Student with Diabetes

[Amethya]

Hello! So I'm a new medical aide and I've been having an issue with a parent.

This child has type 1 diabetes and since the beginning of the school year, his BG has been ranging from 300 to 400, with no ketones trace in his urine. His teachers has expressed deep concerns about him, that he seems extremely lethargic and not responsive at times during class. I tried to explain to his mom about this concern, but she just brushed it off to "Just make him drink lots of water and walk around, give him his insulin (OmniPod)". It got really bad to the point where she had to call her doctor, I don't know what she told her, but she chewed me out that I need to get used to this because I will be with him the whole year. Which I understand, but 300? She seems to be really against me because I'm not the old medical aide.

Then it's gotten worse lately, the kid is still not getting better, and his BG was okay for a few days, but lately it's been going high again. I started to notice that his mom is sending him horrible lunch, mostly junk food and sugary drinks. Yesterday he had a donut, pizza, a sunny D and an orange. The teachers are seeing this too and expressed they want to call CPS on her because of this situation. I asked them that I do not want to be involved with the report, but if they come to ask me questions, I will answer them as honestly as possible.

I need advice on this situation, I am doing my job, just checking his BG, doing the proper Treatment and then sending him back to class. He is drinking his water and allowed to go to the restroom, but what else can I do for him? Should I bring his doctor in the loop? Anything would be great!

Thanks!

[MrNurse(x2), ADN]

I would ask for a release to let you talk to his endocrinologist or pediatrician. Preface it with the caveat that you want to be on the same page concerning her treatment. Don't initiate any CPS report before you talk to the doctor, he may know the situation. Eating healthy foods is expensive and this family may not be able to swing it, trust me, I know from experience. This is my first year with a T1D and mom is OK when glucoses are in the 200's, so I have decided that I am OK with it.

[Amethya]

I won't do the report, the teachers want to though. I'll call the doctor and see what's going on.

[kidzcare]

Do you have a diabetic plan in place for this student? Get written order from the dr that say "if blood sugar is over XYZ then the treatment is ABC"

CYA!!!!!

[kidzcare]

I won't do the report, the teachers want to though. I'll call the doctor and see what's going on.

If the teachers want to call, that is their right and their decision.

[Amethya]

I have a diabetic plan up, I have gone to see his Doctor as well because his mother requested that I learned about what he has and what I can do for his OmniPod. But this just popped up because the mother has been causing distractions here at the school, and the teachers are starting to notice these things and want to report her. So I told them I will call the doctor and see what I can learn about the kid and send her my Logs of his BG and refrain for a while before we talk about this with her and the admin.

[Amethya]

The diabetic plan basically states that if he gets above 160, to call mother and do the treatment, which is walk around, water and insulin. Since he has the OmniPod, it does the calculations for me, so they told me not to worry how much to give him. He has PE first then Lunch afterwards. I just checked his BG, its 382, I gave him some water and sent him to PE, in hopes it goes down. The machine gave him 2.45 units.

[BeckyESRN]

Speak with the doctor or the child's diabetic educator. I had a very similar situation last year and the meal plans that mom was turing in to the diabetic educator was WAY different than what the child was actually eating here at school. So, the clinic kept increasing his insulin, thinking he was insulin resistant, when really he was just eating crap food and not telling the educator. He packed, so I wrote down what he had for lunch for a week, sent it to the educator, and suddenly his lunches became much healthier!

[Amethya]

Yeah I sent it to his doctor what he's been eating the last few days and what teachers told me he ate at lunch.

His BG just now was 233, he is eating mcdonalds pancakes, hashbrown and water. He got at least 3.80 units for lunch.

[MrNurse(x2), ADN]

That's not a healthy choice?

[Amethya]

*sarcasm* Totally, because McDonald's is known for it's healthy food.

[Amethya]

So I got in contact with his doctor, she basically said that there's no reason to call CPS. As long as his carb intake goes well with is insulin intake, then he can eat what he wants. And that she will follow up with the mom on the BG numbers she has gotten during the last two weeks and see if they have to change his medication to fix the numbers.