Learning to Use Your School's Medication Policy Safely

From the WebMD Archives

Aug. 14, 2001 -- Along with books and homework, kids are taking medications to school -- for asthma, ADHD, diabetes, HIV, migraines, epilepsy, even a cold. But taking medications to school is not as easy as carrying a lunch box, and taking medications at school is not as easy as eating a peanut butter and jelly sandwich.

There are reports about kids being given the wrong medications. Some kids have to go to the nurse's office -- while in the midst of an asthma attack -- to get their inhalers. Some parents have to drive across town to give their child an insulin injection.

And medications at school can result in penalties. One diabetic teenager was suspended for giving a glucose tablet to a classmate. Another was suspended for giving Midol to a friend.

Every school sets its own guidelines regarding medications based on state laws -- and those laws vary widely. One school may allow kids to carry over-the-counter medications; another may suspend a child for the same thing.

There is only one federal mandate regarding medications at school. Under section 504 of the federal law -- the American Disabilities Act -- schools are required to provide for the health needs of children with chronic health problems, says Howard Taras, MD, chairman of the Committee on School Health for the American Academy of Pediatrics (AAP) and professor of community pediatrics at the University of California in San Diego.

"If a child has asthma or diabetes -- and won't be safe in school unless someone helps him with medication, then the school must [help] under federal law," Taras tells WebMD. The trouble is, schools sometimes tell parents that they [the parents] have the responsibility for providing the service. "That's when you have parents driving across town to give their child an insulin shot."

Limited numbers of school nurses are part of the problem, says Anne Marie McCarthy, PhD, professor of nursing at the University of Iowa. Her study published last year in The Journal of School Health helped shed light on problems that have surfaced in recent years.

McCarthy surveyed 649 school nurses in big and small schools across the country. Nearly half of them reported medication errors in their school during the past year. Three-quarters said that unlicensed personnel -- school secretaries, health aides, and teachers -- dispense medications to students.

Those unlicensed personnel were three times more likely to make medication errors.

School nurses are simply spread too thin to do their jobs the way they would like, McCarthy tells WebMD. "A lot of school nurses are responsible for multiple buildings, for large numbers of children. And there are a lot more children in schools with higher healthcare needs -- kids with IV tubes, wheelchairs, ventilators, children taking medications. So it's no wonder unlicensed people end up dispensing medications."

So, how can you make the system work for your child?

The AAP and the National Association of School Nurses recommend you follow these steps to ensure that all goes well in medicating your child in school:

  • Contact your school nurse or principal. They can explain the rules your school follows for handling and distributing medicine.
  • Find out who is responsible for administering medication in your school, and what medical training they have.
  • Deliver the medication yourself, in the original container, to the school nurse or office.
  • Put everything in writing. If your child has prescription medication for a specific illness, you'll need a note from your child's doctor. A similar note, either from a parent or doctor, is advisable for any over-the-counter medication your child is taking for an illness.
  • Tell your child never to share prescription or over-the-counter medication with another student.
  • Keep natural and homeopathic remedies at home.
  • Tell the nurse about any special considerations for storing the medication, such as need for refrigeration.
  • Know how your children will get the medication. Will someone call your child to the school office, or will he or she have to remember to get his or her medication?
  • Call the nurse or your child's teacher periodically to find out if your child is getting the medication according to your instructions. Schools often keep a medication log.
  • Update your child's medical history forms as needed.
  • Be certain that your child knows what the medication looks like and how much and how often it should be given. Doing this will help your child know if he or she is getting the wrong medication or incorrect dosage at school.

"School policies vary as to whether a child can keep medications with him," says Taras. The AAP recommends that a child should never carry certain medications like Ritalin. "We also recommend that certain medications be considered for a child to carry, like an asthma inhaler," he tells WebMD.

But overall, schools make the final decision if your child can carry his or her medication.

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