I had a situation yesterday that I'm personally frustrated about. I had a student who brought her insulin pen to school, and her brand new meter, and left them with me. I thought everything she needed was in the case she brought, but I didn't check it right away. Later, I realized there were no needles for her insulin pen and figured I would ask her about it when she came to check her sugar before lunch.
The problem is that we're a new school and I *don't* have all the paperwork I need on this girl! I sent home paperwork to mom, and called her to make her aware I was sending home and how important it is to get back to me, but it didn't come back. My supervisor said that I can keep the pen in the office and she can check her sugar here, but that she has to self-administer since we have no authorization or order.
So she comes back to check her sugar and it's over 200! She has her insulin pen and I ask what her regular dose is since her sugar is so high - 13 units! It's apparent to me that her diabetes is not well-controlled. Unfortunately, she also states that she forgot her needles at home. Now, what do I do?? She obviously needs insulin but is not likely in immediate danger. I try to contact mom to no avail - she's working and the kid doesn't know a work # or even where she works, but cell (only phone) is turned off. Other #s I have for anyone are no longer working (I work inner city, so no surprise). She is completely asymptomatic. I did receive an order sheet from her diabetes clinic for insulin in school, but it did not have a specific dose/time on it. It did, however, have a signature with parent's authorization for school nurse to contact the clinic, so I did. They stated that she's been without a meter until they just gave her one the other day and that based on her A1C, she probably runs 300's, which didn't surprise me.
The girl, meanwhile, is upset because she doesn't understand what the big deal is - after all, she's gone without her shot before and been fine. Attempted to educate her, and she rolled her eyes and turned away.
I ended up calling 911 for an ambulance to come get her so she could be treated since even if I had regular insulin needles, I had no order for how much to administer. I just feel so silly for doing so, and such a waste of resources, when she had no symptoms and seems to run high in general (although I had no official documentation of such and it was an educator I spoke with at the clinic). My supervisor and the principal agreed we had no other option in this case but it frustrates me!!! I guess I did the *right* thing, but surely there's an alternative, right?? Could I have asked to speak with her physician and taken an order over the phone to administer the insulin (if we had a needle)? Does EMS carry insulin syringes? At least then we could have avoided leaving school and avoided an unnecessary ER visit... Would love your thoughts on the matter. Thanks!