What Have I Gotten Myself Into?

Published

Specializes in School Nursing.

I have a 5th grader who has type I DM. Her numbers at home are out of control. She comes to school very, very high and by the end of the day I get her normalized, only to start over again. She is very rebellious and is not monitored at home closely, but that is a whole nother thread!

Today she did not come for breakfast and since she was absent yesterday I thought she was still absent. She showed up at lunch with a very high BG and trace ketones. I asked her what needs to happen in order for her to get her blood sugar under control. She replied "rewards". I asked her to clarify and she said she just wanted some recognition at home when she does do the right thing, not only lectures when she does not.

I told her I will give her all the congratulations she wants! I told her I'd be turning cartwheels if she came in with her sugars regularly under control. She rolled her eyes and said "yeah right". So I offerred her a deal.

If she goes one week with her BG in the range that does not require ketone testing (under 250) for the entire week...I will go to the playground, turn a cartwheel, and let her take a picture. She said "it is ON".

So, being that I have not turned a cartwheel since I was maybe 13, and I am not the most graceful person out there, and anything but svelte...what in the world have I gotten myself into?!?!?!?!?

Up Vote Up Vote ×

I think it's great! I have a brittle diabetic whose numbers dont make sense and I would do any type of systme if I thought it would help. He's been diagnosed over 4 years and he goes from 375 to 67 in a few hours. It's awful. I keep trying to look for patterns but so far no luck.

Hope she makes it-better get practicing your cartwheels!

Up Vote Up Vote ×
Specializes in LTC and School Health.

Aww, you poor thing! This is too funny. In all honestly, she is in fifth grade and need to be more responsible. I blame her parent/guardian. Trust me, in middle and high school no one will be offering cartwheels and praise for normal blood sugars. You need to show her tough love. This is her body and her health that requires life style changes.

I've had diabetics in K grade that have been more responsible.

Up Vote Up Vote ×
Specializes in School Nursing.

I agree, I keep telling her that in Middle School she will be expected to do all of this herself (I only help her count carbs at this point, she does her own sticks and shots). I also think the parents bear much of the responsibility. She told me last week that she had not been doing her Lantus at night. I talked to her Mom later about some supplies we needed and Mom offerred up that same bit of information. Um, if you know your diabetic kid is not doing their Lantus, WHY are YOU not doing it??? She says that the student will say she did it, and even if Mom is sure she is lying she does not want to give another dose and bottom her out just in case she is telling the truth. So, why are you not INSISTING that you observe each of her injections? Put them up somewhere and get them out yourself, then let her do the care. ANYTHING so you know that she is getting the medicine she needs. I just don't get it. :(

Up Vote Up Vote ×
Specializes in Adult/Ped Emergency and Trauma.

I just wanted to say Boston thinks you are AWESOME!

Of all the nurses that would have come on here whining (Like Boston Himself)!!!!! I can see the post's headline now, "Why so many non-compliant DM Deathwishes?" Then we would go on to say how they are peeing nothing but sugar and ketones, and how they will be blind, Limbless, and in a coma by 25!!!! And, . . . So be it, 'cause we tried dadgummit!!!!

But not you. Not by a longshot. You have approached her from another dimension. You took the time and care to get into her head and ask why? (on her level/on her terms). That is care I am sooooooo guilty of not giving in a while. I am so proud of your approach with this kid (who sounds to have a support group of 1 = Nurse Purple Scrubs!!!!

I applaud your thinking "out-of-box!" You just might be not only her biggest life changing impact on self-responsibility for her future DM maintenance, but you maybe just saved her life- and saved her sight, and ability to walk in the future

Thanks for a lesson in patience, understanding, and going the "next" extra mile!:yelclap::bowingpurPurpleScrubs

Up Vote Up Vote ×
Specializes in School Nursing.

Wow, Boston, thanks! Sometimes I feel like I'm spinning my wheels, it's nice to get a pat on the back now and then. :heartbeat

I am afraid for what is going to happen over the summer if we don't get this under control before June. She could go DKA without anyone noticing how bad it's getting until it's too late. Hopefully I can make a breakthrough in the two short months we have left together.

Up Vote Up Vote ×

You are straight up awesome.

Up Vote Up Vote ×
Specializes in Acute Mental Health.

Kudos to you!!! Thinking outside of the box is truly awesome! I hope you get to do your cartwheel :)

Up Vote Up Vote ×
Specializes in nursing education.

Purple_scrubs, you are so positive. This is awesome.

We have a family who comes to the clinic...mom is more concerned with her own social life than taking care of her diabetic young teen daughter. After I exhausted every avenue I could think of, reporting mom to social services finally had some positive impact on the girl's DM management.

But I cheer as often as I can!!

YAY Purple_scrubs!!!!

Up Vote Up Vote ×
Specializes in Adult/Ped Emergency and Trauma.

yeah, that's how jaded I have become (I have to work on that!) first thing that popped into my thick head was H&HS. But I am glad it did, because it showed me how little I would try first in education- and how much I need to change ol' Boston's :redbeathe!

It's nurses like this, that keep us all compationate:hug:!!!

I would too say wait awhile on H&HS if you got the 2 months. Seeing your commitment, and energy- I have a good feeling this noncompliant girl has met her match, and it's Purple's way or the "No"way.

I also have to give credit to DM patients. I know how non-compliant I am on a Rx for antibiotics, and who am I to judge someone else. I totally realize children are different (no nursewhooping needed), and they are still dependent on others for their "life steering," but I know I would be introuble with my nurse if I was in her shoes.

Purple, You have really started something. Thanx!!! You Go Girl!!!!!

Up Vote Up Vote ×
Specializes in Adult/Ped Emergency and Trauma.

Oh, and by-the-way, I would tell you that "I" would do that Cartwheel with you, but it would take about 6-10 firm backed nurses to help me do them!!!! Lol, but I hope you keep us updated on her progress, I'm bookmarking this!!!

Thanks for sharing with us! Even more grateful for the encouragement- and reality check!!!!!

Up Vote Up Vote ×

As the mom of two kids with type 1, I applaud you :)

Our school district doesn't hire RN's in any of the schools, and will only staff with agency LPN's if there are medical needs like diabetes. It's so frustrating, and several times I've had to pretty much train the nurses myself because they had no experience with children that have diabetes.

Up Vote Up Vote ×
+ Join the Discussion