T1D advice

Specialties School

Published

Specializes in IMC, school nursing.

We have a Kindergartner who is a T1D. Mom met with both of us before school, seemed straight forward. Fast forward 7 weeks and we are seeing daytime sugars rarely below 200, a mom who says anything around 100 is low and a fear on mom's part regarding lows. I called the endo nurse at Hopkins that she sees and I was told her sugars aren't what I see. I related the last weeks and reminded the nurse that I am myopic to the school results only. It sounds as if they aren't "seeing" the same numbers. I asked for clarification on acceptable sugar levels and was told that my expectations were accurate. Now we are only covering her carbs for snacks, but her nice low 100's are going to upper 100's, some of her HS numbers are maintained > 200 all night. I wonder if Hopkins is seeing the numbers in the journal or there is a different journal to report? Meanwhile, the daughter comes in and says things like "mommy is going to have to come in here and teach you how diabetes works" and "mommy is going to come in here and do my boluses because they aren't right". We are trying to work with this woman, but her comments are very condescending. It would be like me criticizing her work or her management of her daughter to her daughter's face. She had her daughter thinking we were only there for her diabetes and she would get irritated if I had her wait to test if there was another student. She even got an injury one day and didn't come see me because she thought I was only there for her fingersticks, despite being told during class my role. So my question is, should I even try to dialog with mom and let her know I reached out to the clinic because my 30 years of experience with diabetics was being challenged by the info she was giving me, or let it go? Thanks.

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Specializes in Pediatrics Retired.

Considering your description of this parent's behavior, I think it's especially important to to have a conversation with her, with admin present, to let her know you have spoken with her doctor and her bluff is being called. Otherwise, you're enabling her to continue to skapegoat you.

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Specializes in IMC, school nursing.

Thanks OD, have discussed with admin and they agree.

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Specializes in school nursing, ortho, trauma.

Yes Mom needs to have that sit down with you and an admin. (and maybe a rep from Hopkins on speaker if you can schedule it?? that may be too pie in the sky, but this lady seems to have her head up her butt) If the mom isn't going to be 100% transparent with all of the information with all involved parties, it puts everyone at a severe disadvantage and the child is the one that pays the price.

Reminds me of a child I had years ago who's mom came into my office screaming that blood sugars over 150 were causing cellular damage to her child - as if i somehow had control over the blood sugars of a pubescent boy. The whole scene was so very needlessly dramatic.

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Specializes in ICU/community health/school nursing.

Don't bank 100% on the K's comments about mommy coming in to teach you about how diabetes works....is it possible that's kid-fabricated?

Also completely agree with everything above. The situation is odd. Good luck.

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Specializes in Cardiology, School Nursing, General.

Good luck and hopefully things get fixed and you can have at least a good relationship with the mother. It would benefit the child so much if all the adults can work together.

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