Administering Medication to Students
Recent guidance from the Texas Board of Nursing (BON) and the Texas School Nurse Organization (TSNO) has raised concerns for school districts about administering nonprescription medication to students, whether provided by a parent or the district. Districts are particularly concerned about whether nurses may administer nonprescription medication provided by a parent to a student without an order for administration from an authorized medical practitioner.
In their Aug. 19, 2024, statement on administration of over-the-counter medications and treatments in school settings, the BON indicated that it is reviewing and updating its guidance in consultation with the TSNO and other relevant stakeholders. TASB Policy Service will monitor for updates and, if needed, recommend revisions to FFAC(LOCAL) to align with any new guidance from the BON.
What Should Districts Do in the Meantime?
As the BON notes, its “primary focus remains on ensuring that students receive safe and appropriate care in school settings.” At the same time, it “recognizes the importance of parental authority and autonomy regarding their children’s medical care.” It also points out that the Nursing Practice Act “is silent on the universal and standard use of safe over-the-counter medications when the parent or guardian appropriately authorizes the treatment option to be administered by a school nurse.”
Amanda Bigbee, TASB Policy Service director, notes that like the BON, “school districts must protect student safety, safeguard their nurses from legal liability, and respect parents’ rights. It’s a tough balancing act.” She recommends that districts with questions consult with TASB Legal Services or their district counsel. They may want to consider these options:
- Make no change to policy for now. Most districts’ FFAC (LOCAL) policy calls for the superintendent to designate the employees authorized to administer medication provided by a student’s parent. If your district is concerned about a nurse administering nonprescription medication provided by a parent without a doctor’s orders, the superintendent may designate someone other than the nurse to administer nonprescription medication.
- Contact your policy consultant to request revisions. We have sample language for districts that would like to:
- Require a physician’s written orders authorizing a district employee to administer nonprescription medication provided by a parent upon the parent’s written request and when properly labeled and in the original container
- Authorize the district to administer nonprescription medication (purchased by the district or parent) to students under protocols established by the district’s medical adviser who is licensed to practice medicine in Texas and with parent permission
Athletic Trainers
Athletic trainers are governed by different licensing requirements than nurses. TASB recommends that districts that employ athletic trainers have policy language that authorizes the district to purchase nonprescription medication that may be administered to a student in the athletic program by a licensed athletic trainer in accordance with a standing order approved by a physician licensed to practice medicine in Texas and with prior written parental consent. If your district employs an athletic trainer and does not have provisions on this topic at FFAC(LOCAL), please contact your policy consultant.
Medications and IEP and 504 Plans
Jasmine Wightman, lead attorney with TASB Legal Services, reminds districts that they are obligated to comply with requirements in a student’s individualized education program (IEP) or Section 504 plan, including the administration of plan-recommended medication. “If a nurse is uncomfortable administering nonprescription medication, an herbal substance, or dietary supplement that is included in a student’s IEP or 504 plan, the district may appoint another employee to administer the medication. The district may also wish to convene an Admission, Review, and Dismissal (ARD) committee meeting to discuss the medication issue.”
TASB looks forward to the BON’s guidance on nonprescription medication in a school setting and will continue to work with districts to comply with law and regulatory guidelines.
