To what extent do we get involved?

[PNWscouter]

I am sure that many of you have scouts who are diagnosed with ADHD and are on meds. Many of these boys need this medication to maintain focus in their daily lives but it seems that some could do without (or lower doses.) I have one scout that is on medication, I cannot remember the name or dosage at this moment (it is on the med form if needed) and he takes another medication to sleep. When I handed over this medicine at summer camp, the medic responded with "wow, that is a large dose, no wonder he needs XXX to go to sleep." Now, this scout is a great boy but a follower and very lethargic. At camp, even after reminders and pointing him in the right direction, he walked to the health lodge to get his meds but the first day (I found out later) he forgot what he was going for and came back without. The second day the door was locked and he shined them on. I take responsibility for this. Either myself or ASM should have accompanied him to the health lodge but we didn't until I found out that he missed two days. I don't know if it was coincidence (was the drug still in his system?) or not but he was a different boy after missing his meds. He was alert, laughing and not walking around in a trance. Also, I tried to time the drug I was giving him to sleep with the directions, it was supposed to be administered one hour before bedtime, well on most days he was so wiped out from the days activities he was asleep minutes after taking this pill. Now, here is the kicker. When his father picked him up he asked if he took his meds. I told him that there were a few days he missed and I did not have the knowledge to diagnose the boy but explained to him what I saw. He went off, telling me that he didn't believe his son should be on these drugs, the psychiatrist wrote this prescription without even talking to the boy based on what his teacher told him. His mother thought he didn't seem as focused as he should be in school so she went along with it. Now, I have to agree with the father, there are not many 10y/o boys that are 100% focused. I also told this father that the boy needs less time in front of the TV and more activity in his life, I am sure this would help him sleep as well. He told me that the only thing he does at home is excercise his thumbs. This boy is overweight but not greatly so and is winded on short hikes. He is also a very bright child and I am often very impressed when talking to him. It also appears to me that his parents do everything for him. At camp I had to show him how to cut his food. He didn't want to earn his totin chip because his parents would not let him carry a knife (I talked to his father and he indicated this was not true) and he did actually earn his totin chip while at camp. He has no desire to work on his scout book alone but will work on it if I sit down with him showing him each page to read. He basically just follows what others do or say. In the beginning he would go home and tell his mom the outings were terrible and he wanted to quit scouts. Then he would slip up and admit he had a little fun. After his parents told me this, I would ask him when we returned from an outing,in front of his parents, if he had fun, and he always said yes. I can see great potential in this young boy but not in the stupor he seems to be in. What do I do?

[bbng]

This is a toughie, in big part because it simply is not your call to make. You have explained to the dad what happened with the meds and what the boy was like off them; you then learned that the mom and dad have very different ideas of what it is needed by their son. That is not a good place to be for you, so don't get into that one. However, you do have something to talk to them about. Leave the meds and what you saw in him at camp out of this, but ask if you can meet with them to talk about their son. Explain how you see great potential in him and ask if they can help you with some tips on how to keep him focuses and to motivate him to become more independent. This puts the concern before them without being at all judgemental about his meds, and it also alerts to them to something they may not know--just how very hard it is for him to focus NOW. Good luck, and I commend you for being careful but advise caution in this.

[Bob White]

Tell the parents what you observed and then you have to allow them to parent their son.

 

(This message has been edited by Bob White)

[FScouter]

You already did what you should do. You gave the dad the rundown on summer camp, that he missed two days, that he perked up, that he works on Scout stuff when helped, and that he has potential. Good job.

[Cubmaster Jerry]

I agree with the others. There really isn't a whole lot more that you can do. And even though it may be desirable, I wouldn't even go as far as deciding on my own to NOT give him meds when you are charged with doing so. However, the next time you are charged with doing so, I might ask the father if you can hold off on giving them, referring back to the positive experience from the last time.

 

Good luck,

Jerry

[Bob White]

NEVER EVER give a dosage that is anything other than the physician described dosage. If the parents want to alter it then have them get a doctors order changing it. NEVER EVER give a dosage different than a doctor has ordered.

 

Better yet, follow the recommendations of the BSA. If the scout is not capable of taking his own medication then a parent or legal guardian must be there to administer it. The BSA neither requires or recommends that a leader be responsible for administering prescribed medications to a scout.

[ScoutNut]

There is obviously a disagreement between the parents on this issue. That is not uncommon. These medications are heavy duty & it is a very personal & stressful decision to make.

 

You can not make judgments about what is best for this boy. He might be recently diagnosed with the correct combination of medications still being sorted out. He might be reacting to a medication that his body has grown used to over time. He might have more problems than you have been told about.

 

I would also not take everything the venting father told you as gospel fact. There is no psychiatrist that would prescribe medication, based solely on the input from 1 teacher, without ever examining their patient in person. At least none who want to keep their license to practice medicine.

 

As the others have said, keep out of it.

 

[Cubmaster Jerry]

good points, ScoutNut.

[PNWscouter]

I agree that I just need to step back on this one, I have done all I can. I did not nor would not intentionally not give meds or withhold meds from any scout. If mom drops him off and gives me the meds and written instructions on when and how to administer them that conform to the instructions on the bottle, I will follow the instructions. If dad drops him off and does not give me the medication then I will not. Hopefully dad will be bringing him to the meeting. Here is another question, lets say that the bottle reads take 3 pills a day. Parents instructions read only give one in the am. Is there any liability to administering instructions as the parent wishes vs. the Dr's instructions on the bottle?

Also, just out of curiosity, are there any Dr's on here that could tell me how long these drugs stay in a persons system?

 

[johndaigler]

PNW,

 

To determine how long any of these drugs stay in the boy's system (with any accuracy), the doctor would need to know the drug, the dose, the boy's weight, the length of time the boy has been using this and/or other drugs, and a couple of other factors.

 

Usually, dose decisions (size and time of delivery) are based on a the boys "usual day" - the school day, typically. But, often changes are made for summer because of the boy's schedule changes. Often, activities like Scouting fall outside that usual day and aren't prioritized (most often not even considered, at first) in the timing and dose determination.

 

Though, you should remain non-judgemental, I think you would do your Scout a favor by offering to help the parents with gathering information about the Scout's behavior while he is with you and your Unit. There are standard forms for your comments and observations. If you can offer this with the understanding of how complicated it is for parents to agree to prescriptions for behavior altering drugs for their children, I'm sure the parents will see your honest concern and legitimate offer of help.

 

BW's right about conflicts between the doctor's prescribed dose and the parent's suggested dose. You'd be off base doing something other than the Dr's orders. Get the parent to straighten that out - you should not be stuck in that position.

 

BTW, when camping with the boys, don't forget the buddy system!

 

 

Good Luck,

 

jd

[ScoutNut]

I would tell the parents it is their responsibility to come on the trip & administer the meds themselves.

 

From The Guide To Safe Scouting -

 

"The taking of prescription medication is the responsibility of the individual taking the medication and/or that individual's parent or guardian. A Scout leader, after obtaining all the necessary information, can agree to accept the responsibility of making sure a Scout takes the necessary medication at the appropriate time, but BSA policy does not mandate nor necessarily encourage the Scout leader to do so. Also, if your state laws are more limiting, they must be followed."

 

As far as how long drugs stay in the system, it depends on the drug & the body taking it.

 

[John-in-KC]

Sounds like an ideal chance to recruit a parent to be a Scouter ... and not supporting the Baby Sitters of America.

 

If the youth needs assistance with meds, as stated above, the ideal situation is the parent is available. That means the parent is at scout camp, having fun and helping lead other young men.

 

Might be useful, though, if the parent gets Fast Start, YP, NLE common core, and NLE Position Specific training along the way.

[PNWscouter]

Parents helping are not an option. Dad works all of the time and mom is not willing, trust me I have asked.

 

So, what is considered administering medication? If I hold the medicaton bottle under lock and let the scout take the bottle and swallow the correct number of pills am I free from liability?

 

Also, who would I contact to see if I would be liable to follow a parents note rather than the Dr's orders on the bottle if the dosage was less or at a different time than the Dr's orders? I would not give more than the Dr's orders but at different times could cause problems as well.

 

 

[johndaigler]

PNW,

 

BW's answer comes straight from the Scoutmaster's Handbook AND G2SS. Your liability would stem from stepping outside of that written parameter.

 

Parents don't have the right to prescribe prescription drugs, nor do the minors in your care. Do what the doctor says or stay out of the situation. Ensure that the Scout does what the doctor says or stay out of the situation. Again liability arises if you make the choice to act, or allow the Scout to act, outside the doctor's legal authority to prescribe certain drugs.

 

Again, I'd suggest helping by monitoring and describing the boy's physical behavior when he is Scouting. Try to avoid the whole administering medication issue.

 

BTW, doesn't your Camp have SOPs concerning all of this? You'd probably have additional issues if you were to make choices that undermined the rules of the camp and role of the camp staff.

 

jd

 

[PNWscouter]

Yes, at camp I give the meds to the medic and let him deal with them. He administered them as the parents wished but I would give the scout his medication before bed since it was impossible to track down the medic and guess when would be the appropriate time. (He had to have them one hour before bed.) The main reason I posted this question was for our troop other outings throughout the year.