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Does this seem odd?

Discussion in 'Parents of Children with Type 1' started by KylorsMom, Jun 11, 2013.

  1. KylorsMom

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    So we have had our little guy at a new daycare for about 2 and 1/2 months now. I held a training class for them about Kylors care, and then they had a diabetes educator come in a do a class. But the director still has us coming in for every meal to give insulin.
    I really did not mind at first. I thought it would be good to get them trained on the job so to speak, myself. And don't get me wrong they are AMAZING! But we are spending nearly 25% of our income to send him there and having to leave work twice per day after they have had tons of training.
    I know that in public school the rules are pretty plainly set out (most of the time) but what about daycare? The girls who care for him were actually administering the insulin for two days and doing great, but then the director freaked our and said they did not have enough training.
    Any thoughts?
     
  2. Sarah Maddie's Mom

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    Is this a private daycare?
     
  3. DavidN

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    Can you manage the insulin delivery over the phone? Use them as a tool, like a syringe or a pump. They give you the BG and carbs and you verify the bolus etc ....

    This is how we do it with the school.
     
  4. Amy C.

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    I would meet with the director to state you want them to give the shots and what needs to be in placed for this to happen.
     
  5. momof2marchboys

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    If you are not using pens I would suggest using pens over the vial and syringes - our school loved the pens b/c they were more comfortable knowing they had 2 units or 5 units and not having to draw up insulin out of the vial

    As for them giving him the insulin if the ones that are with him all day feel they are comfortable giving him the insulin then sit down with them, the director and yourself to get a plan - like for our school they were text me each day what the carb count was for each item in his meal and then we did his insulin after lunch so we knew what he ate for sure. I made a cheat sheet for them to use for the carb ratio and correction factor that they used to calculate his insulin and if they had any questions they texted or called me. At the end of each day they emailed me a log of his blood sugar tests from the day and his carb intake and insulin amounts given.
     
  6. shannong

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    I would meet with the director and let them know that you want them to do the shots. I suppose at that point they have the option to refuse to do the shots (if it is a private daycare, not sure they could refuse if it was a public daycare), but I think more than likely they will be willing to do them and perhaps it was just not clear to them that you wanted them to now take over doing this. I don't think they should make decisions however about the dose - similar to what other people have said, my son's school would always call me at snack and lunch time to tell me his bg and then I would tell them the dose. My son would administer his own shot, but clearly a 3 yr old cannot do that. Good luck. I'd bet if they have been amazing, they will be willing to work with you on this.
     
  7. CAGrandma

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    If the school receives ANY federal funding - it could be a subsidy for pre-school, or food, etc. - then they have the obligation to provide a safe place for him to go to school. Which means they have to find a way to do his shots too.

    If it is a purely private school then you have to negotiate with them and set up a program that will work for them. Do they want a couple of people really, really trained? Do they think the pen would work better? Do they want you to do all the calculations and talk to someone over the phone? What safeguards would make them comfortable? Basically - what specifically are they afraid of.
     
  8. KylorsMom

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    It is a public daycare, I know they do receive state funding. We are using the pens, and actually they do everything but give the shot. They count the carbs and do the math. Then they have another teacher double check the math. The center calls us anytime they have a question, or if his number is below 80. I really feel that the director is afraid of something going wrong and liability.
    My endo has offered free training but they are about two hours away so the center doesn't think that will work. The director did try to contact the public health nurse who was completely unhelpful, called the school district nurse who was too busy and then I called the diabetes health educators who gave training but would not "sign" anything saying the training happened. Not sure why something needs to be signed but the director seems to want that. In all honesty I think it boils down to her being afraid of the shots. We are in the process of getting approved for the animas ping, I am hoping that helps but I am wondering if they would refuse to give a child a shot from an epi-pen if there was an allergy due to non-suficient training, because it's pretty close.:mad:
     
  9. MomofSweetOne

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    No, epipens are FAR worse than insulin syringes in my experience. And I'm still needle-phobic and have gone back to being dizzy with syringes now that my daughter is pumping. With epipen, you're already dealing with a major crisis. With an insulin pen, you're avoiding a crisis. Big, big difference....and needle size!
     
  10. Mish

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  11. KylorsMom

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    Ok so I have done some digging, and now am more confused than ever.
    So I found this:

    http://www.diabetes.org/assets/pdfs...ed-to-insulin-and-glucagon-administration.pdf

    I am in Idaho and under the heading "may insulin injection be delegated" this is what it said:

    IDAHO
    ADMIN
    CODE R 23.01.01.490
    (06)(b)(2) (2009) (administration of
    injections may not be delegated).

    Does this mean that we can't have anyone else do it? Guess we all have to add "laywer" to the list of new job titles that come with being a parent of a CWD :rolleyes:
     
  12. hawkeyegirl

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    I'd guess that statute means that a nurse must inject the insulin. But that's the school's problem, not yours.

    As an aside, I believe even private daycares have to administer insulin. I'm pretty sure that's what the big Kindercare case from a few years back held.
     
  13. KylorsMom

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    Really? So do they have to have a nurse? I think I may have to call the ADA
     
  14. shannong

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    Have you started with just asking them to do the shots? Have they refused? The reason I am asking is that when my son started going to school I spent a lot of time looking into the laws regarding whether teachers will administer glucagon (they won't), but my son goes to a private school. I really ended up over-thinking things regarding how I would advocate for the rights of my son, but when I asked his teachers if they would administer glucagon, right away they said "yes, show us how to do it". I'm hoping that you have a positive response too.
     
  15. hawkeyegirl

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    Well, I hate to say for sure, but that's the impression that the linked website gives. ETA: Now I'm less sure. I think nurses are prohibited from delegating the delivery of insulin, but I don't see anything prohibiting a non-medical professional from delivering insulin. That is to say, if they had a nurse on staff, I don't think that nurse could delegate the shots to a non-medical professional. But I don't think it necessarily means that a non-medical professional can't do it if there is no nurse on staff. I think before you call the ADA, I'd meet with the daycare and just say, "So when do you think you guys will be comfortable giving the shots?" Like of course they WILL do it, and you're just confirming when that will be. ;)

    If their answer is unsatisfactory, then I'd contact the ADA. I don't know how your state statute will affect things, but I really am pretty sure that even private daycares have to administer insulin under the Kindercare case. The fact that your school gets federal funding makes it a no-brainer. They HAVE to do this.
     
  16. Amy C.

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    The Kindercare case covered testing, not shots.

    Getting their cooperation is the best way to go.
     
  17. hawkeyegirl

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    Ah, you're right. However, in this case it's a moot point, since the school does receive federal funding.
     
  18. mmgirls

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    No it does not mean that there has to be a nurse on staff, It could be a school district nurse that is off site. That nurse would have to come up with a delegation plan that is based upon "doctors orders" and then train and verify the assigned person that they are compitant of following the delegation plan. Once they sign off that they can follow the plan then the assigned person is working uder that nurse's licence.
     
  19. KylorsMom

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    UGH! This whole thing is just ridiculous! As if there needs to be anymore uphill's with type 1!! Our T1 support group leader is an RN, an ADA mentor and on the board st the t1 camp and has offered to come in and do another training session. I e-mailed the director all of this information, so I am hoping this will be enough. As it is Last week I totally forgot to go by after breakfast and then this morning my husband forgot. He runs around a lot so was only in the 180's but still, I felt like a HORRIBLE parent. It is just not hard at all to give the insulin, I don't know why it's such a fight!

    Sorry just one of those days
     
  20. greenpalm

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    Hilarious! Sorry you are having trouble.
     

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