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Anyone with a child in middle school with NO nurse/health care staff?

Discussion in 'Parents of Children with Type 1' started by liasmommy2000, Apr 20, 2011.

  1. liasmommy2000

    liasmommy2000 Approved members

    Oct 31, 2006
    Sorry so long!

    Our small school district has NO nurses at all. For elementary school Lia has been cared for by the office staff and for the last few years, an aide who comes to her in class/cafeteria etc and assists her. I know many kids are capable of caring for themselves even in elementary school but with her having ADHD and poor focusing and math skills I have been reluctant to let Lia do this. Especially with gym some days but not others, sometimes having an extra afternoon recess, sometimes not etc.

    Next year she will be in sixth grade at the middle school. I know she is now capable of doing many of her tasks. I am hoping we can try no aide next year as I can see her complaining about having an aide following her around middle school already. Any BTDT recommendations etc? What issues have you had? Anything you would do differently?

    Right now our 6th grade is located in one small wing of an older building that they share with the district's early education program. However there is a possibility they will be moving to the main middle school with the 7th and 8th graders. However I've been assured that even now in the middle school each grade has their own wing, lunch period, lockers etc and are self contained. For the most part they do not see or interact with other grades except at arrival/dismissal. So really it will be a very small environment. We have just purchased a cell phone for her and added her to our family plan. It's Verizon and I have the parental controls so I can block a lot of things and it will be mostly used for medical reasons/to call me. I'm hoping she and I will be able to communicate through text with just the occasional phone call. So with all that here are some specific questions.

    If your child has a phone and uses it to communicate with you do they excuse themselves to the hallway or do they text right in class? I would assume for calls she'd have to go to the hall, but texts?

    If your child is low at class change time do they wait in the class they are in until they feel better or do they just proceed to class as long as they aren't feeling too weak?

    How do you deal with after school activities? Ask the teacher/coach in charge to be trained to assist in emergencies? My concern with this is that in our district many of the classes/activities are in six week blocks and so a new person every six weeks. IF they offer child care for 6th grade which is up in the air now with the building change, that won't be an issue. But they now offer after school activities two days a week in six week blocks and also tutoring another two days for kids who qualify (Lia probably will). We will be uitilizing these if there is no after school child care and will use the tutoring regardless.

    I assume we will still leave the back up supplies in the office as we do now (she already carries her regular supplies with her) and have the secretary(ies) trained in glucagon.

    Anything else you can suggest? Of course now that I think about it, IF 6th grade stays where they are she will be bussed to the other building for the tutoring so we would need back up supplies there etc. Ugh. I am SO not ready for this change esp not knowing exactly where she will be or if there will be child care available etc!!! Right now I work 7 am to 2:45 pm three days a week and can pick her up right after school on those days. The other days either my sister picks her up or my dh or she goes to the child care. But middle school gets out earlier and I don't know if I will be able to convince my employer to let me juggle my schedule even more!
  2. lotsoftots

    lotsoftots Approved members

    Sep 11, 2007
    My daughter is in 6th grade, our school has a district nurse but not one in the building. I made sure I did a 504 plan for her and in that I have that she can use her cell phone at anytime anyplace as long as its to myself or her dad about anything diabetes related, she has a pass so that she can left any class room to use the restroom or get a snack or test herself ( most of the time she just test in the classroom) for gym she does a temp basal works pretty well or if she wants a snack she will just do 10 carbs uncovered..Before school started the nurse came in a trained all the 6th grade teachers that she would have even the elective teachers, plus when a new class stated she gave the teacher a refresher class :O) one of the ladies in the front office helps Samantha out the most if she needs it. We do have supplies in the office, in her locker and in her purse which goes everywhere with her..the only class we keep a box of supplies in is gym since they go outside...the gym teacher was so proud of himself that he remembers to bring her box every time they go outside..lol
    I was really worried about moving to JR but so far so good, they have been great to her and all her teachers watch out for her even the lunch room ladies, no one hovers over her or does reminder or things like that they just let her know if she needs them they are there for her :D
    If you need anything else let me know or if I left something out...lol
  3. Michelle'sMom

    Michelle'sMom Approved members

    Aug 21, 2009
    My dd is just finishing up her 6th grade year. She also is in a middle school with 7th & 8th graders. The nurse shares duties between the middle/high schools, so she's out a LOT.

    DD carries a bag with her meter, snacks, glucose tabs & glucagon (at the school's request). She has a supply box in the clinic, & her insulin is kept there as well. Our 504 plan allows for carrying/using a cell phone & it works very well for us. She texts if she's high to verify the correction with me, or if she's unsure of what to do about activities in gym class. Otherwise, she does everything on her own.

    All of the 6th grade teachers have been trained in emergency care, in part because my dd is the only independently managed T1 in the school & the only one on a pump...there are 4 other T1 students in the school.

    We've had some minor issues, but nothing we couldn't handle quickly.
  4. dejahthoris

    dejahthoris Approved members

    Jan 28, 2011
    When my son was in middle school I had him keep a bag of skittles and his bg monitor with him. He also had other snack in his pack and binder. He could test, eat a snack, call me, drink water and go to the rest room whenever he wanted without asking. There was a nurse but she was not always there. There were 2 people assigned to him who had training in glucagon and basics of t1 to help him if needed when she was gone. The teachers had some basics too, like how to recognize a low and what to do in an emergency and what t1 was. There were extra snacks for lows in all his rooms and special snacks for pe too. He always had a small snack before PE. I made a form to help him and the nurse figure out carbs and corrections at lunch that had his carb ratios and all on it to make it real easy to figure out - I know you dont have a nurse but this kind of form might help your child and whoever helps her "do the math" . We also had the carbs of the cafeteria items.
  5. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Sep 23, 2007
    Oh, Middle school....

    We have a nurse, but Maddie prefers to manage on her own. Yes she has a phone and does text me her numbers and she has called when she had a big issue. But ... and it's a big but, I have seen that it's just not easy.:( No matter how thoughtful one is about laying good plans and setting in place good practices it's a difficult time.

    For one thing, they are rushed. Our school has 4 minutes between classes. This is stressful and really, who can get from point A to point B and god forbid you need to pee or check your bg? :eek: And then there's the needing to fit in business. :cool:

    After almost 2 years of Middle school my advice is to focus on your child. Focus on instilling and understanding that D mgmt comes first and if she's late for Spanish then that's ok. Be very clear in your meetings with the teachers and the administration that D is a high maintenance condition and that your child is assuming a great deal of responsibility and that she needs their support or she will struggle to maintain even bgs and that it will make her school life more challenging.

    Most issues can be handled without a nurse if your child is able to stop and do what needs to be done, but it is, I think, a very challenging time.

    Best of luck!:cwds:
  6. liasmommy2000

    liasmommy2000 Approved members

    Oct 31, 2006
    Thanks for the thoughts. She does have an IEP (for diabetes and ADHD) and this includes mention of a "school plan for a child with diabetes" with everything that would be in a 504. I plan to add being allowed to carry a cell phone, extra time for dealing with D etc to it. I'll meet with the counselor and/or principal before school starts to go over everything. Yesterday we had her IEP meeting and I discussed the basics with the 6th grade special ed teacher. She said extra time wouldn't be an issue at all.

    I plan on packing her lunch every day except once a week. I don't think she should have much trouble on the packed lunch with sticky note of carbs, but hot lunch will probably require a phone call from me even though they can provide carb counts. Everything is self serve except the main entree so I need to work on the whole eyeballing serving sizes with her this summer.

    I'm sure some tweaking to any plan we come up with will be needed once we set this in place. I just hope we can get it pretty well down pat to start.
  7. PatriciaMidwest

    PatriciaMidwest Approved members

    Mar 2, 2010
    I agree with Sarah's post. My DD is in 8th grade, we have a nurse but she prefers to be on her own. It IS hard because as Sarah said there is just 4 minutes between our classes too, and they want to be just like all the other kids. It takes a lot of reinforcement from my husband and I to keep her on track, as well as a lot of communication with teachers...but it is definitely worth it for her to have some independence and control.

    My DD texts us her numbers and I respond back if she needs to set a temp basal or tweak something.

    I would push to have someone in the school office fully trained on D care. She needs to have a place to go if she gets really low and isn't feeling well.
  8. Jordansmom

    Jordansmom Approved members

    Aug 23, 2008
    My DD was dxd at 12 and the day after she was released from the hospital the Endo expected her back at middle school. They have no nurse or any medical supervision. It was the longest day of my life.

    My DD carried her meter and glucose in her binder. Insulin and supplies were in a drawer in the office. The school provided a print out of school lunch carb counts. But by the time she was even half way competent at guestimating, she knew their counts were way off. She had a cellphone and texted me when she felt off or needed help. If she was low, I'd make her retest and text me again when she came up. She tested and texted me in class. If she rarely needed an actual phone call, she'd ask to go to the bathroom. Unless she was really low, she'd move on to the next class when the bell rang.

    She was already cast in the school musical and she had to immediately stay after for long rehearsals. That scared me more than school. I sent a lunchbox full of snacks with the carb count on each item and told her to test and eat a snack after school-before rehearsal.

    I'm not sure what my advice would be if I'd had other options. I just wanted to say in hindsight, my DD has done fine at school entirely on her own, and prefers to be independent of any office interference.

    The cellphone was critical, and eventually when we got a Dexcom, I felt immensely more comfortable with the after school activities.

    Good luck.:cwds:

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