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Nurses Not Always Dispensing Drugs to State Students

Posted on: Monday, 15 November 2004, 21:00 CST

The Associated Press Seven months after the West Virginia Board of Education toughened its policy for dispensing over-the-counter and prescription drugs in schools, nearly half of the states county school systems have failed to do the same. Some counties say they have more important issues to address than updating their medication policies. But 56 percent of county systems have taken the policy a step further by requiring a doctors order for any medication, including cough drops in some cases, to increase safety and to protect themselves from lawsuits, according to a statewide survey by The Associated Press. We used to have a stockpile of over-the- counter medications, and it became a nightmare to keep track of everything, said Kathy Verzich, a school nurse in Grant County, where a doctors order is required. Now all parents have to do is fax a form to the doctor to sign and they fax it back. Students in West Virginia and across the nation are taking more over-the-counter and prescription drugs at school than ever before as the number of children with special health-care needs are mainstreamed into classrooms. More children also are suffering from chronic illnesses such as diabetes and asthma. Its not going to get any better when one in three kids coming into kindergarten today will develop Type II diabetes, said Don Chapman, coordinator for health education at the state Department of Education. Much of the health-care burden falls to school nurses

. In West Virginia, there is one nurse for every 1,500 students in kindergarten through seventh grade. The national recommendation is one nurse per every 750. It would be safer for kids and I think kids would be healthier and happier if we had more school nurses, said Teresa Ryan of Lincoln County, chairwoman of the West Virginia Council of School Nurses. Until then, youre going to have problems come up with medications. About 5.6 percent of K-12 students receive medications on a typical school day in the United States, according to a 2000 study by Ann Marie McCarthy, an associate professor at the University of Iowa. The most common medication is for attention deficit hyperactivity disorder, followed by over-the-counter medications, analgesics, asthma and anti-seizure medications. McCarthys survey of 649 school nurses is one of the few national studies that looked at dispensing medications in schools. She found that errors were three times more likely to occur when unlicensed personnel, including school secretaries, health aides, teachers and parents, administered medications to students. Most problems were related to dosing, either missed doses or overdosing. School nurses say its common for parents to send Tylenol to school, along with a multi-symptom cold medication that includes acetaminophen, the active ingredient in Tylenol. If both are administered, the child gets a double dose that could cause liver damage or even death. As many as 100 people die each year and 13,000 land in the emergency room as a result of unintentional overdoses of acetaminophen, according to the U.S. Food and Drug Administration. Although the state has had a policy of encouraging parents to give medications at home, it was vague, and implementation varied by county. Last year, the Board of Examiners for Registered Professional Nurses urged the state to update its policy or risk the licenses of its school nurses. About half the counties adopted the plan requiring a doctors order for every drug. We live in a different time, said Paula Potter, principal of Riverside High School in Kanawha County. Theres so much abuse, even with over-the-counter drugs. Somebody might send Advil to school and if the student takes 10, they say its my fault they did that. We now have clear guidelines. The state policy adopted in April was a compromise. It allows secretaries and others who take online training to give over-the-counter drugs. It also allows all students with potentially life-threatening conditions, such as asthma, to carry and take emergency drugs with a doctors prescription and parental permission. The policy gives high school students permission to take over-the-counter medication, such as Tylenol or Advil. Students in kindergarten through eighth grade still have to obtain medication from the principal, teacher or other designee. Not everyone is happy: The Putnam County school board is considering whether to abandon its one-year trial requiring doctors orders, and some doctors complain the new policy creates pressure on doctors. Thats an argument that doesnt work in counties like Ritchie, where a community wellness center is in the school, said county Superintendent Richard Butler. Students can go there. I go there, employees go there, Butler said. Its a good thing. While the state policy is not perfect, some say it has consistency that had been lacking.

Source: Sunday Gazette - Mail; Charleston, W.V.

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