Update on school nurse issues (long/rant)

[momofphoenix]

So on Thursday we had a BIG meeting with the principle, the special ed director and the EFMP director (exeptional family member personel) about the School Nurse and how she has been this year.
I had went to the meeting with bulitins on issues, written down all our concerns, things that have been done that were outside of dr. orders, etc etc.

One of my concerns was how she was holding him from lunch and recess and making him feel bad about having D... Yes she made little comments to him about having Diabetes and how it made her job harder :eek:

My main concern was how she wont allow me to make any I:C ratio changes without new Dr. Orders, he was on a 1:25 for lunch with lows within an hour and a half so The dr and I changed him to a 1:30g. I wrote a note with the new ratio change and signed it she refused to do it and did the 1:25 sure enough he was 41 an hour later :mad:
The Special Ed director said that it was not ok for her to do this etc etc... so leaving the meeting we felt like they understood our concerns and agreed that things needed to be changed with the nurse... They even said WE HAVE VALID CONCERNS!!!

THEN we get a call 15 minutes later saying how they need NEW dr. orders filled out stating the new ratio changes and on the orders the ratio's need to be spelled out in the sliding scale section :eek: I was like WHAT??? HE is on a Correction Factor NOT a sliding scale!!! They then tried to tell me that he needs to be on a sliding scale since it makes the nurses job easier and less confusing :eek: So by this time I am so fed up and honestly Pissed off that I call Childrens and leave a message with the Pump nurse (and we arnt even on the pump and I need to call her since the school nurse was so rude to the other nurses at Childrens that NONE of them will talk to her!!!!) So I am talking to the pump nurse and explaining what the school wants she got just as mad and upset as I was!!! She was so mad that the nurse is being so stupid about this and how she is actually putting Phoenix in dangers way by NOT doing the new ratio's that she actually send blank orders to the school to have the nurse fill out and send back to her (so she see's what she wants) and if it is what we think it is Childrens is going to explain to her that she doesnt know how to read the orders and to get some extra training!!!
I really thought we got through to the school about needing new orders each and every time there is a ratio change and how that puts a hold on a pump for Phoenix, cause we arnt proving to the Endo we can handle changes by needing new orders each time... I explained what low's can do to Phoenix and what Highs can do to him I just dont get it... I'm so mad That I want to scream!!!!

I think our next step may be a lawyer???? I'm not sure.

[BrendaK]

Whew -- what a pain!!! Our endo wrote a note to the school nurse saying that the parents are allowed to make any changes we want at any time without his specific written orders.

It's a little different for us because Carson is pumping and I just program changes in the pump without the nurse even knowing about it.

Can your endo write a note like this so they don't have a fit every time something changes?

How did they address the nurses demeaning comments to your son about D making her job harder? That is a huge issue in itself!!

Who told you to get a sliding scale -- The principal?? The nurse??? I'm sure you've done this -- but remind them that they are not diabetes specialists and your are going by the endos orders to do a correction factor.

I would be thinking about a lawyer too, especially since she is putting your son in grave danger by not adhering to the new ratios!

[jules12]

You are doing great fighting for your son's rights. I am so glad that you have the endo nurse to back you up! I got mad right along with you as I read your post! Hang in there!

[Kaylee's Mommy]

I don't understand WHY the school has their heads crammed so far up their behinds.. could you call another meeting WITH the pump nurse.. or someone from your endo's office (I know if i were having these issues Kaylee's endo would be at that school at 7am WAITING for them all.. LOL) you need someone in the medical field to go in with you and DRILL it into their little pea brains that ratios change, you know what you are doing (probably more so than the endo because you are his mother..)

I so peeved right along with you!!

[momofphoenix]

We have had the Endo write the note stating "Due to the Parents KNOWLEDGE OF THIER SON they are more then able to make adjustments and corrections for the diabetes management of their son!!!" This still is not good enough for them....
And it was the nurse who made the comment about putting him on a sliding scale, I blow on that one!!!

It's kinds funny cause I am a very nice and caring person to everyone but it only takes one time of messing with my family for me to flip out on you. this nurse has been messing with us all year and I have flipped out on her (I raised my voice enough to be heard ;) but I was in NO way threatening) and she said I scared her. :D Honestly it did make me feel better

[BrendaK]

So do you have a 504 plan in place. If the doctor says you are able to make changes and they are not abiding to those changes, they are very very legally in the wrong. What is their reaction when you point out what the letter says about you being able to make changes? Why is that not good enough?

[momofsingingdiabetic]

I think he's at a DOD school which refuses to do a 504.

[momofphoenix]

DOD school say's NO 504 but we have an IEP

[Kaylee's Mommy]

We have had the Endo write the note stating "Due to the Parents KNOWLEDGE OF THIER SON they are more then able to make adjustments and corrections for the diabetes management of their son!!!" This still is not good enough for them....
And it was the nurse who made the comment about putting him on a sliding scale, I blow on that one!!!

It's kinds funny cause I am a very nice and caring person to everyone but it only takes one time of messing with my family for me to flip out on you. this nurse has been messing with us all year and I have flipped out on her (I raised my voice enough to be heard ;) but I was in NO way threatening) and she said I scared her. :D Honestly it did make me feel better

LOL.. glad you 'scared' her LOL.. you are in a military base school, correct? so you don't have a 504? I would see if the endo or a nurse would be willing to go to a meeting with you.. let them explain to the dim whitted nurse that she is putting your son in danger by not following orders.. If the endo won't go with you..(our office has a fund for this.. so the nurse/endo/cde gets paid for these trips.. ) maybe it is time to contact a lawyer.. let him draw up some legal documents and threaten them into doing what they are suppose to do for your son...

[saxmaniac]

We just ran into the "parent cannot override I:C" problem at school. I forgot to bolus for breakfast and called up and asked them to give them 1U of Novolog. They couldn't. They said they could follow the correction formula and give a correction shot, because that is on the orders.

Irony: I just realized that such a correction would have been the exact same as the missed bolus. So what matters not is the medicine that goes in, but the reasons why, and the paper trail behind it.

Turns out there's a MA state law that says the parent cannot make dosage recommendations. On top of that, the doctor cannot delegate dosage recommendations to parent. That's it. It's terrible, but the law hasn't caught up with intensive D care yet. Simple as that. This makes sense when you think past D - what if you had a dingbat parent who told the nurse to give their kids 10x the amount of prescribed antibiotics, because she felt he needed it today? You and I know it's different for D, but the law does not.

Sadly, the only likely way this law will change is when a nurse refuses to do what the parent says, follows the orders to the letter, and an awful low results.

So, the nurse isn't being obstinate, she does have to follow the law, as annoying as it is for us.

There's a few ways to get around this. Our endo's office said if this ever happens, simply page them, and they will fax a one-time order over to them. The endo is happy to do this because they know we are on top of things. This makes sense, the school needs a paper trail so they can CYA.

Since food isn't medication in the eyes of the law (but it is to us) we could also simply pad out the meal with some extra carbs to make the I:C that you want. Obviously this only works in one direction, though.

When we get the pump, then I can just program the pump, and have the Doctor's orders say "follow the pump". One huge plus here.

In your case, the nurse is overstepping the line when they say sliding scale is easier -- the same as the other thread where they wanted to change pumps.

[Abby-Dabby-Doo]

Jessie I'm sorry you're going through this nightmare. The comment that puts fuel under my fire is that " it's making her job harder'? WTH? IT IS HER JOB! Harder or not, that's what she's getting paid to do.

What have you done to check out the laws in your state? I would start there. Is it possible to check with another nurse at another school site? I don't want to hear a "bad situation" has happened to Phoenix, and that's the straw that breaks the camels back.

[blbrocky]

Sounds like a good appeal (justification) for the pump.

[Jacob'sDad]

The parents can't make I:C changes that the school is expected to follow? That's absolutely crazy. That policy is rediculous and dangerous. My kid is on a pump. We are testing out using Novalog instead of Humalog. I notice on day one that he is running lower, so I do the common sense thing and back off virtually everything on the pump.
Now when he goes to school the nurse simply does what she always does and enters the carbs and BG into the pump and it calculates the dosage. Unless I tell her I have changed some settings she doesn't know. I assume almost all parents of pumpers have done the same thing many times. Of course if the changes become permanent I will let her know.

I guess I've never even considered that our Endo has the final say on dosages. At our Endo appointment we exchange ideas back and forth and come up with a plan together. If needed he will write new forms for the school but it always says that the dosages can be changed by the parents.

If an Endo writes on a form that the parents are qualified to make changes,
I don't see how that doesn't override any other rules or laws.

[Riley'sMom]

Jessie,

I don't have any advice for you but I do appreciate your posts. We'll be moving from a VA public school at the end of this year to a NY DoD school so we'll have to start the IEP process all over again. Reading your posts helps prepare us for some future issues we may be dealing with, hopefully nothing as bad as that nurse you are dealing with though.

ryan

[Charmed7]

I would "Make a deal" and say, I will have the doctor fax in the orders each time there is a change if....insert your deal here.

Some suggestions:

You fire that nurse
You treat my son and my family with the utmost respect
You learn how to factor my childs corrections
You take your head out of your a$$.


I don't know, get creative.

Here's a link I found the jdrf.org (I think I suggested that site to you in the past)

http://www.ed.gov/about/offices/list/ocr/index.html?src=mr

I would definately start doing some research into your legal options before this becomes a dangerous situation for your baby.

Charmed

[badshoe]

Call Crystal Jackson at ADA.
Tracker her down and get on her radar.
She can help.

[MReinhardt]

I am so sorry that this is happening to you. Its challenging enough to deal with the school on lots of issues, and its challenging taking care of a child with diabetes.

My thought that if the school wants to put your child in danger, then hotline them in for child neglect, and not following drs orders. School on the other hand would not hesitate to hotline a parent in.

[deafmack]

I am so sorry you are going through this. It makes me so mad that this nurse and the school is being such a PITA. You can tell the nurse is really old school and set in her ways. Someone needs to give her a "swift kick to the moon." The fact that she is only to work with a sliding scale shows how resistant she is to change. You are the parent and I am 100% behind you.

[Tamara Gamble]

Bennet is right about Crystal. She is in Virginia so she would probably grab onto this one. Call 1-800*-diabetes and they should connect you.

Tami