suspended for doing the right thing...

Nurses Relations

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Ok, so I'm a school contract nurse through a home health agency working with a very young diabetic patient. The school is great, couldn't be more supportive of my role and continuously praise my efforts at keeping the client's blood sugar levels within range. That being said, the parents are much less than cooperative, downright non-compliant mostly. They have the "feed whatever whenever and cover with insulin" mentality, and cannot seem to understand why I won't jump on board with their dangerous, and if I'm honest, abusive behavior. After a particular incident occurred recently in which the client's blood sugar was well above the MD's range for the client, I refused to give the client a sugary, carb-filled treat with the client's classmates. I discussed the situation with my supervising RN as well as the school principal and we all agreed that adding fuel to the fire was a big no-no for BS levels, regardless of the fact that everyone else was going to have the treat. The client's parents were informed well ahead of the event that the class would have said sugary treat and could have brought in a diabetic-friendly alternative but did not do so. Furthermore, the parents called my employer after I clocked out to inform them that they were furious with me denying their child the sugary treat since everyone else had it (I took my client onto the playground so nobody ate in front of client) and since BS was high and I had to treat with insulin anyways why couldn't I just give the kid the treat?! Well, after much griping, my RN mgr decided to call me and determined it would be best if I were to take the next day off-without pay!!!- to let everyone cool down. So, what can I do about this whole situation? Keep my mouth shut and poison the kid next time like they wanted me to do so I don't get suspended without pay? ~feeling like a flamin' bag o' poo after being stomped on a few times right now :no:

Just like that school in New York rewarded kids to poor to pay for a school carnival ticket by separating them from their peers to watch a fun movie? Kids still know that they've been separated from their peers and are being treated differently.

No, not at all, he went out to recess with other friends. READ.

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Specializes in critical care.
reread, the recess was a substitute reward, not punishment.

I'm not sure it would have felt that way to the kid.

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Specializes in critical care.
this dec. was not made only by nurse, the extra recess was given as an alternate reward, because the kid likes recess.

Recess alone on the playground while the class is having a party with sugary treats?

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Recess alone on the playground while the class is having a party with sugary treats?

No, the recess was with other friends from different classes that the client plays with on a regular basis.

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I am sure you meant well...but that being said if I was the parent I would have been put for blood. You overstepped your bounds and you were wrong.

A type 1diabetic will never be able to control the blood sugar with diet.They have a non functioning pancreas.

Your job is to cover your patients glucose level. Not to control the diet.

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Specializes in public health.

Can the parents be sued for child abuse and neglect? I am sorry this happened to you. There are some irresponsible parents out there who don't understand the importance of blood glucose and just being plain ignorant!

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I am a diabetic and a nurse. When speaking with my diabetic educator, she informed me that it is considered malpractice to teach our diabetic patients to avoid all sweets, deserts, etc. When we do so we are teaching them to do something which is impossible for the majority of the population and setting them up for failure. Oftentimes, once they fail once, they throw in the towel and give up.

If you are concerned about this child's glucose level and the need to live as normal a life as possible, you should contact the physician regarding the child's treatment regimen. It's hard enough to be a kid. It's doubly hard to be a diabetic as well.

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Specializes in MICU.

You could have prepared a comparable snack for the child yourself if you felt it was your place to monitor the food intake. And maybe involving the child and parents in this process would have been helpful and a teaching opportunity for them as well. Life isn't about omissions, it's about alternatives. Just something to consider- good luck and so sorry this happened.

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Yep, she's a 1:1! The reason why she is, is because this child is developmentally delayed, and cannot manage themselves. I'm a 1:1 at a school also, and it is OUR JOB to monitor intake constantly! Otherwise, he would just come to the health office to get his blood sugar checked and receive his insulin. Those that are saying that she shouldn't be worried about what he's eating are wrong....everything he consumes falls completely on her shoulders. Maybe if you have a fully capable, competent patient, but not a special needs child who is developmentally delayed. Otherwise, she wouldn't have to follow him around at school all the time. 1:1's are there with them constantly for a reason. They arrive at the patient home, get on the school bus with the student, attend class with the student, and ride the bus back. Those of you who are saying that it's not her job to monitor intake are wrong. Otherwise, she wouldn't have to be there. She consulted with her supervisor, and was told she was doing the right thing. The parents were notified ahead of time so that they could provide a diabetic alternative. Any 1:1 school nurse would have done the same thing.

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She's a 1:1 nurse. She IS responsible for his intake. The parents were supposed to provide a diabetic alternative, and did not. You can't whip up something from the school cafeteria either. The parents should have provided something, as they were supposed to.

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It sounds like his BS was already high, which is why she wouldn't let him have the cupcake. As a one-on-one school nurse, she is there to specifically monitor his BS and intake, and administer insulin. Every seems to be saying that he can eat whatever he wants, which is confusing in the school setting, because that's the whole reason why you are there. In this case, she did check with her supervisor, however, I would verify with the physician that there are no diet restrictions, regardless of how high BS is, just to cover myself.

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Autumn, I work with DDD clients. It's an awesome job and I love it. Even people with developmental disabilities (or their families/guardian in the case of minors and those without the ability to consent) have the same rights in medical treatment. They get to choose how they are treated, even if we don't agree with the choice. Infact we have to be even more careful, because it can be so easy to put our values on them. They, even more so than children without disability, should not be excluded from group activities. You've heard from a number of diabetics here who are type 1 explaining how treatment works and how using insulin to cover works. I've not heard anything that would lead me to believe that the doctor's orders said to withhold sugary foods if the CBS was over a certain amount.

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