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Middle School Care...am I off base?

Discussion in 'Parents of Children with Type 1' started by 2type1s, Feb 18, 2011.

  1. 2type1s

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    Hi all.... I have posted a few times before about Zoe's nurse, and I'm just wanting to see if I'm out of line. Here's the history:
    Zoe has the same nurse Morgan did, and I wasn't thrilled then, but we got through the middle school years without too much trouble.
    Here's what is going on:
    The nurse has only called me one time this year. She didn't leave a voice mail, just saw that there was a missed call from the school. Called back and they couldn't find the nurse. 30 minutes later the nurse calls back and tells me Zoe is out of cartridges and her pump is out of insulin and she has no supplies! I look at the original call and now an hour has passed without my child having insulin. By the time i get to the school I'm seething. I never got a note that her supplies were low, Zoe's box was full of trash (old sets, needles, paper peelings, wrappers) and it was obvious she had never looked in there. GRANTED zoe should have told me that she was running low, but she didn't know there wasn't any extra in the filing cabinet (where the nurse keeps the bigger supplies).
    I have had calls from Zoe's math teacher saying her blood sugar is 300....400,.etc) what did I want to do? this is because the math teacher is a friend and KNOWS that's bad. Once, when she was 450 (and had been for the past 4 hours) the math teacher called me and told me Zoe was not doing well and when she called the nurse, the nurse told her to "drink water" she was doing vision screenings and couldn't deal with Zoe at the time. That's why she called me, because the math teacher knew she needed insulin! I was LIVID.
    Now this week we have had the same thing again, a day with highs (400's for hours) and each time the nurse has Zoe call me. I speak only to zoe, and not the nurse. Zoe is arguing with me that she doesn't want to change out her set while I'm trying to work with a severely autistic child (who's losing it because I'm on the phone) and I have no adult to see if zoe's doing what she's supposed to. Zoe was told to come back to the nurses station every hour to see if it had come down, and she had to wait for her to get there several times. Each time I talked to zoe, not the nurse. finally I called the school and asked to speak with the nurse when I got a break. She told me zoe should be walking in that minute to check in. zoe got there and was frantic because she couldn't find her Dex. I HEARD the nurse tell her "well, you better go look for it and get back here quick". I said "wait!" don't send a kid whose been high all day, and had 3 corrections out by herself without a finger stick!. DUH! Well....she was still high, crying hysterically because she was feeling bad, confused, sick and had now lost her Dex. (It was turned in at the office). So now I'm even madder. I tell her that her top priority was to help Zoe find her Dex, get her calmed down, and if she couldn't do that, I would call the principal and have him put the classes on lock down until the expensive piece of medical equipment was found! Zoe came home very sick with ketones, couldn't eat dinner and went to bed at 8:00. She was miserable. so, after dealing with the nurse through phone calls and e-mails before this event, I decided to call her boss. The head nurse for the county was very supportive and told me that this was not acceptable care and needed to get Donna's side of the story. Well, she called back several hours later and told me that from now on Zoe's nurse will call me and not have zoe call me. She was "just trying to get Zoe to be more independent". BS, she was just trying to be lazy. I expect the adult caring for my child to call me and fill me in. I NEVER get a call for extreme lows or highs (as noted in her 504, I will be notified by phone if she is under 50 or over 350). When Zoe was in elementary school, if she was "off" I was notified and prepared. Is this typical middle school care? If you've stayed with this post this long, thanks...didn't mean to write a novel, but apparently needed to vent!
     
  2. Lisa P.

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    Nah.
    You were entirely right and it sounds like you handled it perfectly.
    Hopefully now things will go better.
    Just my opinion, of course. But sounds spot on to me.
     
  3. JacksonsMom

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    Sharon,

    I haven't posted on here in a long time, but after reading your post I couldn't help but comment! I would be livid. I do not have a middle school aged child (mine is in Kindergarten) however I can say that I wouldn't find this type of care acceptable. It sounds like the nurse just isn't doing her job. Sure at that age children need to learn to be responsible, however they aren't there yet and need supervision! DUH! I don't know how you remained so calm!

    Good luck in the future working with her. I hope the situation improves!

    Stacy
     
  4. Mik's Mom

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    we are going through the same kind of thing with my daughter who just moved to the middle school ( see my thread about school issues). I have called for a 504 meeting and told the nurse she was indangering my childs health and safety- a parent shouldn't have to fight to get the nurse to provide the care outlined in their 504 plan- but sadly we do. Good luck and vent any time!
     
  5. Sarah Maddie's Mom

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    I'll just say that even with terrific nurses we've sometimes had inventory issues at school. I have been working with Maddie to make her more attentive, but when you're 13 there are far more interesting things in life than how many infusion sets you have at school.:p

    I think the nurse behaved badly overall, but I thought I'd just mention that even with an attentive nurse, things can slip through the cracks.

    Hope things look up from here on out.:cwds:
     
  6. mom24grlz

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    wow! Ashleigh is in middle school and I would be ticked if they let her run around at 300/400 for hours at a time. Ashleigh has gone up to 200/300 at school (usually from breakfast spike), but a correction brings her down. There was one day where she couldn't get below 200 no matter how much she corrected. The nurse ended up calling me and I told Ashleigh to go ahead and do a site change. Our school nurse is really good at letting me know how Ashleigh's doing. She also calls to let me know if she won't be in her office for some reason.
     
  7. 2type1s

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    thanks, I'm feeling a bit better just getting some support! I loved our elementary nurse and the high school nurse (my older daughter is in 10th grade, and the nurse calls me when I need to be aware of something, however Morgan only goes now if she has a problem, she's completely indepedent for her care). I also know that there have been many complaints about this nurse from other parents. I hesitated because Zoe has 3 more years there! (Mik ....I saw your post and decided to do my own instead of hijacking). I talked to the Endo in the fall about my concerns, and she told me she could have Zoe declared independent once she turned 11, and Zoe could just text/call me and we could work out problems like we do all the time. However, Zoe has other issues (thyroid disease and a weird pain syndrome similar to MS) so I'm afraid to pull out the plug completely! She does have a 504, which is why I'm so angry!
     
  8. Pauji5

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    I agree with you completely. The nurse is there for her.. and it isn't up to her to decide when your child should become more independent.

    I have been dealing with elemtentary school, and now with our sons diagosis, (he's in 7th grade) it's a whole different thing with Middle School. Our nurse is good, and granted, Spencer still isn't getting tons of insulin and doesn't always get a shot a lunch, but she has him recording his own info, checking his supplies (which I remind him and fill has back pack),etc. While it is middle school, they are still kids and the adults are there to Help them.....

    Your nurse sounds lazy and I hope things get better for you!
     
  9. PatriciaMidwest

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    Our nurse is about this same caliper. It is frustrating. In some ways it did force my DD to be a little more responsible with keeping her insulin filled, etc. so she can avoid seeing the nurse, but the we've had our share of struggles. It has gotten better for us now that we are in 8th grade (nurse hasn't changed too much but my DD has matured!)

    I would be really mad if the nurse didn't tell me she ran completely out of insulin. Good grief -- why wouldn't she leave a message at least? I'm glad you called her supervisor.

    My daughter would likely fight a site change at school too, esp. with our nurse. I don't leave any sites at school, I have her take a shot if there is an issue. Honestly, I don't want our nurse involved any more than she has to be at this point, she still doesn't "get it" and is likely to just mess things up.


     
  10. bibrahim

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    As a school nurse, I think she needs more training. She also needs to be contacting you herself. I only have two sets at school, but we have never had to have my daughter change her set at school. We do have back up supplies just in case. You can ask for another 504 meeting to fine tune things. At our last meeting I was shocked that the nurse thought that the pump did everything. People just don't get it for the most part. She should have also had ketones checked if she was running that high...lots of questions here.

    The school nurse training is called HANDS and you can read about it at nasn.org

    Also, is she an RN or what is her level of training. Many schools have health aids who aren't licensed. This may be the case, unless you know she is an RN or LPN. Either way, she definitely needs more training and a kick in the A$$!!

    Good luck.
     
  11. Jensmami

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    I would be LIVID too, specially since the nurse is not doing her job as defined in your 504.

    My DD has always done her own management in Middle School. She only went ones to the nurse (it's her 3rd year in Middle School) and it was not for diabetes related issues, but because she felt sick. The nurse told her to check her BG and it was 100ish and the nurse told her to drink a juice, since her target is 130 in school. Of course Jenny refused and told her that I would be really mad if she would drink a juice now, since her BG was great. :eek:

    Jenny has a cgms, which makes things easier for her. The only thing we keep at school in the nurses office is the big red. If her pump set would fall out, I would run to school and handle it. Only happened ones or twice. Jenny has always a few syringes in her bag, so in an emergency she could draw up some insulin from her reservoir. I check her D bag and pump every night and make sure everything is filled up (glucose tabs, insulin, strips and battery). If it is tight I put an extra battery, reservoir or strips in her bag.

    Next year she will go to a new school to High School, I hope things will work out that well too.
     
  12. Amy C.

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    My son has never had a nurse at his school. Diabetes management at school was greatly simplified when my son went on the pump before 7th grade. We have been so lucky in that he has had to do a site change only twice at school for the past 4 years and was able to manage as he is old enough.

    Granted the nurse should be doing more, it seems she is doing a lot more diabetes care than she ought to. The one thing I noted is that Zoe seems to run out of insulin prompting a site/cartridge change while at school. I check the insulin levels in my son's pump and determine if he might run out of insulin that day. If he doesn't have enough, he changes the site and the insulin. I see it as my resposibility that my son has enough insulin for a school day.

    I agree with the others in that you should not be speaking to Zoe, but to the nurse. Also, someone else needs to be trained to help out with blood sugar tests as this nurse does seem busy with other tasks. Could Zoe test in the classroom? This way she wouldn't miss so much class waiting for the nurse.
     
  13. 2type1s

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    Zoe does check in the classroom, but if it's off (low or high) she gets sent to the nurse. She also has a cgms, which does help. She has a bag with extra supplies that I normally check every night, but of course this was the one night i forgot! She did have insulin have insulin at school, sorry for the confusion there! she just didn't have a site, so couldn't put the insulin in. she also had syringes, but the nurse didn't think to give her a correction. Zoe has done her own site changes since diagnosis, but she has a little system she does, and doesn't like to be rushed. I think I'm going to make some changes as far as having to leave the classroom. when she's home alone, she does carb counting, corrections, site changes all by herself. She really doesn't need to be leaving the class so much! I will talk to her Endo when we go this week for the girl's check-ups. But, like I said, because Zoe has other health issues besides diabetes, I can't close the door completely!
     
  14. CAGrandma

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    This is actually a simple issue. You have a 504 in place. The school and the nurse (who is an agent of the school) is legally required to follow the provisions in the 504 until and unless written changes are made in it. It is not up to the nurse to decide to "encourage Zoe to be more independent" or any such nonsense. If the BG is outside the parameters set in the 504 then the nurse MUST follow the directions. So no, you are not over reacting - if anything you are under reacting.
     
  15. Mom2rh

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    Haven't read all the responses. I'm sure you've gotten a lot of good advice and support.

    Our school district has the following protocol.

    http://www.chicousd.org/documents/HS-308ab_Diabetes_Protocol.pdf

    I suggest you offer this as STANDARD for all schools in the district. Your DD should not be at school with a BG over 400.
     

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