insulin pumps in the school setting

In NJ, the student is allowed to self-administer any med for life threatening illness, including insulin for diabetes. If you're comfortable with insulin pumps, that's great. If not, call the rep from the company where the student got the pump and ask them to come into school and inservice you. My kids keep the spare tubing and insulin in my office. Some come to me when they test, others don't. You have to treat each student differently. Some don't know too much about testing and diabetes in general, so I watch them very closely. Others are "old pros" and I never see them unless there's a problem. They need the independence as they enter their teenage years, so I try and give it to them. Make sure you have an emergency plan for all children with diabetes, and get the MD's orders for glucose checks, coverage, ketone checks, coverage for carb counts, etc.

In NJ, the student is allowed to self-administer any med for life threatening illness, including insulin for diabetes. If you're comfortable with insulin pumps, that's great. If not, call the rep from the company where the student got the pump and ask them to come into school and inservice you. My kids keep the spare tubing and insulin in my office. Some come to me when they test, others don't. You have to treat each student differently. Some don't know too much about testing and diabetes in general, so I watch them very closely. Others are "old pros" and I never see them unless there's a problem. They need the independence as they enter their teenage years, so I try and give it to them. Make sure you have an emergency plan for all children with diabetes, and get the MD's orders for glucose checks, coverage, ketone checks, coverage for carb counts, etc.

-thanks for getting back to me...what do you do for field trips?

I try and go. Usually the field trips are pretty fun in middle school. I hopefully get a nurse sub to cover my office or go on the trip. If not, I send the parent a note stating that a nurse won't be going and they have three choices: student goes and if there's a problem, staff calls the parent and/or ambulance, parent goes on the trip, or the student stays home. Legally you cannot make the child stay home but we hope that will not be an option. Most of the time, if the parent is not comfortable with their stduent's ability to manage their daibetes, they don't even sign them up for the trip. I don't really know what I'd do if the kid was non-compliant and I couldn't go, fortunately I haven't had to deal with that yet.

I try and go. Usually the field trips are pretty fun in middle school. I hopefully get a nurse sub to cover my office or go on the trip. If not, I send the parent a note stating that a nurse won't be going and they have three choices: student goes and if there's a problem, staff calls the parent and/or ambulance, parent goes on the trip, or the student stays home. Legally you cannot make the child stay home but we hope that will not be an option. Most of the time, if the parent is not comfortable with their stduent's ability to manage their daibetes, they don't even sign them up for the trip. I don't really know what I'd do if the kid was non-compliant and I couldn't go, fortunately I haven't had to deal with that yet.

have you been trained on the functioning of the pump in the event the child becomes incapable of addressing highs/lows in blood sugars....who covers the school for you when you're out sick and is this person trained as well?

The pump rep came in and trained me on the pump. I had the student come down and train me ( so I could assess their ability to use it) and I trained the sub. If we don't get nurse coverage in our office, we are covered by another sub in the district. There are 8 of us and we each have a "buddy" (who was trained by the pump rep as well). If we can't get a nurse, we call for a non-nurse sub to cover the everyday workings of the office with very specific instructions as to what they can and can't do, and when they should call the covering nurse. It's not the best plan but it's the best we can do. We only have 2 nurse subs in the district, which makes it difficult to get a nurse, but that's because a sub makes a whopping $85/day where if you were in the hospital, you'd make that in 2 hours!

The pump rep came in and trained me on the pump. I had the student come down and train me ( so I could assess their ability to use it) and I trained the sub. If we don't get nurse coverage in our office, we are covered by another sub in the district. There are 8 of us and we each have a "buddy" (who was trained by the pump rep as well). If we can't get a nurse, we call for a non-nurse sub to cover the everyday workings of the office with very specific instructions as to what they can and can't do, and when they should call the covering nurse. It's not the best plan but it's the best we can do. We only have 2 nurse subs in the district, which makes it difficult to get a nurse, but that's because a sub makes a whopping $85/day where if you were in the hospital, you'd make that in 2 hours!

-i understand the frustration regarding subs for nurses....we experience the same problems...do you work under a supervisor or school nurse leader...do you work for a health dept or do you work for the schools ? are the 8 nurses unionized? what do the full time nurses earn? how many students in the district? how do you divide the nurses coverage?

We are supervised by the Assistant Superintendent of Schools, who is an administrator, not medical. We are lucky though that he has really been advocating for us. We are members of the teacher's union and make the same money as them (teacher's are definitely underpaid), about $38,000/yr to start at step 1. One nurse covers each school. The high school nurse has 2 part time aides (non-medical) and the biggest work load. She has over 1400 students!! I have about 800 in the middle school. The elementary schools have anywhere between 400 and 650 students. The hardest thing is not having anyone medical to consult with in person on a day to day basis. We do a lot of emailing and phone calling, and we meet once a month.

We are supervised by the Assistant Superintendent of Schools, who is an administrator, not medical. We are lucky though that he has really been advocating for us. We are members of the teacher's union and make the same money as them (teacher's are definitely underpaid), about $38,000/yr to start at step 1. One nurse covers each school. The high school nurse has 2 part time aides (non-medical) and the biggest work load. She has over 1400 students!! I have about 800 in the middle school. The elementary schools have anywhere between 400 and 650 students. The hardest thing is not having anyone medical to consult with in person on a day to day basis. We do a lot of emailing and phone calling, and we meet once a month.

As far as I know, we've always been under the board of ed. We've also been lucky and considered on the same level as teachers. In many other states, school nurses are paid the same as an aide. I can't imagine how those areas get qualified nurses to work for such little pay, although you can't beat the hours and convenience.