What Have I Gotten Myself Into?

Specialties School

Published

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?!?!?!?!?

Go Purple Go! You have much more compassion than I do. I have the very same situation, but her mother is a registered nurse.

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Specializes in school nursing, ortho, trauma.

...and you''ll have someone take video and post it to youtube for all of us to enjoy! :w00t:

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

I think it's amazing that you found a new way of thinking and a new approach to get through to her! Kudos to you.

Oh, and just a word of advice. If you end up doing that cartwheel... do LOTS of stretching prior to doing so. My babysitters kids talked me into doing a cartwheel for them when they were playing around. I felt muscles I forgot I had, lol.

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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

Couldn't have said it better myself!

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The deal you made with that child is AWESOME!! Will be a way to help her now and will for sure be something she won't soon forget! KUDOS to YOU!!!!!!!!!!!!!!

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

YOU are a great nurse :)

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Very cool. Hopefully she'll see some cause and effect with feeling better when she's under control, might be a bit more motivating since obviously mom isn't going to help.

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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.

First, thank you for advocating even when the person doesn't want you to. My sister is a new teacher, first year about to be behind her, and she had a student (3rd grade) with T1 DM who, because her parents never administered insulin correctly, was a brittle diabetic that slipped into DKA durring class. My sister, who in high school thought all Jewish people lived in Brittan (LOOOONG Story for another time), had no idea what was wrong. She called 9-1-1, but also called me (since being a nursing student gives you a depth of knowledge known to few) freaking out for help.

Lucky for the girl, she had an insulin pen on hand and a sliding scale for fast acting in her back pack, still had to talk her through the administration of it, but a crazy afternoon none the less. She's actually going back to school part time to become a nurse now!! Crazy thing that she is!

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Specializes in LTC, assisted living, med-surg, psych.

OT: @ Wanahakalugi---It took me a moment, but I got the gist of your user name. :lol2:

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What an awesome wake-up call for me!!!!:zzzzz-------->:eek:

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I think that is great! Better you than me doing the cartwheel!!!

Do you think she understands exactly what can happen if she doesn't start complying?

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Specializes in School Nursing.

Wow, really feeling the love...thank ya'll!

I know she knows the complications, but I think she is at that developmental stage where she truly believes it is not going to happen to her. She is a good kid, but rebellious at home (not so much at school, she is never in trouble and for the most part respectful to teachers and myself). Mom has a lot going on also (another special needs child, an older teen, and a relative with two babies living in her home). I think part of the problem is that Mom does not have patience for her antics so she just lets her handle it herself, which obviously is not working.

My next tactic is to offer to be mediator between Mom and Kid and try to talk out exactly what each one needs from the other in order to have this go smoothly. Maybe have them agree what each side will do and sign a contract. If Mom will agree to come down for a meeting :(

Again, thanks everyone for the support. Now I know I am doing the right thing even if I end up looking like a fool in the process!

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