Unstable Diabetic

Jolie, BSN · May 22, 2014

This is a question for your school's legal counsel, as the answer varies depending upon your state law, and the type of school (public versus private.)

I implore you and your school NOT to rely on "trained medical staff" of the water park. They are likely to have basic first aid training and little else. They probably do not have legal standing to intervene in an emergency without parental/guardian permission, and will not likely have access to emergency drugs and supplies. Nor will they be willing to use yours.

It is my opinion (not a legal expert) that this student should have the same standards of safety and care on a school field trip that s/he has at school.

But I will also acknowledge that I am stumped by the educational justification for a water park trip,

JustBeachyNurse, LPN · May 22, 2014

Generally the park staff is either life guard with basic first aid or basic EMT. Most EMTs cannot administer glucagon or even check blood glucose. That is a paramedic (EMT-P) level skill in most states. Keep that in mind

lvnforschool · May 22, 2014

My boss - (Principal) is looking into it, but she asked Me, and the Health Aid about it. I have No clue. I might be an LVN, but im not a attorney..lol. I forwarded the question to my RN, but shes on her way out to retirement. They want me to go since I am licensed, which I guess is ok, but its not really what I was hired for.

Lev, MSN, RN, NP · May 22, 2014

Her pump may be malfunctioning or she is making the incorrect calorie/carb calculations and programing the pump incorrectly. She needs to see her primary care doc or endocrinologist and have the pump checked out.

coughdrop.2.go, BSN, RN · May 22, 2014

Well the California Ed Code only talks about how unlicensed personnel should be trained on medication administration for field trips. For emergency medication administration, the staff should have adequate CPR and training. So if the glucagon goes, a trained staff member must go.

The School District can request you to go because you are a licensed professional and would be better to send than a health assistant or trained teacher.

OldDude · May 22, 2014

It is my opinion (not a legal expert) that this student should have the same standards of safety and care on a school field trip that s/he has at school.

- Exactly! The school is sponsoring the field trip (educational attachment not relevant - wink wink) so the plan of care remains unchanged regardless of the geography. Until the ins and outs can be worked out in your state I would recommend you go on the field (and enjoy a day away from school). If you're present, it can't be shown the standard of care was compromised.

iluvgusgus · May 22, 2014

Maybe her mother could chaperone and take some responsibility for her daughter's care on a field trip... to a waterpark...I know nothing about Ca or school nursing, but to have a school nurse become a student's personal nurse for a field trip to a water park sounds a bit ridiculous. And expensive.

OldDude · May 22, 2014

Maybe her mother could chaperone and take some responsibility for her daughter's care on a field trip... to a waterpark...I know nothing about Ca or school nursing, but to have a school nurse become a student's personal nurse for a field trip to a water park sounds a bit ridiculous. And expensive.

I agree....but that's if you apply reason and logic to this scenario. Reason and logic don't apply to the public school system.

lvnforschool · May 22, 2014

Im new to school nursing, and with only being an LVN, who was hired to take care of the sick kids on a day to day basis, asking me to go on a field trip is fine, but my co-worker whos only an Health Aid, is saying I would have to be with her (all day) at the water park is ludicrous. Theres no way I am willing to stand in 30-45 min waiting lines for her to get on water rides! Geez, am I wrong here, or ?

iluvgusgus · May 22, 2014

Lol I dont think you're wrong, this trip is not educational and is not necessary to her education, so I dont understand why you essentially have to be the babysitter for the day, unless you want to just go with the flow, then why not. But I would maybe contact the parents and say that her BS are very unstable, she is not controlling her sugars or her pump, this is not safe. Maybe you could recommend her not to go on the trip unless she either chaperones, BS is under control or her MD gives written permission to do so because the school does not have the resources to personally chaperone a kid who is a brittle diabetic. The kid is about to go out in the sun, get dehydrated, eat a bunch of junk, etc. That whole scenario just sounds like a set up for something disastrous. When I was in middle school we had "field day", out in the hot sun all day, and the diabetic kid passed out! I remember it very clearly like it was yesterday, so I honestly would not want that responsibility as a nurse because this whole situation does not sound safe. As a professional I think it would be in your best interest to protect your license and not take on that responsibility and make those recommendations to the principal and the parents.

lvnforschool · May 22, 2014

Crap, your totally right. I am hoping they will get a teacher like before, who is trained to go with her. We cannot make the parent go, or keep her from a field trip due to her disability. I havent heard from my Boss regarding who's going for sure yet. Im kind of upset she didnt just ask the RN, or someone who can give a definitive answer. Now if I say NO, I look like a bad person.