Discussion in 'Parents of Children with Type 1' started by HaileesMom, Mar 17, 2009.
We have a meeting with the principal at 4pm today. Wish us luck
Our daughter Shannon started giving her own shots within a months time of dx's. and she does do it herself at school. however the nurse is trained to do it if neccessary. she has had experience with her own father. Every one is different. they start when they feel ready. and for them to push her is wrong.
Oh, that's just wrong and sad I'm so sorry you are dealing with this. No kid should be forced to do an injection until they are ready to. They have enough to deal with being a kid. My SD never gave herself an injection. We never forced her to. She was on MDI for 8 months. She now will bolus herself on the pump with our monitoring, but that is a whole different ballgame to just push a button rather than actually giving yourself a shot.
YDMV so will what kids do independently.
Crystal Jackson at ADA is a great resource for school issues.
The point with independence is not what they do at 9 but at 19. Pushing skills is as dangerous as not allowing them to take them when they are ready. My goal is to have the kids be independent when they go to college and that included independence from therapy because they were forced to do things they weren't ready for, like poking steel needles into their arms.....
I couldnt have said it better Steven was 3 1/2 at dxd and just turned 8 he does test now but doesnt do injections yet. We feel that he will have his whole life to do his diabetes care and that we want to hand over responsibilities slowly. If your child has a 504 plan THAT has to be adhered to, schools dont like it but tough cookies for them. The nurse is being a control freak and a bit** in my opionion. Good Luck with this situation
Without saying how old my son was - to avoid those comparisons - I will say that Diabetes Camp REALLY helped us with this. My son never wanted to give his own shot but they encouraged him and his counselors were REALLY patient and by the 4th day of camp last summer, he did it! They made an announcement at dinner and everyone clapped for him!
Well our meeting went extremely well today We spoke with both the Principal and the Asst. Principal. They were both very open and willing to train even more people than necessary. And the Principal himself already knows how to give injections....I was SO HAPPY when I heard that
He also told us that the school is currently working on hiring an additional nurse because our current one is split between so many buildings.
Personally I think they should FIRE the current one and hire 2 new ones.
Anyway, they also said they are going to speak to the nurse ASAP and we will be turning in our 504 plan as soon as I get our endo to sign it.
So HOPEFULLY all has been resolved but I will be keeping my fingers crossed until it is officially in writing.
And ...THanks to all of you for your help
Well the nurse can't delegate responsibility but you can ask for volunteers to learn about Diabetes type 1 and how to help your daughter with counting carbs, injecting insulin, symptoms of low and high blood sugars, how to use glucagon, etc. You can do this through your daughter's endo office or have a certified diabetes educator come in.
When the nurse says that she is out of district sometimes, it sounds like she may be working for more than one school district.
If you tell me which state you live in, I can do some research and see if there are state laws in place to back you up and support you along with the Federal Laws that are already in place.
I do agree with the others, it depends on when a child or person is ready to do their own testing and injections etc and that being ready varies from person to person.
You are doing a great job. Don't back down. We are all here for you.
Emma's been giving her own shots by herself since she was 5yo, shortly before starting Kindergarten. When she was in daycare, either DW or I had to go at every lunch to give her her needle. We figured between the end of daycare and the start of kindergarten that if she could give herself her own needle, it would make things so much easier. And we were right! Proud of my little Emma!!
Hi, I am just responding to Tim's picture of Emma. Our daughter was recently diagnosed and we are trying to talk her into trying the insulin pen. From the looks of your pic, it seems that Emma is using the pen? Is this much better than the syringe? We can't seem to get Ally to try the pen, and I hate to get both from the pharmacy if she won't use it. We are going on a trip (flying) in 2 weeks and I feel this insulin pen would be so much more convenient. But this is not about me, whatever my daughter wants right now, we will do. I think she is afraid that the pen will hurt more, just because it is something new and looks scarier to her.
Anyone else out there using the insulin pens? Just curious. Thanks!
Maddie never used a pen but we did find the inject-ease to be a life saver. It's here
You fill the syringe, put it into the inject-ease, place face of device against the skin, push a button (which thrusts the needle forward, it's spring loaded) press down the plunger and done. Because you don't see the needle, and you don't have to do the actual pressing of the needle into the skin, it's just all around more comfortable and less "traumatic" than a regular injection. Imho at least.
I just wanted to say congrats on the meeting with the principle and getting the 504 ball rolling. Make sure they don't derail the 504 by offering you some sort of "health care plan" that "will take care of all of this" - schools often tell you their health plan will deal with all the issues in a 504 and you can certainly have the exact same things in both - but on the 504 is enforceable.
Kids are different and it is known that if you push a kid too early to self-care and they are not ready - you will create lots and lots of burnout issues down the road.
I think this chapter is the Understanding Diabetes book on what ages these tasks are typically handled by kids themselves is helpful: http://www.uchsc.edu/misc/diabetes/books/ud11/ud18.pdf
For shots it says: at age 10 or 11, can draw up and give shots on occasion, although they still need supervision
I would give that to your nurse and principal as well as further proof that she is age appropriate in her care.
Hang in there!
It takes a lot of determination to keep your cool while you advocate for your child. Good for you for doing such a great job! It sounds like you are taking all the right steps. Your daughter should decide when she is ready.
Our experience. We switched our daughter from NPH and Humalog to Lantus and Novolog using MDI at age 5.
Because of the increased number of shots involved each day I decided to try the Insuflon, a small in dwelling catheter, also called and insulin injection aid. This allowed us to pierce the self sealing top of the Insuflon and inject the Novolog that way. Since this process is painless, she learned to do her own shots at age 5 and never complained. (She never drew up the insulin).
It may be worth looking into. There is a good review (including the caveats) here on this website-- http://www.childrenwithdiabetes.com/d_06_311.htm
We pump now, but I think the insuflon is a clever and helpful device.Talk to your endocrinologist to go over all the pros and cons, since you would need a prescription.
Does the nurse expect your daughter to draw up her own insulin and do the math? Or how does she think your daughter can do this? I hope she just needs more diabetes education. Your school nurse is such an important part of your child's care. When you have a great school nurse it is a blessing.
Again-- you are doing a great job!
Oh man... I find this thread so interesting... when I was diagnosed at 8 years old, back in 1994, they MADE me learn to do my own blood sugar checks AND shots MYSELF before I could be discharged from the hospital... interesting... I didn't mind then apparently, as I was always doing all my own shots, checks, just conferring with my parents, I was fiercely independent, but this is quite intriguing... I feel like no kid should be forced into that kind of thing... no worries, I'm not in therapy now from emotional scarring for having to do my own stuff, but what on earth were they thinking back then?!
So Carole, if the nurse is insisting she is the only one who can do injections, then wouldn't the school also be required to have a nurse on site in the event (God forbid) glucagon needs to be administered? That would be my read on it.
In Maryland, according to how our nurses interpret their nurse practice act and other laws (each state is different) - they can train others to give glucagon and epipens. Anything that requires calculation or "nursing judgement" (hooey is that a vague term!) requires a nurse. In their estimation the glucagon does not require these as it is pretty much mix, draw up, inject.
If the nurse says no one else can give the glucagon but a nurse (doctor, etc there is usually a list of medical people)...then yes they need a nurse on site all the time - lunch, sick days, field trips, you name it. There is usually some provision for "emergency medications" in most states. The state law has a huge impact on who can actually be trained but the federal law says that the kid has to have the services, etc. to be able to attend school. How that gets done is up to the state.
So....if they say only a nurse then my approach has been "give me a nurse." Another valid approach is figuring out if the "only a nurse" thing is actual law or they are just making that up, getting the laws changed, etc. They absolutely can't require you to come to school to give insulin or demand that the child change their insulin to suit their needs.
Make sure to put in the 504 that someone needs to be available at all times to give emergency care - including the glucagon - and that some is available to give insulin when needed (lunch, corrections, snack, etc).
Good to know they are working with you now! I would give that nurse a piece of my mind, that's for sure!
Anyway, Kathy started out pretty much doing her own shots after the first week, but I do remember the educators saying they don't really have to even learn until they're older. Every once in a while she wants me to do it and I usually do the shot in her arm, which is harder for her to do on her own. She can do the belly or thigh shot no problem.
I agree with the others that every child is different and you should only let them do what they feel comfortable with.
I knew you would have insight into this, my school/ 504 guru! I'm curious because some consider calculating glucagon (ex. Abby's weight would only require 1/2 dose) as dosing, therefore, only a nurse can do it.
Regardless, this nurse needs a talking to, she shouldn't shame anyone into having to make this type of decision, especially a kid.
If William needed only a half dose then it *would* be considered a calculation here in MD and only a nurse could do it. I think he was right on the borderline starting kindergarten so we went with the full dose so everyone can be trained. His weight remains at a borderline - just over.
Hmmm....if that was the only issue I was having with the school I wonder how unsafe it is to give a smaller child the full dose? Would it harm them to give the full dose? If not, I'd probably agree to writing the orders for a full dose so that everyone can be trained. We have a full time nurse and a health tech but if there was ever some reason both were out or an emergency lock down or whatever, it is nice to know that all the teachers he has are trained.
My DD was dxed 1 month after her 5th birthday and started giving herself shots one month after dx. That being said, whenever she gave herself shots it was always with the supervision of someone who knew how to properly give them and NEVER at school.
Separate names with a comma.