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We are writing to inform you about information the district received just last week from the Texas School Nurse Organization (TSNO) regarding how our school nurses should handle dispensing of over-the-counter medications. The guidance that was provided in the TSNO Toolkit is highly concerning to us. Board President Lisa Alpe referred to the guidance as, “bureaucratic overreach” and a “potential usurping of parent rights.”
In sum, the guidance which the TSNO identifies as coming from the State Board of Nursing (BON) states, “A parent’s request is not sufficient by itself for nurses to administer medication. This is true for all nurses in every setting.”
The guidance further states, “Regardless of what is stated in your district’s Board Policy FFAC or the student handbook, a school nurse should have a signed order (from a MD, DO, APRN, PA, dentist or podiatrist) before administering any medication (prescription or OTC)….. This includes oral and topical medication (such as cortisone or other “itch” creams, antibiotic ointment, orajel, cream or gel with lidocaine, sting relief pads, etc.).”
This guidance contrasts with our current policy and practice and is contrary to clear Texas law from the Texas Legislature. The Texas Education Code (TEC) states, “School nurses must have a standing delegation order from a physician, or a parent must provide written permission and supply the over-the-counter (OTC) medication, in order for a school nurse to administer the medication at school.” Additionally, TEC Section 22.052 allows school nurses to administer OTCs if the medication appears to be in the original container, is properly labeled and the school nurse has received written authorization from parents or guardians to administer the medication.
From a practical standpoint, following this new guidance, provided just prior to the start of school, would severely impact our SBISD nurses’ capacity to support the wellbeing of your children. Everything from cleaning a scraped knee, to providing medicine for allergic reactions to bug bites or stings is potentially impacted. If enacted, parents would have to come to school to administer medication or treatment, unless a doctor’s order is provided. This new rule, if enacted, will have the effect of costing parents more in time and money, disparately impacting students who do not have access to health care and health insurance, and forcing students out of the learning environment.
Also of concern, per the TSNO Toolkit, is the statement that failure to enact this guidance “may result in disciplinary action from the Board of Nursing.” This, too, is problematic.
Our nurses are amazing and perform a vital role in the health, safety and well-being of our students. Last year, they recorded 197,254 clinic visits, of which 34,532 were for health-related services connected to this recently received guidance.
SBISD must put its students first and must put our nurses in a position to treat minor scrapes and maladies in a manner that, with parent permission, keeps students in the classrooms where they belong during the learning day. SBISD intends to consider all legal avenues to pursue this for our students and our nurses, including potential litigation.
Please refer to this link, (agenda item 5B) should you wish to watch our Board of Trustees’ discussion on this topic at their recent August 12 Workshop meeting. |
