Help with Type 1 diabetes

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Specializes in Pediatrics, Community Health, School Health.

New first grader starting on Monday with Type 1. This is my first experience with a student. I had a 3 year-old when I worked at camp, but he had a pump and that was 3 years ago so it's been awhile.

This is my first experience doing it all myself in terms of school paperwork, 504s, IHP, etc. Mom is coming in sometime today to meet with me and I will also schedule a meeting with her, myself, our ops director and is teacher.

Any help navigating through this is much appreciated. I am also concerned b/c I am only here at school from 8-1:30...hoping they can find money in the budget to increase 8-2:30 but that still leaves 2 more hours with no nurse here.

Appreciate any advice, words of wisdom, etc.

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Specializes in School Nurse, past Med Surge.

In my state, the principal is responsible for finding someone willing to be a "volunteer health aid" to cover diabetics in the nurse's absence. It's written into the state law/code concerning care of students with diabetes. I'd start with checking to see if you have anything similar.

Make sure the doctor orders are crystal clear as far as blood glucose coverage. The student likely have a 504 to cover classroom needs (snacks, bathroom breaks, etc.) so an IHP may not be necessary. Setting up a 504 is more the job of teacher's & administrators but you should certainly been included.

Others may have better advice. These are just my thoughts as I haven't had a diabetic in my school yet.

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Specializes in School nurse.

The diabetes medical management plan given by the doctor is key and can be used as the emergency health plan. I don't know what state your in but in NJ only a licensed medical person or the parent can give insulin. Glucagon training is volunteer. Most of my kiddos can do their own BGs but don't know what to do about it. Diabetes is considered a disability so the school must accommodate the student ie you can't make the parent come in.

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Specializes in Pediatrics, Community Health, School Health.
The diabetes medical management plan given by the doctor is key and can be used as the emergency health plan. I don't know what state your in but in NJ only a licensed medical person or the parent can give insulin. Glucagon training is volunteer. Most of my kiddos can do their own BGs but don't know what to do about it. Diabetes is considered a disability so the school must accommodate the student ie you can't make the parent come in.

I am in MA and laws are super strict here (only RN can give insulin and glucagon) but then on the ADA website they say that Federal laws override State laws so it is confusing. I am looping in our school lawyer and asking her if we need to hire a PT RN to cover those two hours in the afternoon.

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Specializes in School nurse.
I am in MA and laws are super strict here (only RN can give insulin and glucagon) but then on the ADA website they say that Federal laws override State laws so it is confusing. I am looping in our school lawyer and asking her if we need to hire a PT RN to cover those two hours in the afternoon.

Your probably already aware of this https://www.joslin.org/2011_Mass_guide_to_managing_DM_in_schools.pdf but I thought it was interesting. Seems like your district would be non-compliant if they didn't have an RN full time.

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Specializes in school nurse.
I am in MA and laws are super strict here (only RN can give insulin and glucagon) but then on the ADA website they say that Federal laws override State laws so it is confusing. I am looping in our school lawyer and asking her if we need to hire a PT RN to cover those two hours in the afternoon.

Generally speaking, federal laws override state laws if they offer more protection, are stricter, etc. On the flip side, state laws can be stricter than federal laws (as long as they don't violate laws/constitution) and then be the legal standard (for that particular state).

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Specializes in Pediatrics, Community Health, School Health.
Generally speaking, federal laws override state laws if they offer more protection, are stricter, etc. On the flip side, state laws can be stricter than federal laws (as long as they don't violate laws/constitution) and then be the legal standard (for that particular state).

And this is exactly why it is so confusing to me about our obligations to having a FT RN vs. PT, etc. I am unable to commit to a full school day right now so they would need to find someone willing to basically work from 2-4 M-F which is a weird time that would be very difficult to find.

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