Rules are Usually There for a Reason

I get the feeling that there's more indignation about the student not being able to carry her own meds than about larger systemic issues regarding the school-based healthcare system.

Since there is only one federal law regarding healthcare in schools (all schools must provide services for children with chronic conditions under the American Disability Act), the regulations for each school district can vary widely. However, it seems that every school has a rule that medications must be kept in the admin office.

This is probably for the students' own good, because apparently medical errors in schools are very high (according to a large survey of school nurses in 2000):

"Errors included giving an overdose or double dose (22.9%), giving medicines without authorization (20.6%), giving the wrong medicine (20%) or unspecified mistakes (29.8%)."

You might think that this is more an indication of short-staffing or lack of training on the staff's part than anything having to do with the students. However:

"A major factor in medication errors was the use of "unlicensed assistive personnel" such as school secretaries, health aides, teachers, parents, and even students, to administer medications. Only 25 percent of the nurses said they administered all the medication in their schools. The other 75 percent said that unlicensed personnel dispense medications to students."

So this suggests that schools started locking up students' meds because the students (or other unlicensed people) weren't doing a great job of administering it themselves, or were being irresponsible and sharing, trading, or selling their meds (which I wouldn't put past high school students), or there were threats of lawsuits or other pressure from parents for the school to keep a better eye on their kids' drugs. Whatever the reason may be, schools seem to have come to some unanimous agreement that meds should be regulated and placed out of students' reach.

This is probably legitamate for elementary school kids, who normally get their meds in monitored doses under their parents' watchful eyes, but I seriously doubt kids in middle school or high school have trouble taking care of themselves, especially if they have a chronic condition that they've probably been lectured and trained on since their diagnosis. But for that 9 year old, I honestly don't know which scenario is worse: one where an ambulance has to be called because her meds weren't readily available, or one where an ambulance has to be called because she accidentally misplaced her own inhaler.

In any case, the rules are there for a reason...and there's probably no changing it with all parents backing it up. A better solution may be to look at this at the systemic level, and ask why there aren't enough incentives for medical practitioners to work in schools.


Source: McCarthy, A.M., Kelly, M.W., Reed, D. (2000). "Medication administration practices of school nurses." Journal of School Health, 70, 371.