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In the 504 meeting today

Discussion in 'Parents of Children with Type 1' started by TheTestingMom, Jan 8, 2014.

  1. TheTestingMom

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    The nurse wanted my sons I:C ratios. Does anyone give this info to the nurse for a pump wearer? Then she called me later and wants me to get orders from the doctor. Even his doctor doesn't have his current I:C ratio. I tried to explain to her that they can change at anytime, that the Endo doesn't even have his current ones. I'm totally confused by this, over the past 3.5 years he's worn the pump we've never had the school ask for them.
    Does your 504/nurse/orders include I:C?

    :confused:
     
  2. virgo39

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    Our orders state her then-current I:C ratios and state that parents can change them. Our nurse supervises my DD, so it makes sense for her to have that information. I let her know when we change it as well (she's had to give a shot a couple of times).
     
  3. Mom264

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    Yes, IME the ratios are a standard part of the orders required. I think school nurses are required to have dr. Documentation of ratios and basal rates. (No one seems to understand these can and do change often):(.
     
  4. TheTestingMom

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    Huh, interesting. I just don't know what she would do with them, under no circumstance do I want her messing with the pump settings. True, I don't think she really understood how they can change so often. Color me FruStraTed!
    She also suggested I could just sign a medical release and she could get them. I said a big fat NO to that.
     
  5. Beach bum

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    Same here, and we have on the orders from the doc that parents can change ratios at any time, so go by our instructions. Nurse has used them in order to double check a bolus by hand when she was concerned pump wasn't working (to compare what pump came up with and what she came up with) and when she had to use a shot. Just another tool for her, she won't change anything unless instructed to do so by us.
     
  6. momtojess

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    I didn't let our school have the basal or I:C ratios when Jess was a on a pump. Initially it was on the orders and said parents can change etc but the school wouldn't accept that so we changed it to say something along the lines of use the pump calculator and do as it says. The school argued they needed to know incase something was wrong with the pump. I said if there was something wrong with the pump then I would be coming to pick her up anyway.
     
  7. mom24grlz

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    Our school nurse has Ashleigh's I:C ratios, but like you don't see the point really. I just filled it in because it's listed on the Diabetes management plan the endocrinologist office puts out. I did put a note that ratios are subject to change by parent. Ashleigh does all her diabetes care at school, and the only time she's gone to the nurse is if she needs extra supplies, or if she is having trouble getting a low BS to come up.
     
  8. TheTestingMom

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    Thanks for all the replies. My husband and I have decided to not let the school / nurse have his I:C ratios. We see no reason that she needs to do anything regarding the pump. I don't want her in there messing around with anything or being tempted. If there is an issue we live as well as work less than 1 mile from the school and can be there literally in minutes. We both can always be contacted by cell phone, son has his own phone too. I can't see any imminent danger that would require her to enter into his pump settings. If there is he should be disconnected anyway. He is 121/2 and independent at school by choice, he is very private about his D. He has shown so far that he can manage himself and knows at any point if he wants to change this he can.

    :cwds:
     
    Last edited: Jan 11, 2014
  9. eloquine

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    Argh, this thread scares me so much for the future... He is entering public school next year, I really don't want to deal with issues like this
     
  10. Sarah Maddie's Mom

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    No need really. Most of the threads you will read about school are concerning problems, but that just becuase people never post, "oh, things are great. School is really responsive and I thought I'd start a thread about it!":cwds: The vast majority of kids attend school without issue.

    If it's really got you worried then start to do a little recon now. But in my mom's words, don't go borrowing trouble. ;-) Most schools really want and try to do well by our kids.
     
  11. Amy C.

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    I ditto Sarah's advice. There are way more kids with diabetes who have no trouble with the schools that those who have trouble.
     
  12. Christopher

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    Yes, Danielle's caregiver/nurse has always had her ratios. What is the big deal? Why withhold them? If you have clear instructions what you want the nurse to do or not do, then what are you worried about? If you are actually worried about the nurse going rouge and forcing her way onto your 12 year olds pump, then you have bigger problems than her knowing what his ratios are.

    It seems odd to withhold that information from the nurse and I think you may be setting up a negative situation between yourself and the nurse.
     
  13. mmgirls

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    in order for my dd to attend on the first day of school, the nurse has to have Dr. orders in hand along with the needed diabetes supplies.

    Our districts forms for Dr.s to fill out request ratios and correction factors along with treatment ranges and glucagon info. But this is all on the dr orders not in a 504 meeting. They are separate.

    A 504 is about accommodations, not daily diabetes care.
     
  14. Beach bum

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    I wouldn't read too much into this. Don't set yourself up for a negative situation. Have everything you want on the 504 ready, have the medical plan ready and go in. Honestly, having the nurse have the info isn't that big of a deal, and if you find that they are trying to change things on their own, they are actually hurting themselves because they are violating the written orders of your doctor.

    Pro's of the medical staff having info:
    They have all info on hand in case of an issue where pump cannot be used.
    They have the ratios so that they can double check the child's math if they are learning to bolus on own.
    They carry that info on class trips in the event of a pump emergency.

    Con's:
    If you have an overly nosey team member, they may just blab on and on about how high or low the I:C is.
    They may suggest you change it for whatever reason they feel is neccessary.

    Honestly though, it's not that big of a deal for them to have the info. I think in all of my daughters 8 years of schooling has a nurse ever had to refer to that chart.​
     
  15. eloquine

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    I am hijacking this thread, but it's kind of related. Does a school NEED to have a nurse there ? We live in rural Vermont, and the school has a nurse that comes in once per week to do check up on the supply and answer staff questions.
    I talked to the principal already to give him a heads up about Robin entering preschool next year (I am the librarian in the village, and we work closely with the school... We are in really good terms). He said no problem, we will do a 504 a week prior to him entering school and train staff, but he said they are not going to have a nurse on site.
     
  16. Christopher

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    Look at it this way, do you need to have a nurse at home to deal with her? No because you do it. But you probably didn't know much about Type 1 before she was dx. But you learned. In the same way, someone at her school can be trained to manage her while she is at school. You may find this useful:

    http://ndep.nih.gov/media/youth_schoolguide.pdf

    When Danielle was first dx I printed this out, put it in a three ring binder and gave a copy to the nurse at her school as well as her Principal.

    Your success at school will really depend on consistant, clear communication and documented instructions.

    Good luck.
     
  17. Sarah Maddie's Mom

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    Go check out the ADA website and read through the "Safe at School" section. I really think it would help you begin to understand the terms, forms and standard practices of school and Type 1 ;-)

    http://www.diabetes.org/living-with-diabetes/parents-and-kids/diabetes-care-at-school/
     
    Last edited: Jan 17, 2014
  18. Beach bum

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    Many here have kids at school with either no or limited nursing staff. The key is to have a designated team trained to help care for your chilled. Have a clear, concise plan of action implemented.
     
  19. Amy C.

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    My son attended a private school from the age of 4 until he graduated that did not have a nurse. I trained the staff in elementary and middle school and he was largely on his own in high school.
     

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