School nurses are responsible for children’s health and safety. Children who are allergic to epinephrine should receive the correct treatment. However, school nurses have to contemplate over both the medical instructions provided by the children’s health care providers and the rules and guidelines provided by school district and the American Academy of Asthma, Allergy and Immunology. While the nurses waver over the two, treatment for children are often delayed, leading to severe harms like anaphylaxis and “severe reactions with epinephrine” (Wahl et al. 2015, 97). It would help for the school nurses to be familiar with the possible treatments, including the use of EpiPens.
Wahl, Ann, Hilary Stephens, Mark Ruffo, and Amanda L. Jones. 2015. “The Evaluation of a Food Allergy and Epinephrine Autoinjector Training Program for Personnel Who Care for Children in Schools and Community Settings.” Journal of School Nursing 31, no. 2: 91-98. doi: 10.1177/1059840514526889.
School nurses across the country have to reconcile health care providers’ specific emergency action plan for their patients with the school standards and the “American Academy of Asthma, Allergy, and Immunology guidelines.” The differences between the two can create confusion and risk in nurses not using the appropriate treatment for its students. School nurses have the special position of being able to work with both health care providers and parents of students in determining a treatment option (Wahl et al. 2015, 97).
School nurses teaching staff that work with children how to properly use an Epipen would solve many of the problems that children with severe allergies are faced with in that environment. If people who work with children aren’t trained to recognize an allergic reaction or are unaware how to treat it, there will be precious time wasted to find a treatment that isn’t immediate and could therefore put a child’s life at risk. Emergency plans such as calling the parents of kids that have documented food allergies could help the child after a certain amount of time, however that time might have a stronger affect on the reaction. In many other cases, children have allergic reaction to unknown allergens in which case, calling a parent would not be effective. School nurses should be given the resources to train those that work with children how to immediately respond to a reaction using an Epipen as well as back up emergency plans. (Wahl et al. 2015,97)
A major problem that school nurses encounter is doctors advising young patients with the wrong emergency medical treatment that do not comply with their “current school district and the American Academy of Asthma, Allergy and Immunology guidelines.” This lack of immediate and proper treatment poses dangers for the patient, perhaps even causing anaphylaxis. As a result, school nurses are unable to do their job efficiently and face complications that can be easily avoided if doctors treated the patients correctly the first time. (Wahl et al. 2015, 97).
School nurses have a dilemma. When a student has an allergic reaction they can treat them with an EpiPen, but by doing so they are going against the regulations set in place for them. Nurses have methods that they believe are much more efficient and effective than the ones set in place. By carrying out their own method they are in “conflict with their current school district and the American Academy of Asthma, Allergy and Immunology guidelines.” Due to these guidelines recent studies carried out show “undertreatment of severe reactions with epinephrine”, and for this reason this dilemma needs to be solved. (Wahl et al. 2015, 97).
School nurses in the United States are challenged by the fact that health care providers are writing emergency action plans in the case of anaphylactic reactions “that conflict with their current school district and the American Academy of Asthma, Allergy and Immunology guidelines.” School nurses must work to be in a position where they could administer epinephrine as often as deemed necessary in order to avoid severe risk to the children being treated. (Wahl et al. 2015, 97).
Doctors treating schoolchildren with life threatening allergies will instruct them what to do in case of an emergency. School nurses responsible for dealing with an anaphylactic reaction must adhere to rules set in place by the “school district and American Academy of Asthma, Allergy, and Immunology.” Choosing to err on the side of the law, less epinephrine is being administered, which presents a severe risk to the child being treated. Laws and “guidelines” must change so that school nurses can properly assist patients in their care (Wahl et al. 2015, 97).