Kindergartner testing in the classroom-- is that a reasonable request?

I've only talked very briefly with Charlotte's teacher next year and the nurse's aide. Before I fill out their paperwork and request a 504 plan, I've been trying to decide what expectations I have for next year. She'll only be there 3 hours, so hopefully D won't be too complicated this year.

I gather from my brief conversations that all D stuff is taken care of in the nurse's office. However, the kindergarten room is about 75 yards from the nurses's office. Is it reasonable for me to ask that if Charlotte feels low that she be able to test herself in the classroom, instead of walking herself to the office with a friend? She can test herself, though she only sort of knows what the numbers mean. And she knows she needs juice when she's low.

I just worry it's that it's a long way to walk for a child who feels low. However, that means the teacher will either have to a) call the nurse from the office or b) know enough about D to treat a low in the classroom herself. There is an aide in the classroom, but I don't know how much she's in that classroom

 

I would say that at her age the reasonable thing would be to say that if she feels low (or otherwise 'off') that a TEACHER or aid or other adult, must walk her to the nurse, not another child. that's always been what has worked for us at younger ages. So not another kid. no way on that one.

I think that if she's capable of testing and then treating, then that's one thing, but the fact that she'll have to stop, wash her hands, check, tell the teacher, the teacher will have to help her get a juice or call the nurse, etc, seems like it would be more trouble than just saying "I need the nurse" and having an adult walk her down. 75 yards isn't really huge, all things considering.

 

That's a good idea. But I'm not sure if their aide is full-time or if there would even be another adult available to take her to the office. But I will find out about that.

Also, depending on the low, there are times I couldn't get Charlotte to walk 5 yards, let alone 75. She can get very whiny and uncooperative.

 

We had a similar kindergarten set-up - the nurse was very close. William walked to health room and the teacher would watch out her door - or he would go with an adult. Our 504 says he is either escorted by an adult or observed by an adult walking to the health room. I personally didn't want to rely on the teacher to be responsible for a low - how much to treat, retesting after 15 mins, etc. I like to know that a trained person has their eyes on William while he is coming up from the low - not distracted by a classroom she has to teach. This does involve having the teacher getting her to wash hands, get out the stuff, test, verify the number, treat, record the info, time for a retest and keep an eye on her. Depending on how frequent the lows are - I think that is a lot to ask of a teacher and negatively impacts the class.

If she is uncooperative when low, would she even agree to test?

I would have the doctor add that if the child refuses to (.... either test or go to the nurse, etc) that the teacher is take some course of action. This could be to call the office and ask that the nurse come pronto with supplies, or it could be that the teacher gives her a juice box - and then calls the office and have someone come to her.

William has never been uncooperative during a low (even when severely low) so refusal to budge or cooperate would get an emergency response. He also keeps juice, tabs, etc. in the classroom (as well as a test kit, glucagon, epipen cause he has anaphylactic allergies). The teacher IS trained on how to do all these things but only in an emergency. In fact all of his teachers are trained.

I think I may be in the minority on this issue but I prefer William is seen in the health room until is he is responsible and mature enough to handle the whole thing himself appropriately.

YDMV for schools without health personnel, huge campuses, etc.

 

Hmm....

K is age 5 or 6 right?

If Caitlin were that age, I wouldnt want her to test in classroom. I would want her testing in the nurses office.

I would look into a 504 plan that explains itd be better for her to test there (and even if she CAN test herself, perhaps have a nurse do it)

JMTC

Jason

 

I agree with this as well. There are too many things that can go wrong in the classroom - clueless (although well meaning) teachers, substitutes, etc. Now that my son is in middle school, he checks in with the nurse only once a day, but prior to that he went to the nurse for all checks, treatment, etc.

To the OP, would it be possible for the nurse to come to your daughter when she is feeling low? That might be something to consider as well.

 

When Adam is feeling low, either the kindergarten aide walks him to the nurse or, if the aide is not there, the health assistant will walk down to the classroom to get him. He never walks by himself...for just a regular BG check, he brings a buddy.

Adam hates to leave the classroom to test, but it's just a necessary evil we deal with. When Adam is low and he has to stay in the nurse's office for his BG to come up, they make it fun for him. He gets to bring a buddy and they play legos. I think the other kids actually LIKE being his buddy, because they are always asking if they can be his nurse buddy for the day!

At the beginning of the year, there is no way I'd let Adam test in the room - he didn't know what the numbers meant at that point. And another big reason was that he just did not enjoy being the center of attention, and the kids were ALL curious. He prefers to do it privately anyway.

 

My daughter is in all-day K this year. There is a full time aide in the class and she walks her to the nurse 2-3 times a day. If she isn't available, the teacher calls the nurse to get her. It's a hike and I don't think another child being the escort would be the way to go.

Our first grades don't have an aide in the classroom, so I've been wondering about our next year's logistics too. I have a feeling they're going to put her in the classroom next door to the nurse's office because it happens to be a first grade classroom.

I'm wondering if at some point next year Caroline can start testing herself in the classroom if she feels low. I was thinking of putting a simple rule in place like "under 100 tell the teacher" so the nurse could be notified... haven't thought it through really, but she has taken to going to the nurse every morning saying she feels low and BG seems fine. It's hard to tell if part of the visit is for the fun of it and I thought self-testing may take that part of the equation away. It may be a whole different ball of wax come September though so I'm just playing with different dynamics in my head. Sorry for my rambling!

I don't think Caroline has ever felt too low to walk at school (knock on wood) and that may be why we haven't looked at having the nurse test her in-classroom. They may have no choice in your case though, if they see her as you described. Sometimes you can't even lead a camel to water, you have to bring the water to it

P.S. I'm not comparing your adorable daughter to a camel

 

Obviously not all lows are created equal. I've never seen Charlotte lose cognitive function, like is sometimes described with lows. She can get whiney ("MY BELLY HURTS!") and uncooperative, but she can still test herself. I sometimes wonder if she puts on more of a show just for me, and that she'd be more likely to be embarrassed to act that way for someone else. Because even when she's low and whiney, she can still be encouraged to test herself and do it okay.

This does give me a lot to think about. I definitely don't want to burden the teacher. I've been a teacher, and I know it's hard a classroom full of kids is. My worry is that if she's already feeling low, the few minutes it takes to walk to the nurse are minutes that could be spent with juice already in her belly bringing her bg back up.

I need to ask about this, but this is a good idea.

 

Our situation this year was similar, and our nurse would not come to the classroom for one reason:

There are hundreds of kids in the school, anyone could have an emergency at any given time, and she needs to be able to be found, in her office.

I agree with the previous posters about having an adult walk her down, not another student.

We started the year with Brody having smarties in his pockets so that he could munch them on his way to the nurse, but after the first few weeks, we didn't even do that. His teacher would take him (and have one of the teachers across the hall watch her class for the minute it took her to run him down there.)

 

The nurse (or someone else that is trained) goes to the classroom to test Charlie if he feels low/high. If he is low or high then he walks back to the nurses office with the nurse and they take care of him there and then walk him back.

 

When Hannah started kindergarten I wanted her to test in the classroom. The nurse convinced me to let her go to the nurse's office (escorted, of course) at least for a few months. I found out that was a great idea. It meant that the nurse got to know Hannah very, very well and is able to give her the absolute best care possible. Hannah is finishing 1st grade and even though she is very mature and capable, she is still going to the nurse for her checks.

 

She'll be wearing a CGM everyday, hopefully. So what about asking the adult taking her to the nurse to check her CGM and if it says she's low or if her BG is dropping, to give her a juice to drink along the way? After just a couple hours at school, the CGM is likely to still be mostly accurate. Then they can test her at the nurse's office and wait for her to come up there.

 

In our kinder class the was almost always a parent volunteer everyday, so asking that if she is feeling lowthat an adult escort be used I don't think would be an issue.

For everyday snack and lunch checks we had a front office lady go to her class room and get her and take her to the nurses office for bg checks and get her snack. Much easier to get someone else to put in there scheduale those times than the nurseing staff or kinder staff.

If my dd really felt low or looked low in class I would have her have a juice box in class without testing and then get her to the nurses officeto test. If she looked bad we would have her test as soon as she got down there so we would know how low she was. If she looked ok then we would wait 15 minutes and test and then figure it out. Sometimes she was not really low and just hungery.

We had CGM in kinder and that was very helpful. We actualy did not test or have the kinder teacher do anything with D care except for keeping an eye out for clues to lows or highs and listening to McKennawhen she said something beeped. Actually we did the same thing in 1st grade Not sure how 2nd grade will go next year, we will set it up that same as this year and after the first week we will see where we can adjust the plan and if possile include the teacher and McKenna in the process.

 

Yes, this. There are times it simply would not be possible for the nurse to go to your daughter.

I know most people feel differently, but Jack has never had an escort to the nurse. If he was symptomatic, I'm sure his teacher would not send him alone, but since kindergarten if his CGM alarmed, he was sent to the nurse, end of story. Frankly, he's in a lot more danger of passing out alone at home in the basement or the yard or something than he would be passing out in the hall at school. He does go to a small school, and his classroom so far has been in the same hallway as the nurse's office, which obviously colors my view on this quite a bit. We also have predictive low alarms on our CGM and the ability to set the low threshold a bit higher while he's in school, which also helps.

I think it comes down to whether or not you want to have your child wait for an escort to the nurse or not. For me, I'd rather have him down there quickly, and based on my experience with him, I'm not worried sending him by himself.

 

We only had the CGM to alarm low, Dexcom set at 90, which is a perfectly healthy number but if that low I would rather her get tested and have her snack or an extra drinck to bring her up a bit.

If the CGM alarmed we would have the teacher look at the display and ask mcKenna how she felt. If arrows down or she felt low we would have her have a juice and an adult eascort to the nurses office to be tested and wait 15 to be tested agian and then a snack if needed.

If she felt fine and just alarming 90 and not dropping then we would have her go to the nurses office to be tested down there and resolved.


With the CGM it allowed the teacher to not be as involved in D care but letting everyone involved to feel like there was a system in place to prvent bad low from happening.

If the CGM was not on or not working well I would let them all know so that they could be extra carefull.

 

I'm glad I asked the question here first before insisting on it-- you've all been helpful. I think I'll just ask that an adult accompany her to the nurse's office. I didn't think about the additional help of parent volunteers. Our school actually requires a certain amount of parent involvement. I know there was a signup for daily classroom help (I couldn't because I babysit during the day) but there may be a parent in the classroom for most of each day as well. I'm not sure if there's an extra adult when they go to P.E. I need to start making my list of questions to ask.

 

I would not ever allow your child to go to the nurse by herself or with another child when she is feeling low Jared did this when he was in 1st grade and ran into a wall because he was so disorientated he hit his head and had to have a cat scan luckily he was alright and another student saw him and got a teacher to help. Also do not allow you kindergarten to test and reli on that number being accurate when Jared was in 5 th grade a teacher had him test because he said he was feeling low the omnipod said he was high and gave him a correction which unfortunately made him so low he had a seizure and had to be given glucagon. Our policy to this day is Jared's bg is checked by an adult whenever he feels low or double checked by and adult if it is high. Also remember that as nice as Cmgs is it is not as accurate as bg testing and should not be relied upon to treat highs or lows.

 

As I have mentioned before our school does not have a nurse on site every day so the day to day things are handled by the school secretary (she needs a raise due to all of her resposiblity IMO).
After Dx in Jan we trained her and our son's teacher how to the meters and gave them a sheet of what to do when his BG was in certain ranges. The Endo's office also had us put on a care plan for him that he not be allowed to go to PE or recess unless his BG was 120 or above and he could not ride the bus home unless his BG was a certain level or above too. So the school secretary had to test him 4 times a day while he was there.
She set an alarm at her desk on when to go and get him from the classroom each day and a couple of the times he was to be tested they were walking past her office anyway so he just ducked in there quick and then got in the back of the line when he caught back up to them.

 

Sophie is older than your little one, but she can test and treat in the classroom if neccesary, but 90% of the time she goes to the nurse to do so. If she'd been the same age as your daughter, I would have insisted that she be escorted to the nurse or the nurse come to her, only because of the way our school is set up. The K and 1st grade classes are behind our main campus and seperated by a playground, and she'd have to go up two flights of stairs to get to the nurse. But like I said, that's how our school is set up.