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Help with school issues

Discussion in 'Parents of Children with Type 1' started by Mik's Mom, Feb 10, 2011.

  1. Mik's Mom

    Mik's Mom Approved members

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    Hi - yes I have trained the nurse- the elementary school nurse even gave her all the information. I just think she is nieve to the seriousness of the situation- and because my daughter is so responsible, maybe she thinks its not her job? I am working out a list of things I want changed, re-worded and added to the 504. I have also contacted a member of partners in health who is educated about diabetes and the needs of kids while they are in school, as well as the laws about the schools responsibilty. She will be going with me to the next 504 meeting- so i'm going prepared and ready for anything.
     
  2. selketine

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    If it says in the 504 that the health plan is attached then ... it is part of the 504.

    At least for us - the health plan is not distributed to all the teachers. It is not that we don't allow it, but we keep the really technical stuff in there. The health plan is accessible to anyone in an emergency. I just generally don't want to confuse people with his basal/bolus rates, ISF's and the like.

    In our county the nurse has asked to be trained by someone from animas on the pump so we did that. As for the stuff she can't do - she needs to learn from you or her supervisor - or they need to arrange for training. How could this nurse be helpful at all if she can't count carbs or know anything about the pump?

    I also agree it is an accident waiting to happen for your daughter not to be able to test and treat anywhere on campus without restriction. Even William (who is 9 and in 3rd grade) has an emergency box with a test kit, tabs, glucagon and epi-pen that goes everywhere with him in the school and he can have access to it in an emergency. I think he would be frightened at school to think he could be low and could not get to a test kit.
     
  3. Mik's Mom

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    Ok, thanks for clarifying that for me- I asked my daughter's endo nurse and she said that the health plan is in fact a part of the 504 and should be being followed.

    I was wondering how the nurse was being helpful as well- other than allowing my daughter to use her office to store her medical items.

    In our school system, the kitchen staff is suppose to give the nurse a monthy menu with the nutritional facts about the daily menu- I know they do this, as I have seen the ones they send to the nurse in the elementary school. It has the carbs for each item and my daughter would say what she ate that day, calcualte the carbs and the nurse would confirm it or correct it if she made a mistake- this is how its been done since 1st gade- so I know it exsists and I know it works.

    I just called the high school and spoke to the kitchen staff - I went to school with one of the staff and she told me she would send home a monthly menu. So now my daughter and I can figure out roughly how many carbs she will have each day- very good news. She is also making sure the nurse has a copy.

    Lastly- what you said about your son would be frightened if he couldn't test if he felt low- hit home. Thats what this is all about. A 12 year old girl who doesn't feel safe when she's at school- its wrong and unacceptable.
     
  4. Sarah Maddie's Mom

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    My last bit of advice...

    Be sure as you rewrite your daughter's 504 that you are very specific about what tasks need to be done and by whom. It really helps later on if things are not being done according to the plan if you can specify that Mr X or Ms Y are not doing abc as per the plan.

    Good luck.:cwds:
     
  5. Flutterby

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    I would make changes to your 504 that someone has to help her count carbs, that she can carry glucose tabs on her and her kit (in a little bag) so she doesn't have to wait for the nurse, that can be very dangerous. As for the dance. I'm assuming this is a public school since you have a 504. They simply MUST provide someone that is trained in diabetes care during the school dance. ALL school functions they must have someone available.

    I'm sorry you are dealing with this. If you need more help, you can PM me, I'm in NH too.
     
  6. hdm42

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    I find it ridiculous that a 12-year old can't carry her supplies with her. The excuse of the lancet is silly. A thumbtack or staple can do a lot more damage, and I'm betting they have those in the classrooms.

    My son carries his test kit, his novopen (with needles), hypo food and his cell phone with him at all times. It's in his 504 plan. He is allowed to test and treat anytime and anywhere and he is allowed to call me anytime he needs to.

    I hope you can beat some sense into them. Good luck!:cwds:
     
  7. PatriciaMidwest

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    Our story is very similar. We had an excellent system in elementary that all kind of fell apart in middle school. You can change this though!

    It's been a lot of work, but I am so happy about the changes we were able to make at my daughter's school. Stay persistent! You know your child better than anyone.

    You will need to revise your 504. Easier said than done but if your daughter has 2.5 years left at this school it is a very wise investment of time.

    First, check the ADA website for state rules concerning Glucagon injections anything else pertaining to D care. Hopefully your state allows injections by non medical personnel. If so you need to put in your 504 that XX many people need to be trained on giving the Glucagon injections. Also, someone trained on Glucagon needs to be on site for all games (even if your child isn't playing, she may be sitting in the bleachers with friends), school dances, school field trips, etc. Our Principal and Vice Principal are both trained and they are always on site for after school activities.

    I trained several people at my DD. School on Glucagon, including the Principal and Vice Principal, 4 teachers, the secretary outside the nurses office, and another para professional. It was a wonderful feeling. Our school nurse was "too busy" to get this done so I just set it up and came in and trained them. These people came forward and volunteered to be trained and it meant the world to me that they cared enough to do that.

    We have problems with the nurse being gone too, so I put a "low box" in our school's front office too, and trained them on low blood sugar. I tell everyone over and over again that they cannot make a mistake by giving her juice (I don't want them to be scared of making a mistake and not do anything).

    At this point I just inform the school (nicely) of how things need to be done and why it's important. I bypass the nurse whenever I need to or feel it is something she will try to squash. I communicate directly with her teachers via email if there is something I want them to know. I inservice the teachers myself and give them the training materials I want them to have. I get my daughter's schedule before school starts and go in and talk to each teacher. I keep things very simple. My big hot buttons are making sure everyone around her what a low blood sugar is and how to treat it and knows that she cannot be alone when low. I always emphasize that if they are in doubt, just get her some juice.

    As far as carbs go, I would really try to get this sorted out at home. If she takes her lunch put a sticky in there with totals. If she buys it at school, get out the menu and mark the carbs by each choice.

    Hope that helps!







     
  8. PatriciaMidwest

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    You are in New Hampshire, correct? The ADA linked to this documents regarding Glucagon in schools:


    Can school nurses delegate the task of administering insulin and glucagon?

    According to NHBON rule NUR 404.06 (b), any nurse who delegates a task must take into account factors such as the stability of the client's situation and whether the nursing needs of the client are changing. Ed 311.02 allows public school nurses to delegate injectables such as insulin and glucagon but NUR 404.06 (b) narrows the option because the person performing the injection must make clinical judgments about dosages and related issues. There may be special circumstances when those working closely with a student are appropriate delegates and in those circumstances, the School Nurse would follow the NUR 400 provisions. It is important to remember that the nurse must always act in accordance with the policies and procedures of his/her employer.


    **Based on this I would tell them your 504 needs to include training others on Glucagon. If they fight it (they may not) I would argue that Glucagon requires no dosage decisions or clinical judgements. Your child is a known type 1 diabetic. If she is unconscious Glucagon must be administered, no judgement required. The syringe is prefilled and they inject the entire dose. No dosage decision is needed. It requires no more judgement than an EpiPen.

    As far as the field trip coming up -- as others said the school will have to provide a nurse.
     
  9. mom24grlz

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    i haven't read the thread, past your initial post so some of these may have been covered. Ashleigh is also in middle school, so I'll tell you how we handle things.




    just read the thread and am schocked that they won't let her carry her meter with her! That is so stupid of them! Did they say what their reasoning behind this is?
     
  10. swimmom

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    Re: the lancet needle being an issue, dd uses Accu-Check Multiclix which has no visible needle so there isn't a school concern. She is very careful to keep her used cotton swabs, alcohol pads, etc. with her D stuff and we dispose of it at home. I don't want to deal with any complaints about bloody cotton swabs being left on a desk, etc. DD carries her D supplies (including tabs) in a zipper compartment of her binder.

    DD has always taken her own supplies and dealt with her medical issues herself at dances, etc. You might insist that she set an alarm on her pump and check regularly at the dance or while on a field trip (or during the school day for that matter) if you are worried that she won't realize she's low.

    I know elementary school to middle school seems like a huge leap. It was for me (more so than for dd!). But they do have to start taking more responsibility for their own care or they will be limited in what they are allowed to participate in. That can result in resentment and depression.
     
  11. Beach bum

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    We have our 504 with see attached health plan. Nurse gets full package, teachers all get 504.

    My daughter carries all supplies on her person at all times, including glucagon. She is out in the portables, if nurse is halfway between her and office, the last thing I want is for her to run back to office, to have to run down two hallways, outside, up the ramp and all the way to the very last portable. This is all written in her 504.

    DD goes to middle school next year, so she'll have to be more independent, but will still need general assistance. We will insist on a cell phone the for the following year.
     
  12. Mik's Mom

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    thanks for advice

    thanks for all the advice. I called the school nurse to tell her that I wouldn't be able to attend the field trip and she said "well I can't go, can't you change your meeting?" to which I responded that I probably could, but that I shouldn't have to and that I wanted to call a 504 meeting, as I didn't feel my daughter's 504 plan was being followed and that I simply felt that the school was jeopardizing her health and safety.

    I said it clearly states in the 504 plan that the school must provide trained diabetes personnel to attend any field trips if the parent isn't able to go. And she said "I?m not going to argue about this over the phone" to which I said well I can be there in 10 mins. Seriously? I was not very happy, I made it clear that I wasn't arguing- that I was just tying to keep my daughter safe.

    She said she had to go and would figure something out. She called back about 3 hours later, much calmer and very polite and said that they had worked it out so that one of the teachers who is also an EMT and volunteer fire fighter and who?s father had diabetes, would attend the field trip and be there to assist my daughter if any medical needs should arise. My daughter has him for a teacher and has talked to him many times about his dad having diabetes and she is very comfortable with him going on the trip with her.

    Now was that so hard? I had to fight for 2 weeks to get them to do what could have been done in an hour and never should have been an issue.

    I'm just thankful that my daughter was able to go on the trip and I am gathering all kinds of information about diabetes and laws for the next meeting.

    She's at the pool now and having a great time with her class- thats all that matters

    thanks again
     
  13. denise3099

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    I didn't get to read all the responses, but I just wanted to put this out there--it's not a matter of being "allowed" to carry her meter. If I were you, and this is just me and I don't know your situation, but I would give her a small case including meter, lancet, strips, and gluc tabs and put that in her back back or purse. She is to carry it at all times. End of story. If they complain about sharps you say, So I suppose you've banned saftey pins from the school. If they complain about blood, you say, So I suppose you've banned nose bleeds ans paper cuts, not to mention scabs and hang nails, from the school.

    You can keep working to get this put into the 504 or to have it actually followed but I wouldn't send my kid out for 1 more day unprepared. You don't want to antagonize the school but having basic supplies like this on your person at all times is the very basis of D care. If she is "on her own" as far as D care so much, then she at least needs to be equipped to manage her D.

    And I would start looking into cgm--but I'd bet money that's been mentioned already! :D

    I'm glad the trip is turning out well--that's great she has a good caring teacher to support her in school.
     
  14. McKenna'smom

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    This is exactly how I envision my daughter handling her diabetes in middle school next year.

    I am currently drafting a 504 and have stipulated that she can carry her test kit, supplies and a cell phone with her at all times. I don't anticipate a problem as she is not the first Type 1 to go to her school and another boy is starting next year too.

    I have been spoiled the last year because our school health assistant has been wonderful and communicative. McKenna goes to her for all testing during the day. Next year will be a big huge step for her at 11 years old to take on that responsibility herself. But, unfortunately, in middle school it is not convenient to go to the nurses office 3 times a day when she can easily test herself in her classroom, between classes and at lunch.

    To the OP, good luck on getting your 504 amended.
     
  15. bibrahim

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    a child not being able to attend a field trip due to a disability is an area of concern an probably a Civil Rights Violation. I had that same problem but then did some internet searching and found this as an example of a CR violation. I e mailed the school about this and said it needed to be in her 504. So far my husband has gone but if he can't go, we are covered.

    Using the phrase "due to these problems, my child is not getting a free and appropriate public education" can get school staff moving. I was counseled to make that statement in regard to my daughter with ADHD and that she needed tested and by golly, they finally decided to test her. Now she is on and IEP and they say she doesn't need it but I want it left in place because I feel the accommodations are helping her and that is why she is doing better in regard to learning and grades. This all came about because her 6th grade teacher and the principal refused to replace her spelling word list that they only gave out once for the whole year, and she lost it so she was flunking spelling. They replaced it once but refused the next tiem. Well, hello, ADHD kids loose things.
     
  16. Mom264

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    Very sorry you and your daughter are going through this.

    My dd is in middle school and is hypo unaware. She carries clicker, meter, strips, glucose and crackers in a purse. She also carries a cell phone in the purse. I bought the purse from Vera Bradley the month before school started. There are outside pockets for the phone and several inside pockets.

    Her DMMP (Diabetes Medical Management Plan -- a legal part of her 504 )stipulates the way she may use her phone, to call or text me or dh regarding D care. She checks wherever she is when she needs to check.

    I also made up little cheat sheets for the teachers small index card sized with all important info. PM me if you want details on it. It is very helpful.

    Also, my dd wears a sensor, so that is helpful to us as well.

    I hope things get better.
     

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