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"
