School refusing to give medications.... help!!!

[rbakers]

Okay, this is a new one for me. We have moved to a new school district. We have been in school eight weeks. The school is calling me now and telling me that they are not going to give difficult child 3 his medications as scheduled because they exceed the prd guide for dosage of focalin. I explained to the head nurse, the asst. dist. super intendent that I know the dosage is in excess of what is recommened. This child simply metabolizes this stuff like crazy. They have pretty much said they are not going to give it to him, period. I am suppose to write the school board a letter and request that they do. The doctor has even written a letter to the school explaining the need.

The only case I found on the web was about DeBorg and the court upheld the schools decision. Anyone else gone through this? Please send help!!!!!!!!!

--------------------
Me - 39, depression, Zoloft, Depokote and now Lorazepam for extream anxiety!
husband - 41 finally supportive
difficult child 1 - 20, add, no medications
difficult child 2 - 13, add, anxiety, depression, Wellbutrin 400mg & Straterra 60mg
difficult child 3 - 13 adhd, odd, BiPolar (BP), anxiety disorder-not otherwise specified, Learning Disability (LD) - Disorder of written expression, Focalin 80mg, 1200mg Lithium, 37.5 mg Zoloft, Risperdal 3mg, Zyrtek, 200mg Lamictal.

"Today, I have one nerve left and your on it!"
Member since Sept. 02'

 

[dreamer]

I am not sure about the ins and outs of how to handle this, BUT when I was in nursing school, yes, we were taught that we COULD refuse to give a medication if it did not match up with the other medications, proper dose and diagnosis among other things. This is becuz when a nurse hands someone a medication, "administers" the medication, she is the last in a chain of "safety checks". (the doctor and pharmacist are the first steps of the safety checks)
IF there were to be a problem related to the medication and dose etc, the nurse who administered the medication can be held responsible, even if she IS following docs orders. (I am not sure if this is ALL states) She can be held responsible becuz part of her job is to look up the medication etc and be familiar enough with it to know how to assess need for the medication, therapeutic results of the medication and possible negative reactions etc. (Not all nurses are conscientious enough to bother doing this, but they are supposed to) Part of this is becuz yes, docs can make mistakes when writing out a rx. pharmacists can also make mistakes filling rxs. And yes, nurses also can make mistakes, too.....but a "good nurse" WOULD and SHOULD question if something seems "different" with a Rx. And yes, the nurse should then contact the doctor and yes, the nurse SHOULD question the doctor and his order. Yes, I understand the doctor wrote the order, BUT it is on the nurses head if something goes awry. She is covering her heinie and actually, she IS looking out for your childs best interests.
That is a GOOD sign if this nurse actually did go thru the trouble to look up this medication. And yes, this is her job.
Your doctor should not be angry to have someone double checking over his shoulder helping make sure he did not make a mistake and actually the pharmacist also should have questioned the order.
Chances are good, if the doctor talks to the school nurse, he can assure her he is aware about the indiscrepancy of what the pdr suggests for a max dose and that it is ok in this case.
No nurse worth her salt should want to be the one to overdose a kid on his medications just cuz she was afraid to question what was outside "norm"

 

[Sheila]

DeBorg was upheld because they had a policy that was applied to all students (therefore non-discriminatory under Section 504) and other options were tendered to the parents.

https://web.archive.org/web/20110315034041/http://www.schoolnurse.com/med_info/legalissues.html
"...in the DeBord case (1997), the court found for the school district in a dispute regarding the school nurse's refusal to administer a dose of Ritalin that would have exceeded the total daily dosage recommended in the Physician's Desk Reference. Critical to the court's finding was the school district's policy supporting the nurse's review of all medication orders prior to administration to insure compliance with safety standards. Because the policy applied to all students, the court did not find discrimination on the basis of the student's disability, as alleged. In addition, the district had tried to accommodate the medication order by suggesting alternate accommodations (e.g., allowing a parent to administer the dose or dismissing the student early)...."

There may be several ways for you to handle this.

1) Write a letter to the sd releasing them and the nurse from all liability for administering the rx as written. Attach doctor's letter.

2) Check their policy to see if the practice is applicable across the board, and if not, go from there.

3) Let them know that natural consequences for the sd will prevail, e.g., withholding prescribed medications will present with behavioral problems to contend with, insist on compensatory education, tutors, etc., if they prove to be needed. Also, student can not be disciplined for sd not following doctors orders.

4) You didn't say what medication you are referring to, so check with-doctor to see if the dosages can be rearranged, longer-acting medication prescribed, etc.

5) Write a letter holding the sd responsible for whatever may occur because of their refusal to following doctor's orders, e.g., student hurts self or others, runs away from school, violent outbursts, etc.


Send any letters via Certified Mail.

I don't have a problem with the nurse trying to protect the student. No do I fault her for wanting to protect herself and the District from liability. Doctor's and pharmacies do make mistakes, so checking this type of thing when there is a questions is a good safeguard to have in place in my opinion.

On the other hand, sds and personnel have huge amounts of immunity from prosecution. They have done their duty by redflagging a potential problem for the parent. For cases like this, the sd can design a simple form the parent(s) can sign releasing them from liability if they want to. It doesn't have to turn into a power struggle nor end up being a case of medical neglect on the sd's part.