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School's Back in Session-How can we help students with diabetes?

Sep 21, 2011

School is back in session! I’m already getting phone calls from school nurses, parents and teachers, all concerned about the safety of the kids with diabetes at their schools. I’m fielding questions, setting up school visits, filling out a lot of medical management forms, and helping with 504 plans. I feel pretty well versed in all this, but not too long ago, I had no idea what any of the forms were, and I figured parents would teach school personal all they needed to know. Boy, was I wrong!

Here are a few things I have learned:

1. Teachers and school nurses have a lot to do besides watch out for our kids with diabetes. I found that so hard to believe at first, having been so embedded in the world of diabetes and kids. How could they not think of our kids first who have to live with this day in and day out? Oh yes, they have another 20 or more kids in the classroom who also have their own needs, which can range from educational goals to behavior problems.

2. Administrators do not always want to sign a 504 plan. Really? How could that be? I’ve found that explaining the rationale behind the 504 plan seems to open the door for most. I did call a diabetes educator that works at the state level one year to add a bit of pressure and another layer of understanding (it is the law), which helped move the process forward.

3. Every school nurse is not well versed in type 1 diabetes and insulin pump therapy. Some have a hard time admitting it. So….a bit of calling, providing a phone number and (hopefully non-threatening) support from my end has helped eliminate some of the pressure on them, and hopefully opened the door to having them ask questions when they pop up. I just had a nurse come in for an hour to go over the basics of type 1 diabetes and insulin pump therapy.

To expedite the process for the school, I have each family fill out a medical management plan (MMP) and a 504 plan (they may be available from your school nurse, or you can download them from diabetes.org) in our office during the summer months. Then, if questions arise, the basic answers are available right at the school. We have abbreviated our MMP to be just 2 pages--so it does not appear as daunting, but has all the important information available.

I emphasize recognizing low blood sugars and how to treat them. Putting glucose tabs in sandwich sized ziplocks and attaching them to clip boards is a well-received option. Schools set aside education times, and I offer to get on the agenda for an hour or so. Teachers, bus drivers and coaches all hear the same story, and once again, the emphasis is on recognizing and treating hypoglycemia. Calculating the carbohydrates for school menus may be a challenge, but can also be a way to help facilitate diabetes control during the school day. The menus generally rotate every 4-6 weeks, so it will not require a full year commitment.

I am always interested in how others work with the schools. Please share your experiences and ideas with us!

2 comments

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  1. Oct 29, 2011

    The National Association of School Nurses (NASN) has a wonderful CE program that they have developed to educate school nurses about diabetes and their role in helping students and families with diabetes: Helping Administer to the Needs of the Student With Diabetes in School (HANDS) I am a presenter for NASN, and encouraged the NJ School Nurses Assn. to bring HANDS to New Jersey teachers in 2010. More information on HANDS can be found on the NASN website. http://www.nasn.org/ContinuingEducation/LiveContinuingEducationPrograms/HANDS
  2. Sep 23, 2011

    I do not know how it's done in other places, but I am a new graduate nurse applying for work in the Spokane, WA area. The first company I was contacted by was interested in hiring me for a small, part-time position as a "school treatment nurse." The job description calls for registered nurses to be paired with an elementary student, go to the school during their lunch hour and help them with carbohydrate counting and insulin dose calculations, etc. I'm fortunate enough to be a pump-wearer myself and have a solid background in diabetes, but you are very right. Most of the nurses aren't well versed in type 1 diabetes and insulin pump therapy. I am curious to see what kind of assistance these kids have been getting because controlling diabetes extends beyond the lunch hour that these nurses would be hired for. I would hope that with the prevalence of diabetes now schools would be open to possibly providing an in-service for their staff? I don't know how many educators have reached out to try and partner with a school and assist in educating the employees there. I know it would be a challenge to try and go into too much detail, but even possibly just a preparation course before or early in the school year to help educate the school staff on what to be aware of for their students with diabetes.

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