Help with diabetic students

[J-lynn]

I would love to hear from any nurses about how often you check on high school students who independently manage their diabetes and the types of questions you would have for them. The nurse I am replacing saw all the freshmen once a day at first. Then she would see sophomores once a week just to check on them. Then once a month she would pull the older kids out of class just to check on them.

Maybe she just wanted to make sure there were no new concerns we needed to be aware of? Or just checking to make sure their needs were being met and numbers good?

I am brand new to type 1 diabetes, so any suggestions would be helpful!!

[halohg, RN]

It really must go from the doctors orders and care plan. I have never had orders not require at minimum before meals and after. They come in do their thing and just report the numbers for documentation.

[algae1492]

It really must go from the doctors orders and care plan. I have never had orders not require at minimum before meals and after. They come in do their thing and just report the numbers for documentation.

Independent management orders exist and they're typically completed after demonstrated competence.

[J-lynn]

Independent management orders exist and they're typically completed after demonstrated competence.

We do have independent management orders, but the previous nurse still called them out of class routinely to check on them. I just am not sure if this is really necessary or what it would accomplish. I hate to pull them from class if it's not necessary.

Also, I will be traveling back and forth between schools and will have to be at the elementary school 3 times daily for a newly diagnosed diabetic fourth grader and then in the special education room 3 times daily at the high school for a diabetic who needs supervision.

[halohg, RN]

Traveling between buildings is especially challenging. I would not pull them out unless it was part of their medical plan. I would have a conversation with the parent and a plan for when you are not in the building. My experience in the past with a true independent is that of a supportive role only and used if symptomatic. I would house their extra supplies and snacks, nothing more.

[aprilmoss]

It took me years to get the district to allow my son to carry his meter/insulin. It finally came to a head when he split his day between our building and the Academy (what we used to call votech back in the day). Anyhow, most of the diabetics end up in my office for one reason or another on a regular basis. I've never had a need to call them out. We have 504s on them typically and train the teachers to spot low blood sugar conditions.

[OhioBPH]

I follow the Dr orders, which means that my independent student (has a pump, carries a glucometer) doesn't come to the clinic unless there is a problem. If the Dr does not order supervision I would hate to pull a student out of class/lunch/recess just to "check in" T1D lives are too disrupted as is.

[OldDude]

As stated above, "independent management orders" kinda offer a reference to - "independent." Leave em alone unless they seek your assistance.

[kidzcare]

As stated above, "independent management orders" kinda offer a reference to - "independent." Leave em alone unless they seek your assistance.

Agree. If they have shown competence, then they can self-manage. Heck, if they are in HS and have been diagnosed for a while, they should be 100% independent. There won't always be a nurse or parent around! At camp this past summer we had one camper with diabetes (6th grade) who was completely independent during the day. She only stopped in at bedtime because we had a difficult time with her bottoming out overnight (likely due to the extreme increase in physical activity at camp). She is 12 and could completely manage herself during the day (diagnosed about a year ago).

[BrisketRN, BSN, RN]

I leave my diabetic students alone unless they come to me, their teacher sends them to me, or their parent expresses worry that the student isn't following their plan while at school. No problems so far!

[Amethya]

I check my only T1 student 3 to 4 times a day. Once in the morning, once before lunch, once before PE and once before school is over.