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Posted on: Sat, 09/16/2006 - 10:46pm
Rosemary S's picture
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Joined: 12/31/2005 - 09:00

mommyofmatt,
I have started a new thread on the CT Ruling for Nurses on delegation of assessment:
[url="http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/002547.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum7/HTML/002547.html[/url]
Rosemary

Posted on: Sun, 09/10/2006 - 8:18am
anonymous's picture
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Joined: 05/28/2009 - 16:42

sorry about the typo in the title but I can't figure out how to edit that part.

Posted on: Sun, 09/10/2006 - 8:24am
MommaBear's picture
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Joined: 09/23/2002 - 09:00

I'm intrigued. what did she change? specifics please, route, time (circumstances), dose, medication, etc........

Posted on: Sun, 09/10/2006 - 8:29am
anonymous's picture
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Joined: 05/28/2009 - 16:42

Doctors orders for treatment were:
1) Epi Pens
2) Call 9-1-1
and the wording stated to use Epi Pens first before any anaphylactic symptoms.
The school nurse changed it to:
1) Use Benadryl
2) Use albuterol inhaler
3) Use Epi Pens
with symptoms listed at each number of treatment.
I have the papers out in the car in the med file but that is basically how it was changed.

Posted on: Sun, 09/10/2006 - 8:30am
anonymous's picture
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Joined: 05/28/2009 - 16:42

OH, I did call the doctor's office and they were outraged and said she had no right to do that.

Posted on: Sun, 09/10/2006 - 8:35am
Nutternomore's picture
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Joined: 08/02/2002 - 09:00

I'd call the CA Board of Registered Nursing to discuss anonymously first. Then probably file a complaint, and get doctor's office as support as needed.
[url="http://www.rn.ca.gov/enf/complaint.htm"]http://www.rn.ca.gov/enf/complaint.htm[/url]
That is completely outrageous!

Posted on: Sun, 09/10/2006 - 10:17am
Momcat's picture
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Joined: 03/15/2005 - 09:00

Maybe you need to have a chat with the superintendant of your school district. The superintendant needs to know what's going on at this school.
Cathy

Posted on: Sun, 09/10/2006 - 10:20am
anonymous's picture
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Joined: 05/28/2009 - 16:42

We already did that. She wasn't any help. She told me PB&J's are a staple of the Kindergarten diet so she couldn't make the room nut free. She also said she suffers from allergies too and understands where we're coming from *insert eyeroll here*.

Posted on: Sun, 09/10/2006 - 10:23am
MommaBear's picture
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Joined: 09/23/2002 - 09:00

Quote:Originally posted by ~*Trace*~:
[b]Doctors orders for treatment were:
1) Epi Pens
2) Call 9-1-1
and the wording stated to use Epi Pens first before any anaphylactic symptoms.
[/b]
"treatment"
treatment for what?
a reaction?
what signs and symptoms did the physician state to be present to administer the epipen, if the epipen is to be administered [i]before an anaphylactic[/i] reaction. As a nurse, I would have at least expected standing orders to contain that. Does the "order" contain that?
side note:
completely unrelated, but if a physician orders me to give a medication (or administer an intervention) when it is inappropriate, or contraindicated, I can be held responsible for the consequences. Even if a physician ordered it. Not saying that is what is going on here, just something mentioned in the course of "signs and symptoms" and physician orders.

Posted on: Sun, 09/10/2006 - 11:13am
anonymous's picture
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Joined: 05/28/2009 - 16:42

I don't have his paperwork here with me (it's in the car) but basically he wants the Epi Pen to be used before anything else including Benadryl. He listed the signs of anaphylactic reactions.
I'm not using his terms in my posts here. As I said the paperwork is in the car. Basically the nurse took it upon herself to change the "treatment" (my words) protocol in the even of an allergic reaction to nuts.
It's not uncommon for a doctor to advise using the Epi first (over Benadryl) from what I understand. In light of ds reactions (to kicking nuts and licking one) the doctor said he wants the Epi to be used first.
Per the school nurse it's to be used 3rd (upon constriction of the throat).

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