Student with DM2 on three day outdoor class

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Specializes in Telemetry, Orthopedic, M Surg, School RN.

I am in a private school. I am assessing whether a 6th grade student could be allowed to go on a 3 day outdoor class trip. No Nurse is present at the trip site. Parent does not want to chaperone. I would prefer and have requested a chaperone as the student should not be restricted from attending and I feel it would be safer.

Student takes no insulin but is prescribed non- insulin diabetic medications to control blood sugar levels. One of the medications is a pre filled once a day injectable. No in school carb counts (brings lunch from home), student's medical order includes FSBS checks only when student feels symptomatic. FSBS have been within the therapeutic range with one low (60's) for the school year.

Seems like the student is well controlled, however I am not sure as to how that will play out when the student is independent on the field trip. Parent proposes the student will self monitor FSBS, administer medication to self at breakfast and check FSBS when symptomatic as usual.

I have prepared an Emergency care plan which I will review again with teachers attending the trip, I have prepared log sheets for medication and FSBS results, I have requested a glucagon emergency pack for the trip, I have asked the cafeteria at the trip site for their menu for the three days, I have researched the hospital closest to the trip site which is a 10-15 min drive and a level 3 trauma center......aaaaaannnnd I still don't feel like it is a good idea to send the student without a chaperone.

Am I overreacting?

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Specializes in School Nurse, past Med Surge.

What do the parents want?

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Specializes in Telemetry, Orthopedic, M Surg, School RN.

They want the student to go.....however, it isn't that simple.

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Tricky situation. The student may be generally well controlled but a 3 day outdoor trip sounds like it will involve more activity than the the students generally have which will cause more fluctuations in blood sugar.

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Specializes in School Nursing.

Diabetic Management Plan? Ask doctor for clarification/orders?

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Specializes in kids.

I have had kids travel and the plan is for them to "run a little sweeter", to avoid a hypoglycemic reaction. If they are stable and MD signs off, I would support it. Will there be any texting availability or other communication in the event of an emergency? or where they can connect with a parent?

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