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My son constantly visits school nurse

Discussion in 'Parents of Children with Type 1' started by DsMom, Nov 9, 2010.

  1. DsMom

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    Hi! I'm new here and have no idea if I'm doing this right. I'm looking for some advice from parents of Type 1 kids in grade school. My first grader son is on an insulin pump and was diagnosed 2 years ago. Since starting full-day school in September, he has been visiting the school nurse way too many times a day. He must go to be checked before recess and lunch and if he has gym--but he also goes if he feels slightly hungry, has "tummy aches" (which I think are suspicious), his site itches, he has a bump on his leg, he's tired, etc. The nurse checks his BG, and although he is high at times, he is never low and the visits are rarely warranted. We never need to check him as much on the weekend as he is checked at school. I obviously can't forbid him to go to the nurse and have tried to tell him how important it is to tell the truth. I know he is abusing his need to visit the nurse and he is missing way too much class time. Anyone else gone through this? Were you able to stop it---and how???

    Thanks!
     
  2. suz

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    My son is also in first grade. He tests in the class room, and if the numbers are out of range then he will go to the nurse.

    I guess you need to figure out why your son wants to go to the nurse so often. Does he complain to his teacher who then sends him to the nurse? You might want to have a word with his teacher and ask her to use her judgment - maybe if she tells him no a couple of times he'll get the idea? Or maybe you need to find a way for him to make-up the time he is missing in class .... 3 (unnecessary) nurse vists a day at 10 mins a time = 30 mins of chores at home or something?

    We have instances when Kieran will say he's low because he wants some candy or gluc tab, and needs the occasional reminder that he can't use his D in that manner!
     
  3. selketine

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    This is difficult - he is young and still learning to cope with this disease and perhaps learning to tell the difference between a high, a low, and what is normal.

    I would discuss whether there are other issues sending him there (like if he always goes during math - does he dislike math? dislike a teacher? bothered by a student he sits next to?). I encourage my son to go if he needs it but to be careful not to go for other reasons. I think it is a fine line to walk - you want him to be able to take ownership of his disease and feel like someone will always listen if he has a problem. Stomach aches and tiredness can be signs of highs and lows both - or just being hungry! I would work with him slowly and in a positive way and encourage the school nurse to do that as well - and not discount what he feels but help him understand it.
     
  4. Sarah Maddie's Mom

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    My dd missed much of 2nd grade because of semi-social visits to the nurse. :rolleyes:
    Turned out that her classroom teacher was in over her head and the classroom just felt too chaotic. I didn't understand this until 2/3 into the school year. :eek: So my advice is to talk openly with your son about the school day and how he's feeling about school. And I'd schedule a meeting with the teacher and a separate meeting with the nurse and once you've heard all three views maybe have a meeting with everyone present to discuss the plan for going forward.

    Nothing punitive, nothing critical... just a simple team get together to help your son understand that all the grown-ups are working together to keep him safe and feeling good and to make sure that he's having a good productive time at school.

    Good luck. :cwds:
     
  5. frizzyrazzy

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    my son is in love with our nurse. ;) Maybe yours is too???? lol

    anyway, I"d maybe ask the nurse to go to him for a few weeks which will remove the whole benefit of leaving class. Also, something to think about, if he's new to the school he may just still be working on his own personal comfort - he may be just a little timid about being away from home and may need that reassurance that he's ok. :)
     
  6. swellman

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    My son really likes our nurse - I think he is using her as a crutch to avoid testing in the classroom as he is still VERY self-conscience about it. I would consider whether your child might be embarrassed about testing in class but it's possible, since he goes for every little thing, that he might be worried about being on his own. I would also consider if it's the teacher doing the sending.
     
  7. frizzyrazzy

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    this too for us. :) He simply doesn't want to test in the classroom. At home he's fully capable of self testing.
     
  8. Lisa P.

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    Another thought is if the work in class is too easy for him. He may be bored, have lots of lag time, and be "self-directing" by using that time to go a'walkin instead of sitting bored or distracting other kids.

    There is a huge disparity in learning levels in most first grade classrooms. If he needs more of a challenge he may be unaware of it himself. If you think this is an issue, he may be able to join other grades for some subjects or even a gifted program (although they usually won't do that until third grade) and that might relieve the wanderlust!

    Also, the stomach aches, he may actually be having some issue that is making him uncomfortable -- Celiacs or food allergies come to mind. Kids who are active and self-directed at home sometimes find when they have to sit for long stretches in their school desk they feel fidgety if they have a bit of stomach or other issues. He may genuinely feel the need to talk to the nurse but not be completely able to explain why.
     
  9. HBMom

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    This may or may not be helpful, depending on the reason your son is visiting the nurse, but my non-d daughter (she is 10 - in 5th grade)has "tummy aches" at school so we bought her a "stress ball" that you can get at sporting goods stores. She keeps it in her desk, and when her tummy hurts, she quietly squeezes the ball, and then finds that her tummy often stops hurting. She has come to the conclusion that sometimes her tummy hurts because she is worried about something (I was surprised that she was actually able to express this without me having to pull it out of her). So, it has definitely helped.
     
  10. StillMamamia

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    Is your child shy or reserved? Maybe he's using the visits as a "comfort bubble" to get out of the classroom. That could explain some of the tummy aches too - feeling uncomfortable around others and such.

    Not saying this is the reason, just throwing this thought out there.
     
  11. virgo39

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    When DD first started at her new kindergarten class, she visited the nurse all the time. I think once she had a sense of trust that she'd be taken care of, she didn't feel the need to go so often.

    Right now, in her first grade class she's been doing the same thing. With her, there are a couple of factors: chaotic class, fabulous nurse, nice nurses office, wanting to go home because her best friend or other friends in school went home sick, being overtired, etc.

    I just came back from dropping aceteminophen off at the school, so the nurse could give her some at lunch time for a headache. The nurse mentioned that she thought DD tended to come to her at about the same time of day -- she is going to ask the teacher what is going on in the class at that time on those days and I'm going to talk to DD about it.

    But frankly, as long as we have a competent school nurse, I do not want the teacher to be making judgments about managing DD's D, kwim?

    It's a challenge because it can be hard to talk about with DD in a neutral way, but that's my goal, and then to address the issue.
     
  12. DsMom

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    Do you mind if I ask when your son started testing on his own? Daniel is a very "young" six year old, and, although he seems to know the ins and outs of his pump (we also use the Ping), we haven't started him testing himself yet. I'm always curious when most kids start.

    I have brought up the issue with his teacher, who was also the teacher of another Type 1 little boy a couple of years ago. That boy has a lot of problems with lows, and went to the nurse all of the time. I think that made her a little nervous, so she lets Daniel go and sometimes recommends that he go. Although of course Daniel does go low sometimes, it's not a huge problem at home. I'm 95% sure he's just going to get out of class most of the time. He's a mischevious little guy and not loving first grade all that much! I wish I could agree with the suggestions that he is shy or bored with class or his tummy really does hurt--but I think he just playing the system!! Of course, like I said, I can't say "Don't go" because he absolutely should go if he feels low--which he is VERY good at recognizing at home--he's right about 90% of the time! I should have been more specific about Daniel's personality in my post--he's charming and sweet but totally tries to get away with whatever he can!! :)
    Thanks for your help!
     
  13. hawkeyegirl

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    My son is in 1st grade and doesn't test himself yet at all. He has no interest, and I figure that there's plenty of time for that.

    I think Jack occasionally uses the nurse as his "mom away from home." He's really comfortable with her, and in 1st grade, they're still little guys, ya know? But I agree that if your son is missing a ton of class unnecessarily, you should try to figure out a way to curtail the nurse visits a bit.

    Does the nurse "mother" him? Does she let him get away with turning a 30 second BG check into a 10 minute visit? I guess I'd start with her and get her on board with making his nurse visits as quick and non-fun as possible. Just a quick wash of the finger, poke, and back to class. Maybe if she can do that, he'll realize that the unnecesary trips aren't worth the effort. :)
     
  14. StillMamamia

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    Does he have to go to the nurse to test??

    Could, as Karla mentioned, speak to the nurse and set up a system to not make testing so "appealing" (for lack of a better word)? Like having her come to class?
     
  15. willie's mom

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    My son would visit the nurse just to take a break from class. I spoke with the teacher without my son's knowlege and asked her to send his work to the nurse. He mysteriously did not need to go to the nurse as much when he had to do work while in there. I would ask the teacher to "screen" his visits to the nurse. Maybe he could check out the bump on his leg the next time the checks BG....
     
  16. simom

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    My son is in first grade. His classroom is far from the nurse's office. He was visiting the nurse quite a bit (she is great!) and we were never sure if it was boredom, his relatively new recognition of the feeling that he is "dropping" (which he sometimes confuses for a low) or something else.
    After talking to teacher and nurse, we've decided to have him test in his classroom. If he is low, or high, he goes to the nurse. If he's in range, he stays in class.
    I don't know if he is testing QUITE as much as at the beginning of the year - but he still does an extra test some mornings.
    Most important to us was to acknowledge that he was listening to his body, and we absolutely didn't want to discourage that.

    In answer to the question about self-testing - he learned at D-camp last year, and developed more and more independence over the last year in doing that. We still test him at night (and sometimes if he's busy watching TV) but he also does a lot of his own tests.
     
  17. Corinne Masur

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    Is there any possibility that your son could be feeling anxious? Does he have worries about going low? Or high? Or maybe other worries about school? It's possible he is using his visits to the nurse in order to get comfort and reassurance. If this is the case, then it would be great if you could find other ways to address his anxiety and it's source.
     
  18. Caleb's*mom

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    My son frequented the nurse's office at school too. A lot of the times he thought his BG was low, and it turned out to be on target most of the time. It actually made him mad that he was wrong lol I think it might just be an exuse to get out of class.
    How is the pump doing for your son?
     
  19. jules12

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    My son is now in 5th grade and this is the first year to test in the classroom - he had no desire to do so prior to this year. Therefore, if your son isn't ready, I wouldn't push him into testing in the classroom. My son wouldn't even eat a snack in the classroom if others weren't.

    It takes time for all three of you - your son, the nurse, and you to figure out when to go to the nurse. It's a little scary for everyone and I know our nurse at the time would never ignore any little symptom from my son. Many times I would get a call to come get him in the first year for a tummy ache, etc but he was fine when he got home. She just wanted to keep him safe.

    You might want to revisit the classroom schedule and see if you need to work in an extra check around some break times or transition times to avoid missing class time. If he is going down 4 times a day, go ahead and setup those times and then you can always back off the number of times.
     
  20. twicker1

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    To answer when MY son started testing on his own, he was in K4. About 9 months after dx. By the time he was in kindergarten he was doing his own tests at school, MUCH to my surprise. I had told the nurse at the time that he would probably want her to do it for him, and found out later that he was getting upset because she wouldn't let him do it. I had to clarify that I was under the assumption he wouldn't do it because he wanted ME to do it all at home. Still does...

    Fortunately, until 3rd grade, the 5 billion trips to the nurse didn't really cause that much disruption in his work, and the nurse was close to his classroom. And YES, I KNOW he was using his BG as an excuse to get out of class, but there wasn't really anything I could do about it. In a way, I kinda felt that if that was the only perk he got out of having D, and his grades didn't suffer, so be it.

    Last year, 3rd grade, we were rezoned to another campus. His classroom was pretty far from the nurse, and he started missing A LOT of classroom time, but his grades were still fine. Last year, we also implemented HIM calling me from the nurse's office with his reading. The nurse and I discussed a loose timeline on helping him become more independent before he gets to junior high, and thought by this next semester we would have him testing in the classroom.

    Well, THIS year, the class is CRAZY busy, and by week 2, we realized that him going to the nurse cut almost 30 minutes out of his class time everytime he went, and he was missing everything! He was SO far behind on all his work. We immediately started having him test in the room. Again, we are fortunate, and I believe most schools are, in that there is a phone in the room. He calls me from the classroom with any BG tests, and amazingly, his tests have been cut in half! ;)

    Now, I don't know if he feels more secure with all his stuff right there, so he doesn't have to worry about getting to the nurse in time, or if we've cut out the "fun" of leaving class. I'm betting it's the latter. He still goes to see her immediately after lunch for carb counts, but that's it.

    Maybe you can start talking to the nurse about a timeline. Maybe after Christmas, or sooner, having him check his BG once a day on his own, and build up. But not if he's truly not ready to do it himself. I know that doesn't cut out the visits, but honestly, at this point... well, my feelings are you want him to KNOW that he will never be denied access to the nurse. I DO like the idea of having him take his work with him though! :D

    And by all means, if the nurse is available to make it to his room, have her start going to him at certain times! That was not really an good option for us.
     

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