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IEP-Diabetics

Posted

Specializes in School Nursing.

Hi all,

I'm an LVN, we hired a new RN a month ago, and I was just wondering how quickly she should get the IEP- 504's done on the diabetics? I've been on her butt about one particiliar Diabetic that has a Dr order for independent but clearly NOT. The parents are having me monitor all glucose checks, and today they requested I watch her put her carbs into her pump, and see how much insulin bolus it gives her. That would not be a big deal, but I have another diabetic coming up at the same time, and have to double check her insulin and she is not independent, so I feel like I should be giving the non-independent diabetic more of my time. :no:

ohiobobcat

Specializes in ED, School Nurse.

I have 3 diabetics who I need to be right on top of when they medicate/check blood glucoses, one by pump and 2 with insulin pens. I often have 3-4 diabetics in my office at one time. I just make everyone stop and take turns, reminding them there is only one of me and many of them.

Are you thinking that the close observation needs to be added to the 504/IEP? The close checks written in my kids' 504s, but I would do it anyways because I know my kids and I know that's what is best for them at this time.

JenTheSchoolRN, BSN, RN

Specializes in School nursing.

We do 504 plans with the diabetics at my school and it always takes time to work scheduling for time for parent/nurse/teachers/principal to all meet in the same place.

I also manage 3 diabetics, two pumps, and one straight insulin syringe draw based on a sliding scale after testing. They are all often in my office at the same moment, along with 2 other kids waiting for lunchtime meds. They know they need to wait their turn and are pretty great about it. I can usually get through 'em all in 10 minutes (saving my insulin draw if needed for last to be able to triple check draw with HS student), but it took practice and getting to know which routine works for which kid :).

lvnforschool

Specializes in School Nursing.

Thank you for the responses. I guess its easy for me to want the RN to quickly get the 504's or IEP's in place asap, but in reality I know she is extremely busy with all the Spec ed kids needs first. I pretty much had to be really aggressive yesterday and kick out parents of the diabetic pumper, cause they were trying to eat/have lunch with her in MY OFFICE! I get they wanted to talk to me, but when I have another diabetic child trying to draw up insulin and double check her carbs with me, and they are sitting in my office just chatting away and trying to guess how many diabetics are at the school, :mad: I just had enough. Shes supposed to be Independent, but parents want me to watch everything. I just feel like the School Nurse RN should jump in here, and help put something in place.

Wave Watcher

Specializes in Community Health/School Nursing. Has 7 years experience.

May I ask what age group you work with? :-)

Thanks!

lvnforschool

Specializes in School Nursing.

High school, and junior high combo. We have about 700 kids. Were located in the foothills, so some kids have over an hour bus ride to/from school/home. The RN has started to give me more paperwork on these kids, so I know she's trying her best. Theres light at the end of this tunnel... = )

Our principals are the ones who schedule the IEP's or 504's . . . . and then the nurse attends the 504's with the principal, teacher, parents. The IEP's usually don't need the nurse there although we are responsible for H&V's and Initial Medical Health and Development reports.

It is up to the principal.

Wave Watcher

Specializes in Community Health/School Nursing. Has 7 years experience.

Ok, I was just asking to figure out what "independent" meant for your student and since she is in upper grades I can see her doing most of her diabetic care when needed with little supervision if the doctor request it. BUT I have taken care of High School kids and they still had to check in with us for lunch BS, CARBS and INSULIN so I can write down all the numbers and document it was done. I never had a diabetic that I NEVER saw during the day. :-)

JenTheSchoolRN, BSN, RN

Specializes in School nursing.

Ok, I was just asking to figure out what "independent" meant for your student and since she is in upper grades I can see her doing most of her diabetic care when needed with little supervision if the doctor request it. BUT I have taken care of High School kids and they still had to check in with us for lunch BS, CARBS and INSULIN so I can write down all the numbers and document it was done. I never had a diabetic that I NEVER saw during the day. :-)

I have. But only because HS student is very, very non-compliant. I have to chase that student down or the student will not check BG. Parent is aware, health care provider aware, and we are all frustrated - my office can get very busy and sometimes I don't have a chance to track student down until 1+ hours after lunch.

I have one very motivated high school student with a pump who manages his own diabetes with the consent of his parents; especially mom who is a stern woman. Don't mess with her kid - he knows what to do.

We have a 504 every year but he really manages on his own.