I said, if it were my kid, there would be a big, big price to pay. Every choice has a consequence. She could get caught giving the kid his inhaler and lose her job. She could follow the "rules" and not give it to the kid and he could die, and I'd make sure the outcome would be the same. And I'd use whatever power I'd have to make sure she'd never have a job besides flipping burgers or retail again. But, I tend to be quite the ass. I'm sure parents whose children die to to negligence would be a lot nicer.

[Bad Doctor Frost]

There are monkeys flying out of BDF's butt

This is true.

Okay, but what about medical ethics? Doesn't a nurse have to swear that she will help someone in need to the best of their ability? By doing nothing (only calling the parent, and not even calling 911) I still don't see how she fulfilled that requirement?

And in the interim.. what would have happened if the kid died while his medication was sitting right there on the counter?

What I think you're not seeing is that a nurse has a duty to her patient but was prohibited by that same duty from administering the medication. There is no wiggle room and if the nurse tries to make wiggle room, she is committing malpractice.

A separate issue is the nurse's handling of the asthma attack. She may be found guilty of negligence.

What would have happened if the kid had died with his inhaler right there? He would have rec'd CPR and EMS would be called but he would not get any medication that is not authorized and that includes the inhaler. When EMS arrived, he would be given epi to attempt to open his airway. I'm not a paramedic so I'm not sure what their rules are (maybe a paramedic on here can chime in) but it's possible the paramedic may be able to give the kid his inhaler. I doubt it though since they have better stuff, like the epi.

So the nurse is screwed either way. That's part of choosing to work in a joke like the public school system.

[road2freedom]

The world needs more heroes... more people willing to take personal risks to do the right thing.

[Bad Doctor Frost]

Reminds of the Walmart "security" people who can't do squat when someone steals something

[Sniper762]

The world is full people that stand flat footed and dumbfounded when the moment arrives. Paralyzed with indecision and lack of confidence, they do nothing. Then after the fact the rest of the world is to blame, not themselves. Their inner being knows the right answer to the solution, they just didn't do it.

Same rules apply for saving a life as taking a life..

Rule #1: Save the life
Rule #2: Then their is everything else.

In those precious moments while his life slipped from him, she failed him and she failed herself.

Period.

[SplashMom]

I had a very long response this thread, but hit the wrong button earlier and deleted it all. I just don't have it in me to type it out all over again.

I am a public school nurse (Pre-K through 4th grade). I'm also one of three certified CPR instructors in our school district. We have strict policies to which we must adhere. Having said that, if a child presented to my school clinic with respiratory issues and had with him an inhaler with his name on a pharmacy-labeled box, I would have him use it immediately. I'm horrified that neither the nurse nor the administrator attempted to call 911 after not allowing the student in this story to use his inhaler. More than 3,300 people die from asthma each year in the United States. I refuse to let one of my students be a statistic if I can do something about it.

[road2freedom]

I had a very long response this thread, but hit the wrong button earlier and deleted it all. I just don't have it in me to type it out all over again.

I am a public school nurse (Pre-K through 4th grade). I'm also one of three certified CPR instructors in our school district. We have strict policies to which we must adhere. Having said that, if a child presented to my school clinic with respiratory issues and had with him an inhaler with his name on a pharmacy-labeled box, I would have him use it immediately. I'm horrified that neither the nurse nor the administrator attempted to call 911 after not allowing the student in this story to use his inhaler. More than 3,300 people die from asthma each year in the United States. I refuse to let one of my students be a statistic if I can do something about it.

See.. that's what I'm talkin' about.

[mk_378]

The article doesn't say how much time passed between the inhaler being seized and the asthma attack. If it was days, the parents needed to act and straighten things out.

Regardless, permission had been granted previously and should have been considered still in force. It's was still the same child, same school, same drug. Doesn't that kind of stuff go into the infamous "permanent record"?

[SplashMom]

The article doesn't say how much time passed between the inhaler being seized and the asthma attack. If it was days, the parents needed to act and straighten things out.

Regardless, permission had been granted previously and should have been considered still in force. It's was still the same child, same school, same drug. Doesn't that kind of stuff go into the infamous "permanent record"?

Actually, medication forms and health care plans do not go into a permanent record, at least in my state. At the end of each school year, all remaining medications are picked up by a parent or legal guardian and medication forms are shredded. We are required to have a new health care plan on file (signed by parent and physician) when school begins the following year.

[sirrowan]

I had a very long response this thread, but hit the wrong button earlier and deleted it all. I just don't have it in me to type it out all over again.

I am a public school nurse (Pre-K through 4th grade). I'm also one of three certified CPR instructors in our school district. We have strict policies to which we must adhere. Having said that, if a child presented to my school clinic with respiratory issues and had with him an inhaler with his name on a pharmacy-labeled box, I would have him use it immediately. I'm horrified that neither the nurse nor the administrator attempted to call 911 after not allowing the student in this story to use his inhaler. More than 3,300 people die from asthma each year in the United States. I refuse to let one of my students be a statistic if I can do something about it.

Thank you for explaining the situation from the perspective of a school nurse. It is comforting to know that not all school nurses are like this a$$ hat in the story.

[hegemony]

shouldn't the mom provided proper paperwork? I mean the nurse was an idiot, but the mother seems to not accept responsibility for not giving the school permission as per policy.

[road2freedom]

shouldn't the mom provided proper paperwork? I mean the nurse was an idiot, but the mother seems to not accept responsibility for not giving the school permission as per policy.

No doubt. The parent failed her own responsibility by not having the paperwork turned in. But I'm sure if she was in the room she would have at least nudged the inhaler over to him...

[Sniper762]

I had a very long response this thread, but hit the wrong button earlier and deleted it all. I just don't have it in me to type it out all over again.

I am a public school nurse (Pre-K through 4th grade). I'm also one of three certified CPR instructors in our school district. We have strict policies to which we must adhere. Having said that, if a child presented to my school clinic with respiratory issues and had with him an inhaler with his name on a pharmacy-labeled box, I would have him use it immediately. I'm horrified that neither the nurse nor the administrator attempted to call 911 after not allowing the student in this story to use his inhaler. More than 3,300 people die from asthma each year in the United States. I refuse to let one of my students be a statistic if I can do something about it.

Awesomeness!