School Nurse Watches Boy Lose Consciousness Because “Inhaler Form Not Signed”

Readers — The very best thing about this horrifying story (tweeted about it the other day) is this perfect comment about the school nurse who watched a boy slip into unconsciousness because of a form not signed. (It didn’t even matter that he had his medicine with him and the medicine had his name on it):

Policy is meaningless if it is followed in blind obedience without consideration of the full consequences of not deviating.

Right! I think that a lot of what is driving us all crazy about incidents like this, and Zero Tolerance absurdities, and even CPS travesties, boils down to that simple problem: Blind obedience. So the question is:

How do we RE-AUTHORIZE people to use their brains and hearts?

That’s a really key issue. It’s the issue when guards won’t let a young boy  use the community center bathroom because it’s after hours. It’s the issue when a school suspends kids for a “prank” that’s really a morale booster. It’s the issue when a parent gets a ticket for letting their kid wait in the car, even though the child is safe and comfortable. Blind obedience to overarching laws written  with an eye to avoiding lawsuits, or an eye to uber-safety.

We have to change the laws and we have to change the mentality of the people enforcing them. Any ideas of how to get there are greatly appreciated. – L.

124 Responses

  1. Unfortunately we live in the Ununited States, were common sense, decency and compassion have left us.

  2. And don’t give me lawsuit avoidance on this one. Do they think THIS is the way to avoid getting sued?

  3. A man on the Today show said exactly what needs to be done: Tort reform. A judge not throwing out a lawsuit 30? years ago where a woman sued McDonald’s because *she* spilled her hot coffee on herself, when she opened the lid while she was driving. And what would her reaction been had her first sip been cold? She would have parked her car and marched her butt inside to have them make her a hot one.
    Now if your kid falls out of a tree you can sue the guy who planted it, whether your kid was hurt or not. If someone breaks into your house and locks themselves in the basement they can sue you because you don’t keep any food in your basement and they were hungry for the three days you were on vacation… SERIOUSLY!
    People should not be rewarded for their own mistakes.

  4. I am waiting for more details to come out here. It was totally unacceptable for the nurse to not call 911 ASAP. But….a nurse giving a prescription medication without the appropriate authorization faces losing her license, as well as possibly facing criminal and civil charges. Good Samaritan laws do not cover nurses in the work place. The parents and the nurse failed this child.

  5. @Paula, what if she walked outside onto the sidewalk and then let him take his own inhaler. It sounds like she wasn’t going to have to actually administer it (not like an epi pen) Only allow him to use it.

  6. What strikes me as utterly baffling is that a 17-year-old is considered incapable of managing his own medications. We already let him drive a car. In a few short months, he will be considered a full adult, able to set out and make his way in the world…yet people think he’s not capable of managing his own medication for a medical condition that he’s probably had his whole life? He probably knows better than anyone when he needs to use it.

  7. Good question @Dani, honestly I don’t know. There are so many what-ifs and Monday Morning quarterbacking in this story. Parents and school administrators together have created this bureaucratic nightmare. I do know that school nurses spend many months pleading and begging parents to complete requirements for medications and emergency action plans, sometimes these are never complated for the year. Who is ultimately responsible?

  8. This is what stinking lawyers have done to our country, our schools and our children. This was my nightmare when I had a child with asthma in school. Fortunately it was a private Christian school and I’m sure they would have valued my child’s life over any rules or even laws. Was this school nurse a REAL nurse? If so, she should lose her license.

  9. this nurse should be criminally prosecuted, her license revoked, fired and the patents should sue the bajesus out of all parties. Anyone who has ever had an asthma attack can attest to the extreme suffering this boy endured. Myself included. She locked the door! This was a crime. I am not exaggerating, she may as well have held a pillow over his face. How dare they let her get away with this? And everyone who requires a rescue inhaler ought to be allowed in every circumstance to keep one on his person.

  10. Dani, you can’t trot out that McDonald’s story because it’s not true and it’s been twisted by the anti-lawyer factions. I’m no fan of unscrupulous lawyers but when I’ve been injured or wronged, I want a good one. In the McDonald’s case, if you actually read it, the store had been warned REPEATEDLY by OSHA that they were running their coffee way too hot, to a scalding degree and had been warned that someone would get hurt. So the judgment the jury sent down was to warn McDonald’s and others to listen to safety inspectors when they warn you. This poor woman (age 79) suffered third-degree burns across her groin, inner thighs, and buttocks. She spent eight days in a hospital, had to go through skin grafts, and was disabled for more than two years — all for a 49-cent cup of coffee in a flimsy cup that McDonald’s served way, way too hot for a drive-in window.

    Now back to the original point of this blog post. I think the solution is giving school districts some backbone and being willing to forgive them if they make a mistake in the name of trying to something that’s just common sense.

  11. @Dani, before using the McDonalds hot coffee issue as your go-to for frivolous lawsuits, please read more about it. Here’s a place to start:

    http://www.caoc.org/index.cfm?pg=facts

  12. Also, Dani, in addition to what Buffy said (and don’t forget that McDonald’s had been sued over this before – they thought it was cheaper to keep settling than to buy a higher quality coffee that didn’t have to be scalded before people would drink it) you should note that most of that “Person vs. Person” lawsuit stuff is really “Insurance company vs. Insurance company” instead.

    If you trip and fall on somebody’s sidewalk and break your leg in six places, sure, it’s a freak accident. And sure, you’re not going to sue. Why should you? It’s covered by insurance! But your insurance company is going to try to get its money back however it can, and it can do that by suing the homeowner’s insurance company.

  13. Well…..I was thinking eugenics for people who can’t think for themselves, but that’s not gonna go over in this climate…mmm… let’s see….I honestly can’t think of what to do except maybe tort reform, as said above. I’m with Ellen on this re: that nurse. I simply cannot imagine not breaking the rules in an emergency!!

  14. I have had asthma attacks and have watched a child having them. For those who do not know, it feels like something is pushing on your lungs so they can’t inflate and you can’t take a breath, no matter how hard you try. The people who did this to Rudi probably would not approve of waterboarding a terrorist, yet they let an innocent boy suffer!

    Why did the nurse lock the door? Was she afraid the boy might manage to crawl out of the room and find somebody who actually cared? Would she have unlocked the door later for the coroner?

  15. What’s more appalling than the nurse is the school district standing behind her for following these rules. Instead they should have said, no child’s life is more important than our paperwork and at the very least she should have called 911. The bureaucracy has become so entrenched that it protects its own first, instead of doing what’s right.

  16. The policy was “no meds without parental signature” and she followed it … however, the policy also was “call 9-1-1 if a child is having trouble breathing” and she did NOT follow that one.

    She chose to follow the first one, but not the second one, choosing instead to lock the two of them in her office while she stood there and watched him struggling to breathe.

    One can only say WTF! Where was her emergency medical training? You do not lock the door between the arriving EMTs and the victim.

    ===============
    The effects of using an inhaler when you don’t need it – or if you try a friend’s – is minimal. Slight increase in heart rate, slight jumpiness, slight increase in blood pressure. It’s like one too many expressos.

    The risk of a serious reaction is extremely tiny. The risk of dying if the inhaler is denied is a lot higher.

    ===============
    Our instructions in ski patrol (which is basically being an EMT but a lot colder) were to ask about inhalers, and go as far as helping hold the inhaler in the correct position if the patient was wobbly. We also gave oxygen and the “towel over hot water” moist air treatments if the patient said it usually helped.

    BTW, if the patient can’t cooperate, the inhaler is not going to work. You’ll need a different delivery mechanism. So you have to make sure they stay conscious enough to inhale at the right time.

  17. I am a RN. You can not give medications w/o an order period. It sucks.

    I think what has to happen is advanced directives so that an RN can do certain things for emergencies. They have to be spelled out in policy and procedure.

    It is the parents fault for not getting the asthma paperwork to the school! I have a child with asthma and it is top priority for me to have the tech equipped with the orders from the doctor to treat my child properly when having a breathing episode.

    It probably was not an RN that was in the school but a parent volunteer or an aide.

    These days school RNs oversee a handful of schools and her job is more administrative.

    My daughter’s are going to MS next year and they asked for parents who are RNs to please volunteer in the clinic. I put my name in. I will tell you I will follow their policy and procedure no matter how ridiculous it is. I will not surrender my RN license to idiot parents that can not get the proper forms into the school to care for their child. I will call 911 and will feel awful there is nothing I can legally do to help that child.

  18. The kid needed his mother to sign a paper to give him his inhaler, yet if it had been a 17 year old girl she could have had an abortion without parental consent. This country is insane

  19. Everything is a lawsuit in the making. My son has a severe peanut allergy and I have a stack of forms I fill out every year. Some have to be signed by the allergist so there is an expense there. I have to provide the school with a written protocol on how to proceed. Alll of this has to be in the hands of the school before my kid can walk through the door to go to school. They actually lost all the paperwork last year and I was scrambling 2 days before school started to redo everything. The school failed this kid by not having an emergency protocol in place. the parents failed by not filling out the required paperwork. Honestly, I hate filling it out every year. I get that. But it is about my kid coming home at the end of the day. The question is how did this nurse come into possession of the inhaler without the paperwork to go with it. If the kid keeps an inhaler on him, he should have been able to self administer. My son has an epi-pen in his backpack in addition to the ones in the classroom and in the nurse’s office. If something happens he can self administer without having to worry about the teacher or nurse. The nurse should have never taken the inhaler without the supporting paperwork.

  20. One point of clarification, very few school nurses are RN’s.

  21. TRS-our nurse is spread out over 5 schools. She is there one day a week. Otherwise you get the school secretary or administrators. I would hope someone would call 911 in an emergency. A nurse should have that much common sense. An administrator might freeze and be overwhelmed.

    If a prescription is required, then the form has to be turned in. Had the nurse administered medication incorrectly and there was a reaction, there would have been a lawsuit.

    It’s too bad for this child to suffer for his parent’s forgetfulness, ignorance, inattention to detail or what ever caused them to not turn in the paperwork.

  22. According to a followup today, the nurse is an LPN. The mother says she did send in paperwork and has a copy of the fax sent from the doctor’s office. The school lost it, she says. She has filed the paperwork every year for 12 years. But they couldn’t use the logic of a kid passing out to give him medicine that has his name on it? Bureaucrats!

  23. Unfortunately, this nurse seems to have done the right thing. You all say she should lose her license for not treating this boy, yet actually providing care to him without proper authorization could have resulted in her losing her license. Thanks to sue-happy parents who need someone to blame their tragedies on, school nurses (and others who administer meds) have their hands tied when it comes to technicalities like this. (And believe me, this is just one of many.)

    THE PARENTS were aware that their child has a life-threatening condition that requires medication, yet they chose not to submit the paperwork that would enable the nurse to administer it. So who is the real criminal here? We would like to say that common sense and human decency would prevail, but unfortunately, common sense actions can be turned against us if things don’t go as expected. Lawyers and the parents that they represent have taken away the ability for people to make decisions, whether mundane or life-or-death.

    I work at a school district-run daycare where a child was kicking and punching a pregnant daycare provider in the stomach, declaring that he hoped her baby would die. Another daycare worker stepped in and tried to pull him away, and was seriously injured while doing so. Not only did the school district refuse worker’s comp to pay for her injuries (which ended in permanent damage to ligaments in her arm), but she was disciplined for restraining him without being Mandt trained. She was lucky she was not sued.

    If a child at the daycare I work for runs into the street, we are not allowed to prevent it, because policy does not permit us to restrain the children without training. We are required to call 911 in events such as this.

    Do you think nurses/daycare workers came up with these policies for fun? No. They are a product of the thousands of lawsuits from parents who blame everyone else if something goes wrong with their child.

  24. How can it be against the law for an RN to stand by while a patient takes his/her own prescribed medication? (Maybe against school policies but certainly not the LAW.) She wouldn’t be administering it. She couldn’t possibly lose her license for that, right? Also if you google this story you’ll find other articles that quote the mother as clearly telling the nurse to call 911, which she did not do. Even if the mother hadn’t asked her, wouldn’t that have been the right thing? Wouldn’t she be breaking policies for not calling 911 when a student was having trouble breathing? How could they possibly be backing her up unless she has some sort of proof that he was faking it?

  25. How do we ever expect our children to be responsible for their own medical condition and medications, if we continually forbid them from taking care of them personally. The Boy Scouts has this problem. When the boys go on camping trips, summer camp, etc., it is mandatory that an adult carries and dispenses the medication. Our schools have the same issue. If medication is necessary during the school day, the school nurse must dispense it.

    This may have a place for elementary school children, but not with middle schoolers and older.

  26. What better authorization does one need, in an emergency, than a prescription medication with the label on it indicating which doctor prescribed it and who it’s for? Let the kid take his medicine; he’s probably been doing it since he was a little boy.

  27. The “rules” caused the problem…but form me, not the rule that says the nurse can’t administer meds, but the rule that says kids (even High School students) can’t manage their own medication- especially for an inhaler (or epi pen). I am sure this “kid” takes his own inhaler when he is not at school. As an asthmatic, I know I did, long before I was 17.

    Last year when packing my daughter for camp (then 10) I noticed forms said ALL prescription and over-the-counter medications needed to be turned in to the camp nurse with signed release. I asked if she could keep benedryl gel and hydrocortizone cream with her in the cabin because she has a mosquito bite allergy (just swelling and bruising – not life threatening) and bites bothered her at night. I was told she could not have it in her trunk if the label said “Keep Out of the Reach of Children”…I pointed out that sunscreen and bug repellent (required), and even some toothpaste says that on the label…

    Kids need to learn to mange their own treatment. This kid probably did not need the nurse’s help, he just needed his inhaler.

  28. An excellent question Lenore – how *do* we ‘reauthorize’ folks to use their brains? Step one might be to learn to tolerate the occasional bad outcome of a person who truly tries to do the right thing, and either makes a mistake, or simply finds that the circumstances rapidly spiral out of the individual’s capacity to cope. Right now, we hold that person responsible. Gotta have someone to blame eh?

    For as long as we look for fault and punishment (usually monetary) after a bad outcome, people will continue to hide behind ‘zero tolerance’ and other policies designed to protect individuals and organizations from legal action.

    And no, we don’t need to kill all the lawyers. We only need to stop calling for their services.

  29. “But….a nurse giving a prescription medication without the appropriate authorization faces losing her license, as well as possibly facing criminal and civil charges.”

    He HAD a prescription. She wouldn’t have been “giving” him the medication, she would have been allowing him to use the medication that he would have been allowed to use anywhere else, at any other time, because it was prescribed for him. There’s no way a nurse can lose a license for *not* interfering with a doctor’s prescription. Her job with an overbearing school district, maybe — but we were potentially talking about this kid’s LIFE. It’s one thing to say we shouldn’t ask people to risk their jobs over someone else’s convenience, but this could have been a matter of life and death. She’s more in danger of losing her license by not giving appropriate, doctor-prescribed care because of non-medically driven, bureaucratic rules.

  30. @Dani

    I hate when the McDonald’s case is used as a reply for darn near any lawsuit-averse issue.

    The woman in the McDonald’s case was/is only well known because of the advent of 24-hour news. Cases like that happened before.

    In total, that woman received something less than $600,000 of which at least $20,000 was loss of income and medical bills.

    She received second and THIRD DEGREE BURNS because McDonald’s served coffee almost 100 degrees hotter than the competition. They could find no other restuaraunt chain that served coffee in the ballpark of how McD’s did it.

    http://en.wikipedia.org/wiki/Liebeck_v._McDonald%27s_Restaurants

  31. When so much blame is tossed around and calls for criminalizing, removing licences, etc are tossed around, often without knowledge of the full facts, and when everyone is so lawsuit happy, change is in
    Ikey. Could the nurse have done some things differently that would have still kept her free from lawsuit and within the boundary of the rules of the school? Probably. Should she have been better prepared for this type of situation and how to respond. Yes. But change won’t happen when blame, accusations, and villafing are happening. Instead of all of the self righteous comments let’s hear some ideas on how to help.

  32. I don’t where the people who are saying “she couldn’t care for him without authorization” are coming from. He didn’t NEED her to care for him, he needed her to GIVE HIM THE INHALER that the doctor HAD ALREADY PRESCRIBED. There is no new care being initiated here, no medical judgment being called for. If the kid had been walking home from school, or anywhere else,he could have pulled the inhaler out of his backpack and done it himself. No one was asking the nurse to initiate any kind of treatment, they were asking her not to interfere with the treatment that had been previously prescribed for the kid to give TO HIMSELF.

  33. “Ideas on how to help.”

    Okay, abolish all rules preventing children over the age of 12 who do not have mental or neurological challenges from administering their own legally prescribed medicines at school.

    That was pretty easy.

  34. Also worth noting that most school districts allow children to carry their own Epi-pen, inhalers, and insulin with the proper authorization.

  35. What you people aren’t understanding is that, in order for him to self-medicate, there has to be written authorization. Again, very stupid, but who is to blame for making school administrators create policies like this in the first place? Parents.

  36. But Lisa, that is the point of this question Lenore asks. How can we re-authorize the school administrators to make a common sense call? No one is “making” school administrators create such policies.

  37. I’m not a nurse, but you know, I think if the choice were between losing a professional license and a kid losing his life, I’d rather look for a new career than know I had a hand in someone’s death like that. Life matters more.

  38. You know, most of the time when people tell me they can’t do something for me because of policy, I say, “I understand, this is not worth your losing your job over.” You can’t just magically let a kid into the R-rated movie without his parents? It’s not worth losing your job over. You can’t give me back the 100 bonus gas points that the pump mysteriously ate and I have to call corporate to get them reinstated? That’s okay. It’s not worth losing your job over.

    IF A KID IS IN DANGER AND COULD DIE, AND YOUR CHOICE IS TO POTENTIALLY LOSE YOUR JOB IF YOU SAVE THE KID OR POTENTIALLY LET THE KID DIE, YOU LOSE YOUR FUCKING JOB AND SAVE THE KID. IT ******IS****** WORTH LOSING YOUR JOB TO SAVE A LIFE.

  39. So much of our policy is being driven by the fringes, and after a while we say “How did we get into this mess?”

    I’ve heard tales of kids selling their Ritalin so other kids can get high. (No idea how high you get off of it… But apparently there is a market for it.)

    So now we have a “No Drugs/No Tolerance” policy, to include toothpaste, aspirin, and inhalers.

    All based on the premise that kids cannot be trusted to make even the smallest decision on their behalf, and *everything*, no matter how trivial, has to be authorized and approved by an adult.

    And a lot of it is driven by parents suing for even the most common mishaps.

    My kid broke his arm at the school playground; truly an accident. No one pushed him, he fell off about a 12″ step onto barkomulch and broke his arm. Go figure. You have no idea how many times we were asked by other parents if we were going to sue, who our lawyer was, etc. etc. etc. – and many were surprised that we did not sue. Apparently a kid’s misfortune is no longer seen as an accident but rather as a potential windfall of cash.

    Is it any surprise that, in an era when a “slip and fall” with no injury settles for an average of $28,000 schools have draconian policies and rules that defy logic?

    To those who blame the nurse: If you’ve never been in a panic situation, you have no idea how you will act. I’ve managed disaster scenes and your brain shuts off. You act on training. You don’t think; you react. If your training says “no form no medicine” and it’s drilled into you that’s what you do. Don’t blame the nurse, blame those who trained her.

  40. BTW, I just want to mention that I was once in a situation where I was at a party, and one of the guests showed up and had an asthma attack on the front steps of the house. The host was calling 911, and I was busy pulling my albuterol inhaler out of my purse (the asthmatic guest had mostly used his up). Do I usually advocate sharing medication? No. Do I realize that this is potentially illegal? Yes. Did I give it a second thought? Of course NOT!!!!!

    The paramedics thanked me, too. Do you think they usually advocate people passing medication around? Of course not. However, in emergency situations, the priority is always to help someone. I have zero nurse or EMT training, but this is a common sense issue.

  41. **If your training says “no form no medicine” and it’s drilled into you that’s what you do. Don’t blame the nurse, blame those who trained her.**

    While I agree we should all take a breath and think maybe the nurse just panicked, what I can’t understand is why the school bureaucrats are standing by her and this policy. They should have said “Of course a child’s safety is more important than any rule and she should have called 911 but we will work hard to improve training and our policies.” Instead, they dug in their heels and defended the policy over common sense.

  42. Reauthorize to use their brains? How about just show some compassion? The nursing profession was created to provide comfort, but I know personally out school nurse holds the job of Paper Pusher and rarely lays a hand on a child.

    My “last straw” moment happened a few months ago. My son gets horrible poison ivy. He loves climbing trees, fishing, and being outside so this happens often. We have the treatment down at this point, and when he went to school, I sent him with some clear Calamine lotion as they only have the “pink” calamine at the school nurse- not cool to have pink stuff all over when you’re a boy, apparently, to reapply if he got itchy.
    He was dosed with antihistamines and I applied right before school, but he got itchy and went to reapply. I wrote a note to his teacher explaining his condition (though she’s been through this before with him, never a problem) and included the clear calamine and some cotton balls. She said the nurse could help him apply and he went to the school nurse. The nurse immediately called me. She confiscated his “clear” calamine, saying she needs a doctor’s note to apply it, and can only apply the pink calamine that they have Standing Orders for. I said go for it, the kid is itchy. Make him comfortable so he can return to class.

    I got a call 20 minutes later to pick him up from school. She said he is incredibly itchy and needs to go home. She never even applied the pink calamine, just sent him back to class with no treatment!
    When I picked him up, she gave me a lecture on Standing Orders, and the form i would need to have my doctor fill out to apply an OTC calamine with no dye in it. Unbelievable. I told her I only wished she had a Standing Order in Compassion, as my child was never treated (even with ice!) and I applied the medicine in the hallway outside the nurse’s office. He wanted to go back to class but could not.

    I have little faith in our school nurse and actually think someone’s retired grandmom could do a better job treating these kids.

  43. I haven’t chimed in for sometime. It’s time I do so again.

    Lisa and those of you blaming the parents–shame on you. An oversight is something that can easily happen, but of course leave it to the likes of you for wanting to blame the parents for everything. That’s part of what’s wrong with this country–EVERYTHING is the parent’s fault. Get real, woman.

    If the details of the story were correct, it was a known fact that this child had asthma. His name was on the box besides that. I’ve had off & on asthma myself–sometimes it goes in remission & I can practically run the 10K marathon without any medication and do just fine, other times, without an inhaler, I can’t even walk briskly in a store without keeling over and feeling like I’m about to die. (I think it’s triggered by allergies, because on days I sneeze a lot I tend to be vulnerable to “breaking lockdowns” as it were.)

    In a case like this, SCREW THE RULES. I mean it, screw the rules. It is like Jane W said, if it comes down to your career vs saving a life, save the life already. Screw your career. If you build your career on the backs of dead asthma suffers, I sure as hell don’t want you as my child’s nurse.

    LRH

  44. @Gator, clearly you did not read the first several paragraphs of Yan’s comment, which was exactly my point in why administrators are forced to make these policies.

  45. But I contend they aren’t “forced” They are fearful. Our challenge is to make them less fearful and be forgiving when they make a mistake in the name of being compassion and logical.

  46. Let me expand on “screw the rules” vs “I’m just doing my job” and “I must follow procedure.”

    I once had a job as a customer service representative & they were beyond anal strict about not using a cellular phone, not even texting your babysitter, while working. Their PCs also had no Internet access. They ALSO had a rule that we only gave “general” support, if someone called asking a somewhat “technical” question, you couldn’t answer it, even if you knew the answer, you HAD to transfer them to a “technical specialist.”

    I happen to be better-than-average in computer knowledge, I even have had jobs based on this to a certain degree. I had someone call & ask “I have your DSL service, I got a new computer, I used to have this free anti-virus software on there & don’t remember what it’s called.” I couldn’t remember myself, even though I used it at home, and I had no Internet access to look up its name.

    I whipped out my Blackberry and managed to quickly look it up, and gave her the answer. I ALSO told her I was not the “official” computer support team and that my answer wasn’t the “official” answer as it were & I would need to transfer her to them if she wanted “proper” support on her issue. This was, by the rules, supposed to do in the first place, but I didn’t want her to have to wait for a long time & have to press 2 then 5 then 3 then 0 along the way AS WELL AS risk getting disconnected, all the while having never heard any sort of answer on the issue when I was fully capable of answering it myself on the spot.

    So I gave her the answer she needed while ALSO offering to transfer her to the correct department and letting her know my answer was an “off the record” answer.

    The customer was VERY thankful because I saved her a lot of time & headache, and that is what customer service is about, is it not?

    Did the “top brass” agree? Of course not. All they gave a fig about what their stinking policies and procedures. You know what I told them? “It would serve you right if the building caught on fire & your landline phones failed and one of us with a cell phone had to call the fire department, and we instead said back ‘sorry, the rule is no using your cell phone on the work floor’ and let your building just burn to the ground.”

    LRH

  47. @LRH please tell me why, if not because of parents who sue, even in instances where the person used common sense/compassion, these policies are in place?

    And are you trying to suggest that it is anyone but his parents’ responsibility to fill out forms to authorize their child to have his inhaler administered by the nurse for his CHRONIC, LIFE THREATENING CONDITION??

  48. @Gator, we obviously need to look to the people who are initiating lawsuits that these policies are predicated on. I.e., take it up with LRH.

  49. Honestly, I think that the change has to come from the people. More of us (well, not so much us, but people in general) have to be willing to stand up and go against policy and the norm, sometimes at risk. This is careful risk benefit analysis, but the community would, I would hope, rally behind a nurse who overrode in this ONE case policy to help the child. She could have gone on record talking about how policy should not interfere with saving a child’s life… people would support this, and anyone claiming the policy should be held as black and white, with no exceptions would appear as a moron. And, I believe, that as time goes on, and more and more people push back, demanding that there is a time for judgement over policy, then things will change. This is different than the current notion of making sure there are policies in place to keep employees from ever having to think, as if thinking is such a bad thing…

    A well-articulated challenge to stupid laws and policy at least starts a dialogue. Included in that, I do think, is the need to address this “blame game” where someone must be at fault. Youngster chokes on a round, not bisect hot dog piece– it’s the hot dog company that needs a warning label?? WTF. Instead, I think society should gently (or firmly, as appropriate to the SITUATION) admonish those who try to blame others for their own ignorance or poor choices. (After all, what book or magazine on parenting doesn’t include that you should bisect hot dogs before slicing until the child graduates college?)

    We spend a lot of time telling children that they are special little snowflakes, not like anyone else (especially in the self-esteem building stuff) but then turn around and pretend that everyone is the same and every situation must be treated in one way. This is false and we, as a people, need to go back to insisting that there is only one-size-fits-most, NOT one-size-fits all.

  50. In today’s story the mother says she did fill out the paperwork and even has a copy of the fax from the doctor’s office but the school must have lost it. If she is telling the truth, the school did still “follow policy” because there wasn’t a paper on file. But there were 4 years years of well documented evidence and prescription in his name. Stop blaming the parents for the bone headed bureaucrats

  51. And I will add, even if she did forget to send in her paperwork, that is no reason to let a child collapse on the floor. Use your heads

  52. @socalledauthor–Brilliant.

  53. This reminds me of that movie “Cracks”.

    It’s insane.

  54. Schools have gone crazy, but they’re damned if they do and damned if they don’t, I think. My final year of teaching (3 years ago), the administration came up with a policy that teachers were NOT allowed to call 911 in the case of an emergency, EVER. Yes, I’m serious. In case of a student in distress in our classroom, we were supposed to call the “Emergency Response Team”, made up of certain trained faculty/staff members, and they would evaluate the situation and decide if we needed to call an ambulance. They told us flat out the decision to go to this new structure was solely to save money because the city was going to charge X amount of dollars for each time the ambulance had to come out (and, how often did it happen?!?!?! I think maybe once during my 5 years as a teacher).

    I decided right then I would never follow such a ridiculous policy. I was not a parent at the time, but I was outraged at the thought that a place that was supposed to keep kids safe would put them at risk to save a few bucks. Pass the bill for the call onto the parents, if it’s that bad! Now I am a parent and I would gladly fork over the money for an ambulance if a responsible adult deemed it necessary. Also, if the administration thinks all the teachers at a school are such idiots that they can’t be trusted to discern an emergency situation from one where a bandaid is the appropriate treatment, then train ALL the staff to be “Emergency Response Team” members. I bet insurance might even kick in money to cover the training.

    Ultimately, the students at our school were safe, even if some teacher did decide to follow the policy. It was a high school and ever single one of those kids was packing a cell phone, so they all would have been calling anyway.

  55. I think what a lot of you are missing here is that the victim in this case is in no meaningful way a “child.” He is 17 years old.

    If he were in his own home, or in the park, or eating in a restaurant, or shopping in a store, and he had a problem with his asthma, he would reach into his pocket, pull out his inhaler, and use it…and NO ONE WOULD STOP HIM. He has probably been doing exactly this, on his own say-so, since he was very young. I’m sure he is also perfectly capable of grabbing some Tylenol for a headache or a Band-Aid for a scraped knee. The reason people are calling this “common sense” is that in pretty much any other scenario I can think of, this never would have happened — there never would have been an opportunity for it to happen. People on the street do not stand between an asthmatic of any age and their prescribed inhaler.

    The school (and many other schools, it would seem) has created an artificial rule that says that students can’t administer their own medications under any circumstances, not even if they have been previously approved by both a doctor and their parents, and not even when the administration of these medications might be time-critical. This is, in my opinion, ludicrous.

  56. Clearly the first mistake has become letting the teacher and/or nurse know that your kid might have a minor medical need in the first place. Minor – I’m talking the calamine lotion or cortisone cream for itch; changing a bandaid with neosporin; aloe vera on a sunburn; even two Tums, or two Advil for a headache. If the kid knows how to treat it alone at home, they can do it on the sly at school. I’m with LRH: screw the rules, don’t even bring it up. Send the stuff in with your kid, tell them to keep it in their backback and keep quiet. They excuse themselves to the bathroom, lock themselves in a stall and do what they have to do. It’s not worth the trouble.

    And if you’re caught…flush it.

    (I’m being facetious because this story really upset me)

  57. You called it @Linda, it’s the same kind of bureaucracy that won’t let teachers make decisions either. They don’t trust students or teachers or nurses or anyone down the line to use common sense. I’m quite sure there have been times all those little people have made bone-headed calls and for that they should be dealt with a case-by-case basis. To throw logic out the window and hide behind a policy the very worse kind of cowardice. Don’t hold me responsible, I was just following policy.

  58. While I understand why the nurse didn’t give the student his inhaler, I don’t understand why she didn’t call 911! Seriously? It reminds me of what my Dad told me last month after we got placed with our second foster son (who was 5 days old).

    The county social worker was doing a quick walk through of our house (which is standard). Our master bedroom is in the garage (long story short, it was a foreclosure and the previous owner built a bedroom with a much bigger closet and bathroom in the garage). To get to our master you have to walk through the “garage/laundry” area, aka the unfinished part of the garage. The laundry room area has no ceiling and because of that you can see the rafters and the wires in the rafters. After seeing the wiring she found it hard to believe that our home passed the inspection to become certified in the first place.

    She immediately called her supervisor who gave her the ok. Really? The wires are 10-12 feet up in the rafters! How is a 5 day old baby going to climb up there? What kid in their right mind is going to try to climb the wall and get up in the rafters? I understand that it “could” happen but still, it was ludicrous.

    When I told my Dad what happened, I told him that she was just following the rules. His comment was, “that is what’s wrong. She was just following the rules without using common sense.”

    How do we get common sense back?

  59. Worth repeating as it seems to be a little known fact, most school districts allow children to carry their own Epi-pen, insulin, or inhalers if they have the correct authorization to do so.

  60. We live in a damned if you do/damned if you don’t society. If you don’t follow policy, a kid my suffer or die, but you keep your job. If you follow you you think is best, you lose your job, and may be blackballed from your career. Same thing as the save a drowning boy/end up labeld a sex offender. I quite franly cannot blame someone for following inane policy if the fear for their future. Things are not going to change unless society changes, and that propbably won’t happen without some suffering along the way.

  61. It’s so stupid. If a kid has a prescription from their doctor, it has their name on it and everything, that should be all a school needs to know.

  62. I agree with your assessment “How do we RE-AUTHORIZE people to use their brains and hearts?” Over-parenting has stolen people’s ability to use common sense. And furthermore, people think of themselves first before helping others.
    I’ve been trying to piece together in my head an outline for a book about America loosing it’s common sense and how to get it back. People have lost the ability to analyze risk and make appropriate decisions based on the risk factors. But even so…no one would read it. LOL We are too busy being alarmists.
    I’m currently writing a cute post for my blog about my 3 yr old driving his little sister around in his powerwheels car, and I’m already positive I’m going to get some posts about what a crazy mom I am for letting them do that. Oh well. No children were harmed in the making of my post, I assure you.😉

  63. I can only hope stories like this drive us back toward allowing common sense, getting rid of zero tolerance. Furthermore, schools should not be allowed to take away rescue inhalers, epi-pens and the like from a competent teen to whom it was prescribed.

    And no school district should ever stand by a nurse who refuses to call 911 when a student can’t breath.

    To the people blaming the parents…. I am in absolute horror that you find equal culpability between forgetting a single line on a form. And and nurse failing to call 911 when a person she couldn’t otherwise help was on the road to death. That is like clamming that a nurse watching a patient have a heart attack is a-okay not calling a code blue if the patient forgot to bring proof that his nitro was legitimately prescribed. … Take care of the emergency, you can figure out prescriptions later.

    Related note, I grew in the 90’s when our current insanity was young. I frequently questioned the complete disregard of basic rights that no one would deny an adult. In favor of policy. All too often I basically heard that rules are important, but that a child’s basic human dignity and rights are so minimal as to be inconsequential. A typical conversation would go like this:

    “Children/teens” are driven entirely by impulse and can’t be trusted to make a decision because they lack the ability to comprehend concepts such as [consequences/responsibility/rights/ human dignity/respect]. “Kids” can only understand rules and force.
    I would reply with calm offense. “So you are willingly and knowingly wronging someone in a way you would never treat an adult simply because [I am /(s)he is] a minor. And furthermore, you think my friends and I can’t tell the difference between justice and arbitrary punishment.” Yes, I spoke like that. My parents introduced me to moral philosophy and the history of the enlightenment/ constitutional law at a young age. So I had a lot more ways to say *but, it’s not fair!*
    Sadly there was but one universal response: Well *YOU* are different, but we can’t just go around [trusting/respecting/helping/teaching] KIDS!

    At least my bus driver respected my life enough to find and administer the rescue inhaler my school would have forbid me from carrying if I bothered to tell them. I kid you not, there was only one student allowed a rescue inhaler. This student used to have a twin… used to… her twin died from an asthma attack so swift, that being in a hospital at the time couldn’t save her life. Even so her parents had to threaten to sue if the school, before the girl was allowed her inhaler. Personally I wish her parents had sued, so I wouldn’t have needed to hide from school staff, just to treat an asthma attack. If I ever got caught it might have looked like I was huffing. I can see how it creates a bit of a feed back loop:
    If the school doesn’t trust the students. The students have to do basic things in secret. Some get caught looking like they were up to no good (why else would they try to hide such activities), thus even the ‘good students’ get caught. Thus the school thinks all kids try to do bad things and the school doesn’t trust students.

    Which give me an idea…. perhaps a study comparing the rate of serious incidents at schools with zero tolerance policies, to schools with out such policies, also compare the rate of punishment. That might help prove the feedback loop.

  64. At one point my older son needed medication.
    I failed to get a doctor’s note to authorize the school nurse to adminster it. A parent’s note is not adequate. The doctor was out of the office and the oncall would take several hours.
    I went to the school. I signed him out. I gave him the meds. I signed him back in, all standing in the office.

    It was the stupidest waste of anyone’s time in the world.

  65. This situation really underscores some unintended consequences of trying to wrap everything in rules and policies and regulations.

    My understanding from talking to medical professionals I know is that a nurse may not “administer” any medication — not even over-the-counter medications that any person, even a child, could walk into a store and buy for themselves — without a doctor backing them up. So, I can choose to buy some ibuprofen for myself and take it, because I have a headache. However, a nurse can’t “administer” ibuprofen to me. I understand that my workplace can’t even provide ibuprofen for use by its employees, *unless* it is merely one thing among many that is contained within a more comprehensive “first aid kit.” The law sees a big difference between “do it for yourself on your own say-so” and “administer/prescribe to others when you can be perceived to be an authority.”

    When a school creates a rule saying that people off the street (in this case, their students) are no long allowed to handle their own medications, and places this task in the hands of a medical professional, everything changes. By making the process just a little bit more formalized, it suddenly got *lots* more formalized. Maybe the school never intended these particular consequences, but that’s how it goes. Letting non-doctors “administer” medications is not likely to change any time soon, and we probably don’t even want it to change. The only real thing that can change here is for schools to stop preventing students from taking care of their own basic needs.

  66. I looked at the news broadcast and the school is claiming the boy was never in any serious distress, and that of course they would have called 911 if it he had been in any real danger. So there is a disagreement about the basic facts. I trust the truth (whatever it is) will come out in the trial….the parents have hired a lawyer.

  67. Part of the problem is this common sense so many of you are advocating for isn’t common.

  68. Lisa Frankly, I don’t care that other parents sued, they STILL shouldn’t have such policies in place. Is it part of the problem? Sure it is, but it’s hardly an excuse all its own. Just as in my story about the job that didn’t allow texting, their justification for it was that one employee one time texted inside company information to a competitor so the no-phones rule was in response to that. Sorry, but I will be damned if I’m going to ignore a text from my babysitter over what some other person did before me.

    As for what is the parent’s responsibility in terms of filing out a form, I don’t think anyone is arguing that an oversight happened in that regard, but the idea that the nurse is supposed to just sit there and watch as she assumes a cover-your-butt disposition and then we blame it all on the parents, that’s ludicrous. An oversight is not an excuse for a nurse to fail to use some stinking common sense. Moreover, it was an OVERSIGHT, and if we as a society are going to rake parents over the coals over an OVERSIGHT, that’s part of a society, one that holds parents to a ridiculous standard & just mad-dashes at the first-chance to criticize, that I want no part of.

    And again, as I observe in the story, the child’s name was ON THE STINKING BOTTLE. Gee whiz, what more do you need, an angel from heaven to appear to you in person to say that it’s okay? Good goo-lee. If we need more proof than that, frankly, we expect too much.

    LRH

  69. Something like this happened to my brother at summer camp last year. He has asthma which can act up unpredictably so of course he was sent with an inhaler and the forms and everything, but there was a problem. The inhaler apparently had passed its expiration date, so he would not be allowed to use it. Only the expiration date means next to nothing, as our mother (a trained medical professional) and my brother’s pediatrician verified. It was only a week or so past and there was no risk in him using it. Yet, they would not have it. They would let him die rather than give him a harmless inhaler. Then we got a friend, (we live a few hundred miles away from the camp) to bring her daughter’s inhaler for him to use. But it was still impossible even though my mom signed all kinds of forms, because it wasn’t his. Now they had a perfectly usable inhaler and would still let him die. Luckily he didn’t need it.

  70. @Dani, under any sensible tort reform, the McDonalds coffee lawsuit would have gone ahead, and would have had the same eventual outcome. The only change would have been to skip the initial “tens of millions of dollars” award.

    McDonalds was serving coffee that was dangerously hot, much hotter than industry standards, and they had been informed of this repeatedly, including by some lawsuits that were settled out of court. If you spill hot coffee on yourself, the expected outcome is reddening of the skin and moderate pain, which goes away within a day. McDonalds coffee, on the other hand, caused third-degree burns (that is, full-thickness destruction of the skin), requiring a week in the hospital to treat, and which took years to fully heal.

  71. “THE PARENTS were aware that their child has a life-threatening condition that requires medication, yet they chose not to submit the paperwork that would enable the nurse to administer it.”

    Was it fully explained to the parents that this 17 year old could not take the life-saving medication if they did not sign the form? Were they told they must re-sign the form every year? Was it ever pointed out to them that they forgot to sign it (I know that it is the parents’ responsibility and there are so many kids at the school that the nurse doesn’t have time to keep track of who didn’t sign and remind them, but that’s not the point)? Did they receive the forms themselves, or was it given to the 17 year old along with all the other beginning-of-school bs papers? Because by 17 his parents probably aren’t going to school with him on the first day, and unless it was specifically explained to me, I would never imagine that a 17 year old would need a parent to sign an additional paper specifically saying their “child” could take asthma medicine. Well, until this happened, that is. And now that I know it, it makes me wonder even more why the heck people sign their kids up for this…

  72. “McDonalds was serving coffee that was dangerously hot, much hotter than industry standards, and they had been informed of this repeatedly, including by some lawsuits that were settled out of court. ”

    Those are all lies. There was 800 complains out of millions users. Coffe was just hotter than average, but there was no standard to be hotter than. If you make coffee out of boiling water, it is much hotter then what McDonal served. The thing about quality vs cheap coffee is bullshit.

    The woman hit the jackop. There was nothing fair about it. Lies and nothing else.

    Sorry, it makes me angry to see lies win big just because it sounds good.

  73. If third-degree burns are the jackpot, I certainly don’t want to hit it.

  74. While I do understand the need for consent forms (don’t want to give ibuprofen to someone allergic), I think it is so stupid the way they do things in the nurse’s office at school. Take ibuprofen, for instance: each child must bring his own bottle to be labelled with his name and administered ONLY to him. This is only done with all the forms signed, of course. The result is that you have a hundred kids with umpteen bottles of meds that are EXACTLY the same. Ibu is ibu is ibu. Not only that, I had to get a doctor’s prescription med form signed so that my under 12 year old kids could take the “adult” version. They could take a handful of the kid’s, no problem, but not the EXACT SAME dosage of the adult strength. Guess I am lucky that they let me use the same bottle for my two kids.

    Back when I went to school, the nurse had a huge bottle of Tylenol that she gave to anyone in need whose parents had given prior consent. I never heard of anyone suffering any ill effects from taking pills from the communal bottle. Common sense is dead, and it didn’t even get a proper burial.

  75. What is with the debate?….. This is rediculous!

  76. I’m not sure what the laws are in the US, but in Australia you are definitely not allowed to administer prescription drugs if you are giving first aid. However you can definitely ASSIST someone in giving it to themselves, ie. hold the inhaler to their mouth while they press it. So if that nurse was over here she would be facing serious repurcusions.

  77. I quietly flout my daughter’s middle school rules — she carries her own ibuprofen, in the same bag in which she carries her contact lens solution. She is 11. She has her period. I don’t want her to have to leave class and go to the nurse (or whoever is on staff at the counseling office) to get ibuprofen when she has cramps. Imagine being 11 “Hi everyone, I have my period, Excuse me while I go to the nurse.” She is under instructions to take it secretly in a bathroom stall.

    I just can’t imagine medical personnel standing by while someone suffers like that. If my child had asthma, they’d carry their own inhaler. Ditto an epi pen.

  78. @ TRS – You say “I am a RN. You can not give medications w/o an order period. It sucks.

    And what was the “in case of asthma attack, inhale this” wording on the inhaler package, with the boy’s name, and probably the doc’s name and the prescription number? How more direct does it have to be?

    I will not surrender my RN license to idiot parents that can not get the proper forms into the school to care for their child. I will call 911 and will feel awful there is nothing I can legally do to help that child. Yet, the nurse at that school did NOT call 911. She locked the door and stood there, watching him struggle to breathe.

    You will do more than “feel awful”. Despite the best efforts of two other trained passerby rescuers working with what we had until we could hand off to two better-trained and equipped ambulance crew who in turn handed off to even better trained and equipped chopper pilots, a vehicle accident victim died. To this day, I remember her name, what she was wearing, what her ribs felt like when I broke them doing CPR, and the exact spot on the highway where she died. Her name was Jolene, she was wearing a black knit top and pants, and I have to see the tree she died under every time I drive that road … several time a year, every year.

    Could you walk into your school nurse’s office and have a flashback to a child lying on the floor where you left them to die for lack of paperwork? Every day you come to work? How long would it take until you went crazy? I at least have the knowledge that we gave Jolene everything we had to give her.

    @ jen How can it be against the law for an RN to stand by while a patient takes his/her own prescribed medication?
    That’s the loophole that I slide through … if the name on the meds and the name of the patient match, and the condition of the patient seems to indicate that they need their meds, I can encourage or “facilitate” their taking that medication.

    I will not hurl myself on a nebulizer or an insulin syringe to prevent its use if the child carrying it says it’s what she/he needs. We’ve had pre-teens calmly declare that “my insulin needs adjusting, can I borrow your bathroom” and pull out a syringe. We watch them for a while, log it and turn them loose after a glucose check.

    Although, as a long-time ski patroller wrote on his reports on a few occasions he “assisted the patient in administering ____” which we all know meant he rifled the victim’s pockets and found meds, and held the patient’s fingers in the right place on the syringe or inhaler. But he got them down the mountain alive to hand over to the ambulance. (and he’s a lawyer for his day job)

    @ yan seiner – “I’ve managed disaster scenes and your brain shuts off. You act on training. You don’t think; you react. If your training says “no form no medicine” and it’s drilled into you that’s what you do. Don’t blame the nurse, blame those who trained her.”
    BINGO! There are a myriad things that nurse could have done: starting with calling 9-1-1, getting a verbal OK from the parents for handing over the nebulizer, or even calling the kids doctor for permission to administer the legally prescribed medication … and she froze. If you want to go into medicine, even the sheltered kind practiced in schools, you have to learn not to freeze.

    On the triage protocol of ABC (airway, bleeding, circulation) … she failed to get past “A” and ensure a working airway.

  79. @Carla E. What you propose/remember should still be possible. It came up at my daycare when an urgent all day building evacuation occured and they didn’t have sunscreen for all the kids. A day or two later they added a big bottle of sunscreen to the evacuation kit and put a stack of authorization forms pre-filled out on the front desk. It looked like most of the parrents signed during morning drop off.

  80. Rules like that are why carried my meds in my backpack and took them secretly when I was in high school in the 90s.

  81. This story sounds absolutely absurd to me and I’ll withhold judgment without more facts. I totally believe that the nurse would not give the inhaler because a form wasn’t signed. Whatever. Sign the form or expect an ambulance bill every time your kid has an asthma attack. I don’t believe for a second that the kid lost unconsciousness and the nurse still refused to call 911 and locked the door. And all this apparently occurred with the mother a few feet away as she arrived before the unconscious, unbreathing child died? Not buying that part on this parent’s word alone.

    That said, schools really need to do away with the rule that all drugs need to be checked into the nurse and let kids deal with their own prescriptions, especially in HIGH SCHOOL. I understand the problem – kids giving drugs to each other, selling drugs, stealing drugs, etc. But at the end of the day, none of these rules matter. It is not like there is not still an illegal drug trade going on in schools. Kids who want to sell their drugs still bring them to sell. Kids who want to get high off drugs still find them to buy. Like all these zero-tolerance-type rules do is make it easier for school administrators. If you see a pill, it is per se illegal in school (even if a vitamin), so the school doesn’t have to determine if it’s over-the-counter, prescribed, in the right hands, etc.

    I also like how lawyers get blamed for all this. It is INSURANCE COMPANIES that are to blame. Frivolous lawsuits (by lawyers and not crazy people representing themselves) are not that common and those that exist (those that are truly frivolous and not just spun that way by the press) usually lose. Lawyers only get paid in these cases if they win. These types of cases are handled on a contingency fee basis, meaning the attorney fronts all the money to sustain the lawsuit – often thousands of dollars. They never see a dime of that back unless they win. Most lawyers are not wealthy beyond belief. They don’t have the money to front tens of thousands of dollars in frivolous lawsuits on the possibility that they win one.

    Insurance companies on the other hand make money every single second that they don’t pay a claim. They are highly motivated to look for every way possible that they may have to pay out money and eradicate those potentialities by prohibitions in their policies when they can and putting the fear of god into their clients when they can’t. They have employees that do nothing other than come up with potential risks and then package those risks as likelihoods instead of remote possibilities. For example, few parents sue when their kid falls of a slide. However, if a kid falls off a slide, the school’s insurance is liable. So the insurance company tells the school that the risk of lawsuit over a kid falling off the slide is great – and lawyers are all evil so this must be true – and soon the slide is removed. Now the insurance company will never have to pay a claim over a kid falling off a slide and it is happy.

  82. I, too, carried my own illicit ibuprofen in high school. My cousin carried her illicit inhaler. When I was a teacher, I knew that my students carried their own meds from time to time, too (both OTC and prescription). I never said anything about it: they were careful kids who knew how much to take and when. Also, they were in HIGH SCHOOL. They were going to be in college soon. Many of them were legal adults already. And they had the meds with their parents’ permission.

    I just called my mom (who is an RN) to ask her some questions about this story and the legal ramifications, and she made a very good point (well, she made several, but this is one I have not seen mentioned yet): When she was working as a substitute nurse, the school and nurse’s office would not even accept medication without the proper forms being signed, thus avoiding this problem. Apparently most districts have this policy. So how did the school/nurse get the inhaler if the consent forms were never turned in? (She also pointed out that the nurse *probably* would not have lost her license if she’d allowed the boy to self-administer the inhaler in the instance of a severe asthma attack, but said since she didn’t know the school district’s policies, she couldn’t say for certain.)

  83. Did the rules say that the nurse could NOT call 911? I mean, really! To me, that is the thing that should have get her fired – a child in need, whom instead of calling for help, she locked herself in the room with him and did NOTHING until the mother came! Sure, she followed the rules, but whatever medicine this so called nurse knows is not enough to recognize a true emergency!

    At my kid’s school, an ALE next door to an alternative high school, a kid had the same thing happen – had an asthma attack. THEY CALLED 911!!! And, they put the schools into a non-critical lock-down, so that no one would be in the way of the emergency staff when they came! They didn’t lock the kid in a room – they got help! Since when does the school need permission from a parent to call 911?

  84. AW13, the school “found” his inhaler several days before – in his backpack or locker. (I forget which.)

    Please, ask you mother, at what point do the nurses call 911?

    When my son was having breathing issues due to swine flu and asthma, the ER had an open room for him before I could sit down. At a hospital known for making people wait for long periods of time. But they do recognize when an issue is potentially life threatening. I would think the nurse would want to err on the side of safety and call an ambulance right away, knowing that he had asthma, had an inhaler and she couldn’t allow him to use it. An EMT would not be under the same rules and could give appropriate treatment. Even if it meant that they were there with him when someone else needed their attention too.

  85. @Selby. I agree with you about sneaking in medication with your child. I do this on the rare occations my nearly 13 year old daughter needs to take medication. I am also a teacher who teaches 5 – 7 year olds. I am in Austrlalia and we also need parents permission for all medication. Our school policy is that students need to hand in thier inhalers to the class teacher so we have it with us at all times. I have never had a problem with my students managing their medication. They are capapble of knowing and telling me when they need it, sometimes they may need my help to assemble their spacers. Also as a teacher I have had asthma training and I have been adiviced by the trainors I am allowed to provide a student with an inhaler without parents consent in emergency cases, as long as we nofify the parents and ring for an ambulance ASAP. And we cannot be sued.

  86. AW13,

    The school allowed students to carry inhalers if the proper forms were completed. The principal found the inhaler in the boy’s backpack during a random search, found no current form on file, then CONFISCATED the inhaler.

    I can’t fathom why a school would not immediately call a parent when it confiscates something that could save the life of a child.

  87. I am totally perplexed as to why the kids have to hand in their inhalers in the first place or any other medication. There is something I am totally missing here, the need to make sure kids don’t grow up with any responsibility seems to be it.

    Also reading the heading – and not the story – I assumed this was a 5 year old kid, not a 17 year old young adult.

  88. Just to point out that the jury did find the woman in the McDonalds coffee case at least 20% at fault due to the fact that she CHOSE to put a flimsy paper cup of hot coffee between her knees near her groin and then tried to hold it there with her thighs. She then CHOSE to open it from the side of the lid furthest from her by pulling it towards herself. It was not found to be only McDonalds at fault which is why the judge reduced the amount of damages she could receive. She did not even get half of what she tried to ask for in that case due to her choices.

    Also similar lawsuits have been tried and failed due to the obvious point of if people got cold coffee and tea they would complain about it both being cold and bad tasting since most tea and coffee does not taste good when cold brewed and thus are brewed with boiling water and this fact is common knowledge.

  89. Poor nurse, stuck between a rock and hard place. She is in a situation where her two contacts (nurses license and school contract and rules) exclude each other completely. She is in a situation where no matter what she will be under investigation. I can totally see the nurse freezing with two inputs that cancel each other out and still leave her open to prosecution either way.
    Poor kid that is gasping for breath and has medication but is not allowed to use it because his parents did not sign a form in the great bustle called life (or maybe they did and he forgot to bring it back in)
    Poor society that is so hung up on forms, rules, blame game and litigation that common sense is near death.

  90. Actually, the judge reduced the amount of damages in the McD’s case because he cut the punitive damages – damages whose sole purpose is to punish McD’s for it’s wrong-doing and not to compensate the victim for her injuries – from the $2.7 million awarded by the jury to $480,000. The amount of damages awarded for the actual injuries was never altered by the judge. The jury did find her 20% at fault and IT reduced it’s award concerning her injury compensation by 20% (they believed that her injuries were worth $200,000 but only gave her $160,000). I’ve seen no reason given as to why she was found 20% at fault nor would a jury ever have to explains its rationale.

    And actually, the woman got far more than she ever asked for. She originally asked only for $20,000 to cover her medical bills and lost wages. Even after lawyers were involved, the offers to settle made by her attorneys were all less than half what she ultimately received (the reduced amount), some very much less. To my knowledge, McD’s never offered more than $800. McD’s got screwed by whomever was telling them not to settle.

  91. Here are the problems I see with this:

    Locked the door? Really?

    911 was never called. WTF? Even if the claims that the kid was never really in that much distress* and the nurse was following protocol designed to limit liability why wasn’t 911 called if only to provide additional cover from lawsuit? The same fear of lawsuits that caused such a rule to be instituted is the same fear of lawsuits that should have caused someone to pick up the phone. (*Anyone who says something like that has never watched someone have an asthma attack and certainly never had one themselves.)

    The parents say they sent in the forms and have the fax from the doctor’s office to prove it. What the hell more do we expect the parents to do? Do they need to start having the school sign forms in triplicate that they received the forms the parents signed? Where does the absurdity end?

    While the nurse might have lost her job with the school she would not have lost her license if she allowed the boy to use his inhaler. The prescription is the doctor’s orders. She also wouldn’t be administering it to him, she would be allowing him to administer medication he already had orders to do so. Neither of those things is administering care without physicians orders.

    What the hell happened to “First, do no harm”? Take the inhaler out to check the kid’s name is on it, set it on the desk and step out of the office to double check that another staff member doesn’t have the form in question on their desk and come back in 5 minutes.

  92. […] School Nurse Watches Boy Lose Consciousness Because “Inhaler Form Not Signed”, from Lenore at Free-Range Kids • because sometimes I think we have, collectively, gone completely crazy… […]

  93. […] him use his inhaler because his mother didn’t sign a form.” [Isa-Lee Wolf, Yahoo via Free-Range Kids] […]

  94. Thanks for the clarification as to how they got the inhaler. Now, in answer to an earlier question about calling 911. Before I even asked my mom about it, she said “If the attack was that bad, why didn’t she call 911?” So, I’ve never seen (or had) an asthma attack, but the first thought that my mom had was, if she couldn’t dispense the medication, why didn’t she take any action that she could? Also when we were discussing the lack of signed paperwork at the school, though the mother has shown a copy of the paperwork she sent in, my mother was adamant that it was the school’s/nurse’s responsibility to remind the parent(s) that they did not have the proper paperwork. (Under the assumption that the school had accepted the inhaler.) But, with the new information I have learned about how they got the inhaler: why on earth didn’t they contact the parent when they confiscated the inhaler and (presumably) realized they did not have the proper paperwork?

  95. @Eliza: “Our school policy is that students need to hand in thier inhalers to the class teacher so we have it with us at all times”

    Fine, teacher, here’s an inhaler. Have fun with it. I’ll be carrying another in my backback so *I* have it with me at all times!

  96. I am feeling grateful that we seem to havea a more commonsense approach in Australia. Some reliever inhalers are now available as over the counter medications. Although in nearly all cases we (school teachers) must have written consent to administer medication, if a child is having a serious asthma attack and is unable to breathe, it is acceptable to give them inhaler relievers even if they have no forms. This was the training received (as teachers) from the Australian Asthma Foundation. This policy was put in place to save lives, because children WERE dying from asthma attacks, and there is a recognition that the inhalers present very little risk and may save a child’s life.
    No procedure is actually worth sacrificing a child’s life for.

  97. When stuff like this happens I start looking for the source of the rules that have to be followed. Start with the school, the District,the State, the Feds. There, the most likely the source of the problem can be located.

    The concept of being fired and losing your source of income as a reason to not help this student has been mentioned several times. I suggest another alternative of having folks volunteer their time at the schools. I have heard it said recently, put some skin in the game. Help see to it, that your child is getting a good education in a safe environment. If you care–be there, Volunteer.

  98. @Larome–Volunteering in the schools is all well and good, but there are two problems with that–one, a lot of parents work during the day, while their kids are at school, and two, a lot of schools make it really hard for anyone outside the school to come in. They have to go through volunteer training, get police checks (and pay for them), and whatever other hoops the school can think of (maybe flu shots in the winter? I’m not sure), just for something as simple as handing out cupcakes in the classroom on their child’s birthday. This doesn’t really foster the “partnership with parents and the community” that schools say they want. Things were different even when I was in school–I remember going to swimming lessons with my school when I was in grade one, and my dad volunteered to go along to help in the boys’ change room, because my teacher (female) mentioned a need for male volunteers for this purpose. My dad didn’t need any kind of screening; he just phoned my teacher and asked if he could do it, and that was that. This would have been in 1990 or 1991, and the risks then were the same as they are now, but if I remember correctly, the swimming excursion passed without incident, and we were back at the rec centre swimming again on our designated day the following week.

  99. It appears that the mother didn’t bother to take him to the ER or call 911 for her ‘turning blue’ ‘semi-conscious’ child either. Again only one side of the story here. Yahoo is known for bias. Amazingly the lawyer for the case (as per another news article) is the same who took the case of the late Casey Anthony’s parents. Hmm….seems some pieces of the puzzle are missing. Including that apparently according to other stories this child had a history of histrionic behavior issues an threatening tantrumsd

  100. Four minutes. That’s how long you have between respiratory failure and the beginning of brain damage when a normal person stops breathing. If the victim has been struggling to breathe for a while, you have less than four minutes because their reserves are depleted.

    Any breathing difficulty severe enough to produce a diminished state of consciousness warrants a 9-1-1 call. That indicates insufficient oxygen to the brain. In the case of asthmatics, an inhaler that late in the attack can send them into a more severe attack (for reasons which are not fully understood yet.)

    ==============
    One response to a school that wants to take critical medications (or meal timing for diabetic children) away from your child and put them in the hands of teachers or nurses would be to whip out a form for all of his teachers as well as all the office staff to sign – a “service level contract” where they sign to acknowledge that your child has a critical need for “X”, that without access to “X” it is likely that your child will suffer physical injury or even death, that the need for “X” may arise at any time, that the child has been trained to know when “X” is needed, and that the child’s stated need for “X” must be satisfied within “N” minutes for optimal clinical outcomes.

    The contract would detail exactly how they would ensure that “X” would be provided within “N” minutes, and specify how often they would be tested to ensure they could deliver that level of service and what the consequences for failing the testing would be.

    A friend’s young nephew is a self-managed diabetic and when he started a new school they were going to take away “X” (insulin, syringes, test kit, glucose gel) and go through the “you must get permission from the teacher to go to the nurse and you must then wait for the nurse to arrive … blah, blah”.

    His father is a procurement specialist for repair services for the military, so he revised the usual service contract to fit the situation and insisted that he was not going to had over his child’s life without knowing that they had a fully developed plan.

    The school promptly got out of the medical business and developed a new policy that says students can possess “X” and administer it according to their prescribed needs.

  101. A 17-year old is mature enough to decide when and how to break the rules. Go ahead and lie to complete idiots and dangerous people, smuggle your own meds in, etc. I cannot see what the school could do him if he had been caught breaking the rules,
    vs. what happened to him in this case. And, as the article pointed out,
    just because he would appear to have recovered physically does not mean that he and the other people involved (perhaps even the nurse) are scarred emotionally by the absolute callousness and ugliness of hat happened.
    How do parents and kids trust this school or their
    community again?

  102. @Waiting on the rest of the story: “Including that apparently according to other stories this child had a history of histrionic behavior issues an threatening tantrumsd.”

    Can you provide a link for that? Was it in a news story or was it an anonymous reader comment?

    Several of my family members have asthma. In addition to dealing with a possibly life threatening condition, they have also had to deal with people, often teachers and school administrators, who believe that asthma is a psychosomatic illness. In their ignorance, they often contend that a child gasping for breath is just being “histrionic.”

  103. @railmeat – you are spot on! If we could just stop looking for someone to blame.

    Lenore, to be honest, I think this issue is so complicated and so ingrained in current society, that it cannot be changed from the top down ie. more laws and rules are not going to fix this. I think it has to change from the bottom up ie. enough people embrace a more compassionate approach to others and are able to trust themselves and other people enough to function as a society without all the laws and rules. And that trust somehow has to be ingrained in children – I don’t think many adults are able or willing to change so drastically. Maybe our kids growing up free-range will begin this change?? Who knows.

    But…. (and looking at all the comments above – which is depressing – and reinforces this thought for me)….. I have NOOOO idea how you change people in that way! Even educated and reflective people, like those posting here (how would you change them?).

    I do have a lot of respect for education, and I believe that someone who’s made a life’s work of studying this sort of problem may have some ideas for solutions. So if it was me looking for this answer, I would contact a sociologist who specializes in creating trust among people and see if maybe they could suggest something??

    Once you have some ideas of how to initiate social change, social media is the way to go. More than just your web-site. There must be ways to get your ideas out to EVERYONE (especially parents and childrent) – some kind of viral YouTube video or something. Again, there are smart people out there that know how to create these things. And there are subversive techniques for hooking people into new ideas too – I bet someone in advertising could help you with that.

    You’re amazing for wanting to tackle this problem!! I think everything you’re doing already is making a change.

  104. “What you people aren’t understanding is that, in order for him to self-medicate, there has to be written authorization. Again, very stupid, but who is to blame for making school administrators create policies like this in the first place? Parents.”

    I do understand that. I’m saying abolish the need for “written authorization” in situations where a doctor has ALREADY prescribed the treatment and the kid is just following doctors’ orders. I’ll blame anybody you like up to and including Dr. Seuss and Leonardo DiCaprio for why the stupid rules exist, but the point is the same — just git rid of any rule that interferes with teenagers following their doctors’ orders. Let the parents who are worried about this send in their own orders denying treatment to their own kids, if they really are worried about.

  105. @Donna mentioned insurance companies being part of the problem. I remember hearing something on the radio about that – that insurance companies in the US have something like 40% overhead costs, while those in some European countries have only 2-4% overhead costs (I don’t remember the exact % – but it was unbelievable to me!). That might be part of the big giant mess you choose to tackle Lenore, in your quest for positive change! It would make sense that if medical insurance was more efficient, insurance companies would be suing each other less….

    I don’t REALLY know what I’m talking about – – just throwing my two cents out there!

  106. Z-girl: Although I haven’t read it, Bruce Schneier’s latest book Liars and Outliers is about what makes us trust and how we can achieve it. Schneier is pretty well-regarded here.

  107. If the kid had known about EFT, he might not have had a problem at all. ( Eftisland.com/html/asthma.html )

  108. @ Gator and “waiting on the rest of the story”:

    I’d also be interested in links to the additional information you mention, as none of my searches, even on the local news sites, mention any of these facts.

    I think it’s ridiculous that a student can’t carry an inhaler, which is prescribed by a doctor and potentially life-saving, regardless of parental permission. If the box has his name, the doctor’s name, etc on it (like the boxes for my husband’s epi-pen do,) there’s no reason to assume the student shouldn’t have it. As I understand it, using an inhaler when you’re not having an attack isn’t either particularly harmful or recreational. It’s not like the kid was carrying something with a black-market value.

  109. Late to comment on this, but gosh I’m grateful to not have rules like this in the first place. Even at school camp a couple of years ago, when she was ten, my wee ‘medical issue’ was keeping her asthma inhaler in her own bag and just taking it when she needed it. Still does at her new school – it sits in her blazer pocket, and she just takes it at the end of every class. This ‘kid’ would have known what he needed. He actually must be a fairly good and compliant kid to have not simply kept his inhaler in his pocket, as I’m sure others above have pointed out. Makes you want to be a rebel🙂

  110. @Waiting on the rest of the story: If a 17-year-old kid is having a tantrum and demonstrating histrionic behavior, and that 17-year-old kid is histrionically demanding his medically prescribed life-saving medication, give him the meds!

    Better yet, let him take care of his own medication and quit treating him like a potential criminal because he takes meds. (Classic zero-tolerance thinking: Recreational drugs are bad because they get people high, some medications produce a high, therefore all medications are bad and must be controlled by adults or the school is gonna look like Woodstock.) If he is stupid enough to sell his medically prescribed life-saving medication or pass it around to kids who wonder if it will get them high, natural consequences await him.

  111. Those of you who say “to hell with the rules” are NOT part of the solution. School policies now have the force of laws. Having a child smuggle in their medications, can lead to larger problems, such as an arrest and conviction for violating drug laws. I know of four cases where a student had been led out of school in handcuffs for this. In only one case were the charges dropped. The other three led to felony convictions. Two were for Tylenol and one was for Midol. In all three the student was tried as an adult. I agree that these policies are BS, but, just ignoring them isn’t going to help.

    I got a 5 day suspension once for using a fire extingusher on a locker fire. The charge of tampering with emergency equipment was dropped, but, it created a problem when I needed a security clearance later on in the Navy. The policy was that only teachers and school employees could use the extingushers or pull the fire alarm. The funny thing is that we were taught how to use the extingusher in shop class.

  112. @leecoursey, on May 26, 2012 at 00:30 said:

    ” McDonald’s served coffee almost 100 degrees hotter than the competition. ”

    Seeing water boils at 100 degrees, every other restaurant serves coffee at below 0 degrees do they? You know I am pretty sure that the last time I went to Starbucks I go a cup of coffee that was not a frozen block of ice.:-/

  113. Water normally boils at 100 degrees, but with the right conditions, it can be superheated past boiling point. McDonald’s coffee machines superheated the coffee.

  114. We have a Fahrenheit/Celsius issue going on here. I believe those who are saying the temp was “100 degrees” above the competition are speaking in Fahrenheit terms, whereby water boils at 212. Nonetheless, I’m pretty sure that’s an exaggeration — the temp was higher, but not THAT much higher. And the reason for that was customer demand — people wanted their coffee hot so it was still hot when they got to their destination with it. Some people complained ti was too hot for safety; others started screaming when it was (by their lights) “ice cold” by the time they got to to the office.

    Jim Collins — in the midst of the crisis, when the kid in front of you might be gasping his life away, yeah, “to hell with the rules.” Even if the rules are good ones, morally speaking life and death issues supersede rules-in-place ALWAYS. But before the situation arises again, it should be “to hell with THESE rules, get some sane ones and we’ll talk.” I’m not advocating keeping the rules and ignoring them, I am saying rules that prevent a 17-yeaR-old from taking medicine that a doctor had the kid’s name put on with instructions for use need to LEAVE NOW AND NEVER COME BACK.

  115. Personally, I love the McDonald’s change. I remember, vividly, going with my family to cut down a Christmas tree and going for hot chocolate afterwards. The farm was in the middle of nowhere, and the McDonald’s was about the only place you could go. We’d order it with ice in it, pull the lids off, let it sit while we ate our Happy Meals, and somewhere in the 45-minute drive home, it would cool down enough to be drinkable. We always used to say that we couldn’t imagine what they were doing to get the water that hot. Go there for some cocoa now, and you can actually drink it right away.

    As for the article at hand, I don’t have any answers, but I agree that it’s ridiculous that he wasn’t trusted to manage his own condition, nor could the nurse do anything to help. We’ve trapped ourselves in a web of rules and regulations in this society. You see it everywhere, from cases like this, to the voluntary weight-loss competition at my old job which almost got shut down because our HR manager had to make sure we weren’t violating HIPAA laws somehow. That story above about the Emergency Response Team at the school was especially scary. Sometimes, you just have to act.

  116. @G
    “Water normally boils at 100 degrees, but with the right conditions, it can be superheated past boiling point. McDonald’s coffee machines superheated the coffee.”

    Not so. The liquid can’t go above 100 (C) or 212 (F) unless under pressure. So if it were in the machine, as soon as the pressure were to be released you would get violent boiling till the temperature dropped below the boiling point.

    I actually find that McDonald’s coffee is worse since the change, not that it was ever very good.

  117. Pentamom,
    My statement was in reference to the people who were advocating students hiding their medications in violation of the rules. I would have just handed the kid his inhaler inspite of the rules.

  118. Gotcha, Jim. I’m thinking, though, the parents advocating that were thinking this: we need to change the rules, but until that happens, my kid is not going to wind up in the ER or worse because of the rules. We should make sure things change, but unless and until they do, to hell with the rules when it’s my kid’s life.

  119. @G “McDonald’s coffee machines superheated the coffee.”

    They ‘superheated’ the coffee did they?….beyond boiling point?…..under pressure (cos that is the only way you will get water beyond 100 degrees)?…..and then served it NOT under pressure, so it would be violently boiling did they?

    Ha ha ha ha ha ha.

    I have heard some odd things said about this case, but this is the winner.

  120. Sorry @Jen and the others looking for my links about how the mother says she did provide the permission, if you read this story, look in the comments the mother is on there and she has a FB page. She says she even filed the paperwork again the next day and it was again lost. http://www.wesh.com/news/31109650/detail.html

    My point, however, is even if she did forget for the first time in 12 years to file the paperwork to let him take his inhaler, we simply have to find a way to let common sense prevail. The kid shouldn’t die because of paperwork.

  121. What we have here should have been very similar to the ‘Good Samaritan Act’. The nurse should not have been held accountable to the writ of the policy because she did what she thought was necessary in order to save a life. Just like accidentally breaking a rib when giving the Heimlich maneuver. It is just very sad that she was more compelled by paperwork and her job than the suffering and possible death of a student! What kind of sh!t storm would the school and the nurse have been in if the poor student had actually died!

  122. She locked the door because she knew she was wrong.

  123. What has the world come to? I can’t believe any human being with medical training who knows asthma can result in death, unconscious or serious brain damage if not treated would stand by and watch it happen. Where was her basic human decency? I have asthma and I would hope that if I was having too severe of an asthma attack to help myself and was near a school nurse that they would give me my inhaler, policy or no. Disgusting.

  124. I feel your annoyance. I never had any luck with this
    kind of stuff, either. So relieved to know I am not alone!

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