Consent forms: To treat or not to treat?
When someone is suffering, the majority of people instinctively want to help in some way. But it’s not always such an easy decision. In many schools, protocol requires written consent to treat or to administer medications. If the proper forms are not on file for a student, schools are following protocol and not treating the student. Just last month, a student suffering from an asthma attack at a Fort Worth school was not given medication because signed paperwork was not on file. As a result, the child was taken to the hospital instead of treated on site, and required further hospital visits the following week.
The school requires that each student have a signed medication authorization form on file before medication can be dispensed. While the parents state they were unaware their son would not receive treatment without the form, according to school policy, the nurse did not have the authority to administer the prescription. The district is now working to avoid the situation in the future by making certain students with medication needs have the correct paperwork signed and on file each year.
While this specific story received a lot of attention, this isn’t a singular event. A number of school nurses are working to determine how to handle parents who either refuse to sign emergency consent to treat and medication forms, or simply forget and fail to turn the forms in. Questions arise like, “Do I just call 911?” “Do I wait for the parent to arrive at the school?” “Do I simply hope the parent arrives in time, regardless of how serious the situation?” These questions put nurses and schools in a tough situation. They can follow protocol and not provide care, with the chance that the student suffers serious harm. Or they can break protocol and provide treatment, and potentially be liable for treating without proper paperwork.
Communication is key in these situations.
It is important that parents be aware what this lack of paperwork means. In the same way, it is essential that schools be aware of which students are not compliant. The nurse may think everyone is compliant, but are they absolutely certain? When student treatment is in question, there is no room for questions. With parents, there can be no ambiguity as to how the lack of paperwork could potentially affect the student. In addition, the school needs to know why parents are refusing to sign the paperwork, or if it is simply an oversight. If it is an oversight and the school is aware, it can easily be cleared up with effective communication with the parent. If there is a valid reason for refusal, perhaps an alternative solution or alternative paperwork can be agreed upon.
Regardless of the reason, the solution needs to be clear to both parents and school staff. There should be no uncertainty in how to act should something happen to the child. In order to achieve this level of preparedness for unexpected events, the planning needs to start early so that neither party is caught off guard. For schools, this means before school starts, and the child is in their care. Consistent reminders over the summer are essential to ensure each student is compliant when school begins. If parents continue to refuse to sign the forms, schools must also consult district, state, and federal regulations to determine how to properly react, and solve the issue before it becomes a true emergency.