Diabetes and School administration

Quickbeam, BSN, RN · Aug 28, 2008

It is going on everywhere. All the teachers I know are upset that they are expected to do skilled nursing tasks for children in their classrooms. My understanding (I'm not in MN) is that this is legal but the school must provide the training.

BradleyRN · Aug 28, 2008

There is a thread on this very topic in the "Nursing News" forum. It is a political issue and until it is resolved, i wouldnt recommend that your wife perform such tasks. It certainly is not in her job description as a tutor, and with states requiring all insulin doses to be checked for accuracy by two licensed nurses in a medical setting, i dont see how they could even solicit such a ludicrous request.:)

LeavingTeaching4RN · Aug 28, 2008

This is a common complaint of teachers and other school personnel. Usually the school nurse provides a short inservice. Students with diabetes usually administer their own insulin. The school personnel is expected to step in if the child can't. This wouldn't be an issue if each school had an assigned school nurse. Instead, the school board in my county, splits one nurse between several schools.

Chipstar · Aug 28, 2008

Bradley,

thank you for your response. And i apoligize for mis-posting!

I will read up on the current thread.

You pretty much addressed my thoughts and concerns for such a request to be placed on a UAP.

Thanks again

~Chipstar

classicdame, MSN, EdD · Aug 28, 2008

I have never worked where a state required two nurses to confirm dosage, but it is a common nursing practice and therefore a "standard of care". HOWEVER, the real issue is, should someone other than a nurse give insulin? In Texas each school has to have "certified" diabetes assistants. The idea is to give the kids help ASAP. However, I think they should check the BS and, if not in PRESCRIBED parameters, call EMS. Just MHO

Chipstar · Aug 28, 2008

classic,

Interesting how they do it in texas.

I think EMS might be a little over the top, but that's just my opinion.

However, if i had a child in school with diabetes, i would not want a UAP to admin insulin. But that's probably nursing bias.

I agree though, that we hould be focusing on the children to make this as independant as possible, but my previous point still weighs in.

Good comment classic.

Kyrshamarks, BSN, RN · Aug 28, 2008

We teach families, we teach friends, hell we even teach grandparents and siblings to draw up insulin and administer it outside of the hospital. We tend to forget that fact that these people rely on lay people to hlp them. As nurses sometimes we get into the self grandizement thought that only WE can do it, well not true and there are no laws on the public administering most meds..

Jolie, BSN · Aug 28, 2008

As I posted in the other thread, patients and family members who care for diabetic children at home are usually tremendously knowledgable of the child's condition, insulin needs, reactions, etc. The same can not usually be said for the school employee du jour who may be dosing and administering insulin, especially if that employee has no personal or family knowledge of diabetes.

I am not saying that insulin can't be safely administered in the school setting by non-healthcare professionals. My experience is that school officials give lip service to training employees for this task, then assign it to whatever secretary, health aide, gym teacher or lunchroom attendant is available at the moment. It is my opinion that in order for this to be successful. there must be in-depth training of a person who will be consistently responsible for this task.

I personally would like to see the "highest-ranking" school official in the building be responsible for administration of critical meds (insulin, nebulizers, etc.) Then, I would have reason to believe that the administrator is taking the responsibility seriously, and not simply pawning off yet another task on the teachers, aides and secretaries.

Quickbeam, BSN, RN · Aug 28, 2008

It is my opinion that in order for this to be successful. there must be in-depth training of a person who will be consistently responsible for this task.

I agree 100%. As a pediatric nurse I trained hundreds of parents, siblings and grandparents to give shots, dose out insulin and straight cath. In general, invested laypeople do extremely well. I find the training given to school personnel on insulin administration sadly lacking.

Neveranurseagain, RN · Aug 29, 2008

There is a thread on this very topic in the "Nursing News" forum. It is a political issue and until it is resolved, i wouldnt recommend that your wife perform such tasks. It certainly is not in her job description as a tutor, and with states requiring all insulin doses to be checked for accuracy by two licensed nurses in a medical setting, i dont see how they could even solicit such a ludicrous request.:)

Yes, the job of administering insulin is covered under "other duties as required," even in a unionized school setting. With the increasing number of Diabetic children, even bus drivers are now being taught how to handle DM. What should be taught in the schools is a standardized training program on DM, and insulin administration. When BS fall within parameters, insulin can be safely given by trained lay people. If BS is outside the parameters, then family should be notified to pick the child up as with any other health issue that has complications. I have not met a parent of a DM child yet that does not have a cell phone or back up friends/family.