School secretary administring meds???

3 Ok, I wanted to find out what others say about this. I don't think it's legal, but just wanted to make sure. My best friends son has asthma. Until today, she has been able to do all his treatments at home. This changed today. She went to the school, to talk to them and give the instrutions for his neb treatments and all that. The school secretary was who she talked to, who said she would pass everything on to the nurse. My friend had to actually go get the meds, so when she went back the secretary was out to lunch. She asked to speak directly to the nurse, at which point she found out there is no nurse, and that the secretary is the one who administers ALL the meds to any kid who needs it.

First off, the secretary flat out lied to her about saying the "nurse" would be the one doing it. This person has NO medical training, or instruction or training of any kind to be administering meds. My friend is livid. She called the county school board, and was told because it is a charter school they can't do anything. She is getting ready to call and speak with the principal, and is going to find out who else she needs to contact.

But I just wanted opinions. This is not legal right?


ETA: They are giving insulin and all as well. She's not just mad about a nebulizer. Last edit by Simply Complicated on Jan 18, '11
I am sure the laws are different state to state but I do know the school systems usually DON'T have a nurse in every building every day. She/he travels from school to school doing lice checks, vision and other screenings and those types of things. So, yes, the secretary gives the meds to the students. Legal? not sure the norm? probably! Maybe a school nurse will post as they would have a more informed response.

I don't know why it wouldn't be legal. I agree it's not ideal. Non-medical professionals give prescription medications all the time in the community and private settings. It's not rocket science. I suppose your friend has two choices: teach the secretary how to administer the treatments, or go to the school and administer them herself when her son needs them.School districts simply don't have the funding to provide for complete nursing coverage. Many schools have one nurse who travels between schools, with health aides, secretaries and teachers picking up the slack.The secretary may have lied, or she may not have. If she said that she would pass all the info on the the school nurse; it could be that there is a school nurse who oversees several schools (or the entire district) and performs more administrative tasks...making sure the prescription is up to day, placing it in the student's chart, making sure the secretary knows how to administer the med via nebulizer. If that's the case, she didn't lie at all. If she actually stated that a nurse would be administering the medications, that's totally inaccurate and she needs to know it is not okay to tell parents a nurse will be performing these duties. Beyond that, what exactly does your friend want to accomplish? Does the secretary deserve to be fired? Is the school district going to hire a full time nurse for the school? Neither of those things are going to happen. I'm not sure why your friend is going out guns blazing. It's a nebulizer treatment.

I know that some schools are cutting back and not having a nurse or sharing between schools...I don't get it either and don't think it is--but if it's a charter school and they are not state funded many times they are not under the same regs. Your friend could call the state board of health. Its frustrating I know. I think sometimes that it's really nurses who are the ones who realize how important it is to have a licensed and trained nurse to administer meds and its the nurses who know what can go wrong. Someone who is not a nurse doens't know when to hold a med or how to assess to assure there are no red flags that need attention or to know what to do if a med doesn't work. If that asthmatic child comes to the office to be administered the inhaler and is in respiratory distress and the inhaler doesn't work would the secretary notice this or know what to do? Or the diabetic child.......its scarry, really scarry. And the fact that the secretary LIED is big!! I would definately be looking for another school with a nurse if I had a child with health problems. If my child was asthmatic or diabetic or had seizure d/o or something that could come up while in school-- no way would I have him at a school with no nurse there full time. Not worth it to me. I know the value of a licensed nurse who is experienced taking care of kids being there in the school. That nurse could be the difference between life and death for some of these kids with health problems. I say your friend should change her child to a school with a nurse--asthma can be serious.

I just found the statutes about it. They are required to have her sign a consent giving permission to a non-medical personel to do the meds, which they did not do. They flat out told her a nurse does the meds. They are also not legally allowed to do any invasive treatments, including finger sticks and insulin injections. Which she does do. I understand it's just a nebulizer treatment. It was more that they flat out lied to her, and she knows for a fact they are doing blood sugars and insulin.

I was a school nurse for a while, and I can assure you that there were times when the admin personnel gave meds.I believe that there should be a mandate for an RN in every school. You can't just 'switch' schools when a child has health issues discovered in the middle of the year. I had a diabetic who crashed into the 20's and 30's - luckily I bought some icing gel to squirt under her tongue and knew enough to call 911. I had an undiagnosed asthmatic (mom later said she noticed some funny sounds when he was playing hard) who had been at recess then became really SOB. Again, called 911.Very scary, IMHO, to not have at least an EMT/Paramedic on the staff.

I understand being angry about the fact that the secretary lied. Short of an apology for the lying, though, what does your friend now expect to happen? They aren't going to hire a nurse for the school.I see no problem with a secretary or other non-medically trained person providing nebulizer treatments, performing blood sugar checks, and giving insulin in accordance to a specific set of instructions. Who else will perform these duties? It really isn't difficult to do these correctly; children, for example, do it all the time. If a 10 year old can check his blood sugar and administer insulin, an adult secretary should be able to handle it.Perhaps your friend can lobby the school board to have a medical aide available at each school when a nurse is not physically present in the building. Typically these are people who have completed CNA training, as well as BLS and first aide. Or she can request that the secretary receive first aide training, to increase her knowledge and capacity to recognize an unusual health situation.The reality is, most schools don't have nurses. If you send your kid to school with an acute or chronic condition, you either need to be available during school hours to manage it, or accepting of the fact that a licensed medical or nursing professional is most likely NOT the person who will be responsible for administering the medication and caring for your child. The world does not revolve around a few kids and their inhalers and insulin pens.My youngest has severe asthma. She has a health aide at her school. Now she just carries her own inhaler in her backpack. When she was younger, even as a kindergartner, she knew to hit the office for her inhaler prior to gym and if she started feeling tight. If it didn't work, she knew to request to call me at home. I made it very clear to the overseeing nurse, health aide, and secretary that I wanted to be notified if my daughter requested my involvement with her care. Never had an issue. It's my responsibility to ensure that my child understands her chronic condition and how to handle it within her abilities, and when to ask for help from the secretary or health aide. It's the school's responsibility to handle it within their abilities, or contact me or an ambulance if it goes beyond them.I'm curious as to what outcome your friend is desiring. An apology for the lie? Additional training for the secretary? It might help her case if she can articulate a reasonable outcome. Otherwise, nothings going to come of it. The school board is not going to hire a full time nurse for each school. They aren't going to call the ambulance to come and have the paramedics administer the meds. Your friend is going to expend a lot of anger and energy, as well as make others angry and potentially alienate her child's school administrators, with no clear positive, realistic goal in mind if she doesn't think this through carefully.

Quote from Simply ComplicatedI just found the statutes about it. They are required to have her sign a consent giving permission to a non-medical personel to do the meds, which they did not do. They flat out told her a nurse does the meds. They are also not legally allowed to do any invasive treatments, including finger sticks and insulin injections. Which she does do. I understand it's just a nebulizer treatment. It was more that they flat out lied to her, and she knows for a fact they are doing blood sugars and insulin.

Quote from Simply ComplicatedI just found the statutes about it. They are required to have her sign a consent giving permission to a non-medical personel to do the meds, which they did not do. They flat out told her a nurse does the meds. They are also not legally allowed to do any invasive treatments, including finger sticks and insulin injections. Which she does.

When she first called me, she had just left the school and was really upset. She is not making a huge deal out of it. She just wants to be sure things are being done safely. She also has a son who has Tourettes Syndrome, as well of a handful of other things, so she has dealt with a lot of issues and problems with these schools. Way more to the story, but she gets very apprehensive with these things, given what she has dealt with in the past. (bad enough people were fired)Her biggest thing is them flat out lying to her. It just makes her question things. She found out that the secretary is supposed to be BLS certified, she also told her she has some sort of certificate from the county. That and her son is only in kindergarten, so she just wants to make sure that if he has an asthma attack that he will be properly cared for. It is specifically mentioned about fingersticks and insulin. Anyways thanks for the replies. I didn't know to much about this, so I just wanted to find out.. so I wasn't telling her false information.

Quote from Simply Complicated That and her son is only in kindergarten, so she just wants to make sure that if he has an asthma attack that he will be properly cared for. It is specifically mentioned about fingersticks and insulin. Anyways thanks for the replies. I didn't know to much about this, so I just wanted to find out.. so I wasn't telling her false information.

I have not even read all the posts yet but because of budget cuts etc most schools do not have nurses anymore. I live in one of the biggest school districts in my state and there are a few nurses spread around the district but for educational reasons not nursing. It states in the parental handbook that the school secretary or staff administers the meds. Even in the Day Cares in my state the staff is allowed to administer meds. Though the person should not have told you that a nurse does it at the school.

My understanding is that is legal in every state but California, my state has very specific legal parameters to define the process for unlicensed personal to administer meds but it can be done.A basic premise of Nursing is to facilitate a patient's ability to care for themselves and/or facilitate their support structure's ability to care for the patient which may include parents, friends, etc. The ANA sued the State of California over non-licensed personal administering meds based on the premise that only Nurses can administer meds. This is obviously not a position we truly believe because we teach a patient's caregivers such as family members how to administer meds all the time. As an endocrinologist opposed to the ANA put it:"The very foundation of modern diabetes care is the training of lay people to safely administer insulin," said Dr. Kaufman. "Parents, caregivers and other unlicensed volunteers routinely administer insulin every day. Nothing about this is new; it has become the standard of care of diabetes treatment world over."The difference here appears to be that we are trying to expand our territory for financial/job security gain. Should we also be arguing that parents shouldn't be allowed administer insulin to their kids and need to hire a nurse to come by 3-4 times a day? Seems sort of ridiculous but it's the exact same premise. The ANA's position is that it's not for securing more jobs, but for patient safety, and I'd feel less embarrassed by the ANA's actions if they had even a small amount of evidence to back that up, but they don't.It would be preferable for public schools to have more nurses, it would also be nice if they still had music, art, smaller class size, more special ed teachers, etc. California has one of the best nurse to student ratios in the country at 2,150 students to each nurse. Obviously, that one nurse can't cover every diabetic kids insulin, so the result is that a large number of diabetic kids in the California school system receive no coverage at all or any other meds during the day.I'm all for protecting the territory of nursing, but using a kid's health as a bargaining chip isn't acceptable and directly contradicts basic nursing ethics. So how do we advocate for nursing when doing so harms patients? It's a difficult question but there has to be a better answer than this.