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Nurse gives dose of reality in diabetic debate

Discussion in 'Advocacy' started by Ellen, Mar 29, 2006.

  1. Ellen

    Ellen Senior Member

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    http://www.nysut.org/newyorkteacher/2005-2006/060330goldman.html

    Nurse gives dose of reality in diabetic debate

    [​IMG]March 30, 2006
    Anne Goldman demonstrates a glucagon injection on a mannequin. A NYSUT Board member, Goldman is also a special nurse representative to the UFT.
    After watching a nurse demonstrate to the NYSUT Board of Directors how to administer a glucagon injection to a diabetic patient in shock, teacher and Board member Dona Vermilya was in distress.
    Her mind flashed back to the "horrendous experience" of having to inject someone who had gone into diabetic shock. First she had to test his blood, something she knew how to do from nearly 10 years of experience, to determine the exact problem. But the glucagon injection required her to read directions, mix a substance, check for air bubbles, all while dealing with "the weight of essentially having his life in my hands."
    Two neighbors, an emergency medical technician and a nurse, were there to guide her but were not allowed to administer the glucagon.
    "I finally jabbed a needle in his thigh," said Vermilya, a teacher for the deaf and former president of the Broome-Tioga BOCES Teachers Association. "I'm thinking about a teacher with a classroom full of kids trying to deal with this."
    New York State United Teachers is closely monitoring bills in the Legislature that would encourage schools to train teachers and non-medical staff to inject students with glucagon to stave off a diabetic coma.
    Some measures before lawmakers would encourage school districts to train teachers and other non-medical personnel, such as bus drivers, to make glucagon injections using a portable kit with a syringe. To show the level of skill and detail required, Anne Goldman, a New York City nurse and NYSUT Board member, demonstrated to fellow board members the use of a glucagon kit to inject a child-sized mannequin. The person administering the injections first needs to judge the severity of the diabetic shock, mix a powder and liquid in the proper proportion based on body weight, and also make sure there's no air in the syringe.
    This could happen while clamoring children crowd the victim, who may be vomiting and going into a coma, Goldman pointed out.
    Goldman, who chairs NYSUT's Health Care Professionals Council, told the board the American Diabetes Association is pressing for such legislation in many states.
    School nurse staffing
    The real solution, said NYSUT Vice President Kathleen Donahue, is to make sure schools are sufficiently staffed with nurses trained to administer care before a child gets dangerously close to a coma.
    NYSUT is supporting bills in the Legislature that would mandate a nurse in each school building.
    Board member Deb Paulin, a bus driver from the Alden Central School Employees Association in Erie County , said she met a fellow driver from another state at a conference who had been approached by the district because "they wanted the drivers to start giving the shots."
    Even with training, it is hard to determine the nature of a particular diabetic's problem, said Paulin, who went through training herself to deal with diabetic family members.
    "I've taken care of insulin-dependent family members and used a stick to test their blood sugar," Paulin said. However, the glucagon kit has no way to measure blood sugar, nothing to clean the injection site and contains no gloves.
    — Liza Frenette



    NYSUT.org. Copyright New York State United Teachers. 800 Troy-Schenectady Road, Latham, New York, 12110-2455. 518.213.6000. http://www.nysut.org.
     
  2. CAGrandma

    CAGrandma Approved members

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    I just read a position paper on the website of the National Association of School Nurses regarding care of diabetic children in schools that relates to this issue and it was not encouraging. It sounded, to be blunt, like there is a turf war going on - with nurses maintaining that giving glucagon is a very difficult medical procedure that should only be done by trained medical personnel (nurses) rather than untrained lay people (teachers, aides, etc.). No where is it mentioned that the effect of an overdose would be less than catastrophic and can be treated by medical personnel or by the child's parents (who should be called if the kids needs a shot).

    Of course it would be great if every elementary school in the country had a full time nurse, but that is not the case and won't be in the near future if ever. In the meantime, diabetic kids are being told they must be homeschooled cause there is no one who can give that glucagon shot if needed. I am upset that the school nurses association is taking this stance because it further isolates diabetic kids and makes it hard for them to attend regular school.
     
  3. Momof4gr8kids

    Momof4gr8kids Approved members

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    Our school nurse has 3 schools that she has to be at. So I have trained the psycholigest, the principal, and the ladies in the office to help (Julia's teacher wont)
    What I read about the nurses association was that they wanted total control over what happens to the student during school time. Such as they wanted to be the ones to say what B/G should be who could take the B/G who could give injections, how much insulin to give and such. I haven't heard of them fighting to make our kids homeschooled.
    If they want to train other personel to give glucagon that would be ok with me as long as they were really trained. Perhaps they could make a little kit that goes in the first aid box that has possibly a sidekick type of meter where the meter is the lid for the strips, some induvidually wrapped gloves, and a few alchahol wipes? Seems like a simple solution, and not a huge road block. If all else fails as far as lancets, and devises, I know they make disposable devises that are harsh, but at that point it wouldn't matter. You could even just poke with the lancet if needed without the device.
     
  4. DustinsDad

    DustinsDad Approved members

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    Maybe a crazy idea, maybe not

    Here's an idea that may lessen the load on staff:
    How about a glucagon delivery system that is more like one of the chemical lights kids use at halloween? Shaft slightly bendable, liquid in a breakable internal container surrounded by a glucagon cylindrical shell that will crumble when bent, and a straining mechanism for eliminating any "rubble" from entering the body along with the glucagon when delivered? It would make a really quick preparation instead of having to inject the bottle first and then the patient. (Just an idea) With the numbers of people needing these things, the market place could bear the weight of some competing styles. Any engineers out there care to take this on?
     
  5. nantomsuethom

    nantomsuethom Approved members

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    A lot of you know that I am one that refuses to let a non-medical person give Thomas glucagon.
    I like Keith's idea. Or if it was in a pen like an epi-pen, I would have no problem training a non medical person to give it.
    I just can't see a person that has never given a shot before mixing, drawing up and injecting a seizing child. They would be so panicked and shaky that they probably wouldn't even be able to open the glucagon kit.
    I work in a school and see how the panic over a nose bleed!
     
  6. Jeff

    Jeff Founder, CWD

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    It's amazing how us non-medical parents are somehow permitted to take our children home from the hospital without a full time nurse at home.
     
  7. jendean

    jendean Approved members

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    Ha Ha Jeff, funny one.
    I can see this from both sides. The problem here is the way that each school district chooses to delegate responsiblilty.
    The problem is that nurses that work at schools have to put their licence on the line in order to train others to do the glucagon.
    Example, the Nurse trains the 4th grade teacher, the music teacher, gym teacher, and two office ladies to do the glucagon. If the gym teacher freaks out and gives insulin instead of glucagon, the school nurse can lose her license for that.
    Not fair, but true.. Schools do not want to pay for nurses, but they want to have all kids with asthma, diabetes, celiac, epilepsy in thier school.
    It is not right.
    strange indeed
     
  8. WestinsMom

    WestinsMom Approved members

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    As a parent that has had to administer a glugagon shot, it isn't rocket science. I had been briefly trained in the hospital and then 2 years later found myself needing to do it. I didn't take the time to read the directions. I didn't "gently swish". I pushed the liquid into the vial, I pulled it back out. It didn't look "right" (since I didn't swish it to disolve it) so I pushed it back in the vial, that did the job. I pulled it back out and injected it. Did I give too much, absolutely! What did it cause? He vomited a few hours later.

    The biggest screw up you can have with glucagon is not using it!
     
  9. Abby-Dabby-Doo

    Abby-Dabby-Doo Approved members

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    I agree with you!
     
  10. Flutterby

    Flutterby Approved members

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    I think the nurse are trying to protect their jobs.. what so hard about a teacher calling the office to get other down there to take care of the 'roudy' classroom while she's working on getting the glucagon ready.. someone can be dialing 911.. I find it hard to beleive the kids in that classroom would be roudy anyway.. they'd probably be just as freaked out and sitting quietly trying to figure out what was going on.. there has to be a system.. no one expects you do to it by yourself.. most schools have an intercom system.. press the office button.. while you are working on glucagon..and like someone said, the only problem with glucagon is NOT giving it.. you can not overdose on it.. I hope to heck I never have to use it.. but sadly, I now the day will eventually come.. and alcohol swab.. at that point.. I wouldn't care.. give the kid the injection.. if they get an infection at the site.. big deal.. I'd rather deal with an infection in his leg than a kid in the hospital brain dead because someone didn't want to give the glucagon injection..
     
  11. Splendamama

    Splendamama Approved members

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    I agree with Jeff. I am tired of being told only "trained personnel" can treat D child. I live with the diabetes 24/7 , I am not a medical professional but I bet I can recognize my childs highs and lows way before a school nurse can. I taught school and had a child in my class that had diabetes. I was told I could not give him his shot, test his blood or treat his lows because I had not been trained!Give me a break! I have been managing my childs diabetes for the past 5 years, inlaws diabetes for 24 years.The school nurse was there once a week. They had the school secretary do this childs medical needs, she was trained by the nurse - a whole 2 hours! If my child went down and needed glucagon, I hope someone- anyone would give it to him!
     
  12. jendean

    jendean Approved members

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    I like how the teacher remembered her "horror"
    Wow. if a glucagon administration was a horror to her, then she should go spend a day in the life of a wartorn iraq, or go back to 1992 and live in Rwanda for a day.
    Tell you what.... one mans horror is another mans, "huh? I dont even remember doing that."
     
  13. troberts1976

    troberts1976 Approved members

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    I know that this is an old post, but I am constantly amazed at the battles between parents and doctors. I've had several instances where my kids were practically ignored by doctors and I knew deep down something was wrong. Come to find out that there was (imagine that). Neither of my kids have diabetes, but I'm the granddaughter of a diabetic, so I'm watching our health very carefully...
     
  14. Ronin1966

    Ronin1966 Approved members

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    Hello Ellen:

    The entire problem goes completely away when the method used is NON invasive (eg big tube cake icing between cheek & gum; whether I'm "seizing" or not)

    Nothing scary, nothing complex, nothing sharp, pointy or spooky looking at all. <reluctant shrug>

    Stuart
     
  15. Flutterby

    Flutterby Approved members

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    Nurses are using this as a position to get what they want. We ALL have been trained in glucagon. What they are failing to say during this 'demonstration' is that you can NOT over dose a child with glucagon. You have a plan of action, someone dialing 911, someone keeping the other kids away and someone doing glucagon, you mix it, let it go clear, pull it up and jab it in.. Its not that hard. I'm so tired of these nurse taking this stance and using OUR children to keep their jobs. The sad this is, is that it makes it harder for us and our children.. the law states only a nurse can do such and such, yet the school doesn't have a nurse.. rediculous.
     
  16. EricaS

    EricaS New Member

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    As a step-mom of a type 1 and a RN, I am sure that being a nurse will not make you any better of a diabetes caregiver than someone who is properly trained. My step-son's mom is not a nurse and she does a fantastic job taking care of him, I am not any "better".

    I think it should be up to the parent to decide who can and can't take care of their child. I firmly believe that the parent is the best resource and decision maker for their child, especially a diabetic child.
     
  17. thebestnest5

    thebestnest5 Approved members

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    You hit the nail on the head!:cwds:
     

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