School nurses in Rock Hill and Clover schools are no longer allowed to dispense medication of any kind without the written permission of a doctor a major policy change as classes resume this week.
Water and air, said Keith Wilks, the executive director of student services in the Rock Hill school district. Thats all they can give.
He said the changes will be frustrating for everyone.
Parents are having to get a prescription for everything, he said.
The hope is to soon allow physicians to give standing orders for individual children, giving blanket permission for certain medications or treatments, but Wilks said thats not permitted yet.
So what exactly will happen when a student needs that Tylenol or Benadryl or even something as simple as Orajel and no doctors order has been given?
Call home, Wilks said. Thats all we can do.
Joy Bower, the school nurse at Rock Hills Dutchman Creek Middle School, said if parents cant be reached, students will just have to sit in discomfort if theres no doctors order for medication.
That could mean more missed instructional time, she said.
One local pediatrician has already seen an increase in the number of orders she has had to write before the beginning of this school year.
Dr. Martha Edwards, with Rock Hill Pediatric Associates, said many doctors are already worried about the increased demand in their offices.
Were already annoyed, she said. Thats putting it mildly.
In recent years, Edwards said, her office had already seen an increase in schools requesting that physicians write prescriptions for over-the-counter treatments in school, but now that its required, it creates a lot more work for staff.
At Rock Hill Pediatrics, she said, if a child has had a physical in the last year, a visit wont be required to write an order for an over-the-counter medication, but there might be a charge for processing. A spokesperson for the Carolinas HealthCare System, which includes Rock Hill Pediatrics, said this is not the case and there will be no cost for prescriptions for over-the-counter medications unless there is an office visit required, which would incur the standard charges.
Fort Mill schools adopted the new policy last spring, and York schools have had a long-standing policy that states any student not in high school needs a doctors order to receive over the counter medications.
Robin Brown, Fort Mills district school nurse in Fort Mill, said the transition wasnt difficult.
It went over very smoothly, she said.
By allowing nurses to give students medications at their discretion, Brown said, nurses had to diagnose conditions, which they shouldnt do in a school environment.
That practice also taught students that there was a pill for every problem, she said.
The only medications of any kind youll find in the health room in a Fort Mill school are Vaseline, hydrocortisone cream, antiseptic wipes and saline eye wash.
Local doctors have been helpful with the policy change, Brown said. Many have been willing to fax orders to a school if the child needs something during the day.
Even dentists and orthodontists, she said, have written orders for Orajel or ibuprofen for students with painful orthodontics.
The change has reduced the amount of traffic in the health room by 10 to 15 percent, Brown said.
Bower, at Rock Hills Dutchman Creek, said school nurses today have far more students with chronic conditions requiring monitoring.
So, while she might dislike the hassles the new medication policy presents, she thinks reducing health room traffic could be helpful.
Theres a lot going on, she said.
The key for families preparing to adjust to the new policy is to be proactive, Brown said.
They just need to talk to their family physician about what issues the child might have, she said. You dont want to wait until they need it.
While the Rock Hill school district has advertised the policy change as a reflection of state law or an interpretation of state law, state regulators say they havent issued any such edicts.there has been no official or definitive changes made.
The state Department of Labor, Licensing and Regulation oversees the state Board of Nursing, which regulates school nurses. Agency spokeswoman Lesia Kudelka said LLR has not instructed school districts to change their policies.
The state Department of Health and Environmental Control used to recommend that school districts create their own policies regarding the distribution of medicine in school, DHEC spokesman Jim Beasley said.
But DHEC and LLR have since determined that only the boards regulating medicine, nursing and pharmacy have the authority to create those policies.
Cathy Young-Jones, DHEC's school nurse consultant, asked for clarification on school medication policies from the Board of Nursing, which referred the matter to a task force.
That group will meet Aug. 30 to address these questions.
Common sense tells us parents shouldnt have to jump through hoops for their children to get basic medication, Beasley said.
Rachel Southmayd • 803-329-4072