I was angry when I read the account today by Alan Schwarz in the New York Times about the Harvard University freshman who committed suicide after receiving medication prescribed by a nurse in the student heatlh service. The woman diagnosed ADHD, which is a disorder that should be diagnosed in a child's early years. In a college student, I would have thought of several other diagnoses. Nurses do not have the training to make this diagnosis and many doctors also lack the experience and training to make the diagnosis. Did the nurse take an adequate history? Did she ask about the student's sleep pattern, diet, alchohol or other fluid intake, the amount of exercise, or fun he had each day? Did she order a thyroid panel, blood count and urinalysis or did she just do a quick examination and write a prescription? I am appallled that the state of Massachusetts allows nurses to work without supervison by a physician and to also write prescriptions. That should not happen and I hope the law will be repealed before more unnecessry deaths occur.
I have had to get very assertive with several college student health services in different states for my own children and former patients. Pneumonia, mononucleosis, and other serious medical problems have been missed and the outcomes could have been tragic. I always advise parents to get the name of a good internist or family physician in the town where their children will be enrolled in college. This way the young people can have a doctor they can call and in many cases this has been lifesaving.