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Possible IL law saying Principals and Secretaries can give insulin

Discussion in 'Parents of Children with Type 1' started by TimandDeeda, Apr 1, 2010.

  1. TimandDeeda

    TimandDeeda Approved members

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    I was hoping to get your thoughts on a new IL law that is about to be voted on. This law says that school administrators trained in Diabetes will be able to administer Insulin. This law will basically eliminate school nurses. Below are some of the main points of this law: Sorry about the alignment below, I had trouble copying and pasting the doc.

    "Delegated care aide" means a school employee who has
    agreed to receive training in diabetes care and to assist students in implementing their diabetes care plan and has
    entered into an agreement with a parent or guardian and the
    school district or private school."

    (a) Delegated care aides shall perform the activities and
    tasks necessary to assist a student with diabetes in accordance
    with his or her diabetes care plan and in compliance with any
    guidelines provided during training under Section 25 of this
    Act.
    (b) Whenever a delegated care aide has a question about a
    student's care, or when an unexpected snack or meal requires a
    dose of insulin not anticipated by a student's diabetes care
    plan, the delegated care aide shall consult with the parent or
    guardian, school nurse, where available, or health care
    provider to confirm that the insulin dosage is appropriate
    given the number of carbohydrates to be taken and the student's
    blood glucose level as determined by a glucometer reading.
    (c) The principal shall facilitate compliance with the
    provisions of a diabetes care plan during all school-sponsored
    activities.
    (d) Delegated care aides are authorized to provide
    assistance by a student's parents or guardian and the school
    district or private school.

    (b) Delegated care aides shall be trained to perform the
    tasks necessary to assist a student with diabetes in accordance
    with his or her diabetes care plan, including training to do
    the following:
    (1) check blood glucose and record results;
    (2) recognize and respond to the symptoms of
    hypoglycemia according to the diabetes care plan;
    (3) recognize and respond to the symptoms of
    hyperglycemia according to the diabetes care plan;
    (4) estimate the number of carbohydrates in a snack or
    lunch;
    (5) administer insulin according to the student's
    diabetes care plan and keep a record of the amount
    administered; and
    (6) respond in an emergency, including how to
    administer glucagon.
    (c) The school district shall coordinate staff training.
    (d) Initial training shall be provided by a licensed
    healthcare provider with expertise in diabetes or acertified
    diabetic educator and individualized by astudent'sparentor guardian. The trainingshallbeupdatedwhenthediabetescare
    plan is changed and at least annually.
    (e) School nurses, where available, or health care
    providers may provide technical ssistanceorconsultationor
    both to delegated care aides.
    (f) An information sheet shall be provided to any school
    employee who transports a student for school-sponsored
    activities. It shall identify the student with diabetes,
    identify potential emergencies that may occur as a result
    the student's diabetes and the appropriate responsestoch
    emergencies, and provide emergency contact information.
     
  2. Nancy in VA

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    I think its good. Its better, in my opinion, to have lay people trained than count on a nurse.
     
  3. kimmcannally

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    I don't see how it's different than us learning how to care for our child's D. Of course, we put our heart and soul into the learning and care. But if we can be trained, so can any school personel. I'd really like to see some of my son's teachers with more training. He was sent to the nurse's office on his own not long ago to treat a low! He was only 80 or so but he tells me he was shaky and holding the walls. (I take everything he tells me with a grain of salt due to his other dx)
     
  4. Mom2rh

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    This is a very complicated issue...I would encourage you to do more research on this. The fact of the matter is it would be wonderful if every public school was staffed with a full time nurse properly trained in diabetes care along with the other ailments children suffer with and need care for while at school. But that is not the case. By insisting that school nurses are the ONLY personnel that can help with a D child, you are asking for something that is impossible...a school nurse in every school. I live in California and every school district I know of is in horrible financial shape...laying off teachers, increasing class sizes, shutting down programs left and right. Since schools can't afford nurses in every school, are you going to let your child be bussed to a diabetes school? I don't think that's a good solution.

    I am a lay person who has been trained in D care to care for my child. Based on my knowledge I could, if called upon to do it, help care of other children with D...I don't see how that is different than other school officials. Asking willing people to be trained is a good solution. In California we have been fighting the nurses union on this matter. I really don't think these laws have the best interests of the kids in mind...just the employment of the school nurses. And I've been around these boards long enough to know that not all school nurses know anything about D. We've been very lucky to have great (part time) nurses...but not everyone has.
     
  5. TimandDeeda

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    I think I have a couple of issues with this.

    1. I do not know if I am comfortable having a school secretary or any other person that is not a nurse give my daughter an injection and measure the insulin correctly. Having trusted family members is one thing but a busy school secretary that is not medically trained amd has to deal with 100's or 1000's students?

    2. What if that secretary is out for the day and another sec has to fill in? It is a different story if a nurse is out and another nurse has to fill-in.

    3. I understand what you are saying about the school districts being in financial trouble. Well, stop giving away the free meals, make everybody pay the proper fees, etc. Alot of people have been living off of my tax dollars and now I want some of that money to work for my daughter.
     
  6. saxmaniac

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    Then don't. This doesn't force you to accept their care. It means that if you want to delegate care to non-nurse, you would have the ability to do so. That's what "entered into an agreement with a parent or guardian". Don't agree to it if you don't want to.

    You should be *for* this.

    Right now, maybe it seems that D is some sort of mysterious thing that only magical doctors and nurses will understand. Hate to break it to you, but you are going to see the Wizard behind the curtain soon enough. You will learn that you will be able to handle your child's diabetes 100 times better than the best nurse or doctor can. You only have one patient, and you are going to want to transfer that specialized knowledge to someone who is willing to learn it. You're going to need a break. You're going to want to sleep eventually.

    But sometimes we're not talking about who can do better, sometimes it's more dire than that. Some people here are stuck with absolute idiot nurses -- nurses who suggest giving the child insulin when low -- and are stuck with the nurse, because they legally cannot train a willing delegate who is more competent.

    We are truly blessed that we have two school nurses who are excellent. They have never second-guessed us and willingly learn from us. However, it was a bit of struggle at first -- they didn't quite believe that we had to change doses so frequently, wanted to follow doctor's orders to the letter even through they are obsolete after 3 days, etc. After about 2 years, they are finally starting to get it and understand our perspective. They were really chained by their previous inexperience with type 1 and the strict nursing rules which really don't apply well to self-managed illness.
     
    Last edited: Apr 1, 2010
  7. rare

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    Or stop paying administration 90+k a year while teachers do all the work and get nothing. They also live off your tax dollars and aren't working for your daughter like they should be.
     
  8. Nancy in VA

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    I think we need to NOT make this a bashing of the school system thread, I mean - come on.

    I definitely think its a dangerous precendent for ALL of us if someone advocates that a nurse is the only one who can give insulin. For school systems that can't afford at nurse at every school, that sets up diabetes schools, and we know we don't want that.

    I think the nurse is so overworked with other medical conditions issues. Its obvious that a "lay person" can do this job, because we are all lay people, and I think its smarter to have lay people do it. And, once this is opened up, it means you can have LOTS of people trained wheras before it was JUST the nurse. Now you can have the principal, assst principal, nurse, secretary, bookkeeper, attendance secretary, teacher, etc, so the likelihood of having a trained person who knows your kid is higher in the event the secretary is out.
     
  9. TimandDeeda

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  10. saxmaniac

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    I explained above, but I'll try again.

    What if your school nurse turns out to be a bonehead who repeatedly makes mistakes, and will not follow your advice because she thinks you're a layman? This is not conjecture. It happens. And there was a secretary who was a type 1 and willing to collaborate with you on the best medical plan?

    With the law, you could elect to train the secretary. Without it, you'd be forced to stay with the nurse. The law gives you more choice.
     
  11. Nancy in VA

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  12. TimandDeeda

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  13. KitKat

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    We have the same law in Indiana and it is working well. A nurse in every building would be great; however, this is not an option for many schools. So what are those children to do with diabetes who don't have a school nurse? Not attend school? Not receive care? Only go to school when a nurse is there? Have parents give up their jobs to care for the child while at school? Call 911 everytime the child is low or needs an injection? All that I just mentioned has happened to MANY families where there is not a nurse or there ISN'T trained lay people. Best practice is to have people trained in the care of your child, not just the nurse. Don't you want them to recognize low and high symptoms and what to do?

    Having people trained keeps the child safe, even when a school nurse is in the building. Many schools do it and do it well!! My son's elementary school, 4th and 5th grade were awesome. At his jr. high there are over 30 people trained in diabetes care AND how to give Glucagon. As an educator myself, I would rather be prepared than not, thus the reason we have tornado and fire drills!

    Lets face it, a school nurse can't be everywhere.
     
  14. saxmaniac

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    You're saying that the presence of one diabetic child is the ONLY strand that's preventing them being fired? I find this very hard to believe. There are other children with other medical conditions that need treatment - what about them?

    I think your problem is a local issue, funding, taxes etc. If you're concerned about your school, raise the issue in your town so they get better funding. Hire your own aid. Whatever it takes, but please try to think about the bigger picture in your state. What about people in other districts that already have no nurse, and the district forces the parent to come in to administer insulin, because nobody at the school is allowed to be trained, even if willing? What about people who have incompetent nurses?
     
  15. Emma'sDad

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    Emma's school doesn't have a school nurse. They really don't feel the need to have somebody overpaid on staff to dispense bandaid for kid's booboos. And if something serious enough happens to a kid, that's what 911 is for.

    As for Emma's care, they have a Teacher's Assistant in charge that comes to the classroom whenever the teacher calls on the intercom, or at specific times to check BG for snack or carb count and give Emma her needle. They also have 5 other people trained to check BGs, carb count, give the needle and even trained for Glucagon. I am quite pleased with their arrangement.
     
  16. Dad of Daughters

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    My thoughts are that I reject this premise of your position. This is much like the argument that the nurse's union in California tried to use in resisting similar legislation there. IMO, budget shortfalls are putting school nurses (and MANY other school employees) jobs in jeopardy, not legislation that is designed to provide parents of CWD's a larger group of adults that can provide necessary care if properly trained.
     
  17. BrendaK

    BrendaK Neonatal Diabetes Registry

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    How do you feel about people living in states where there are NO school nurses anywhere?

    We moved to IL from Michigan. In IL we have nurses. In Michigan, there were no nurses in the entire STATE! Not even in private schools. The secretaries were trained on insulin and D care and they did an excellent job. I believe there were 5-6 people trained on giving insulin, glucagon, etc in the school we were at in Michigan -- there was ALWAYS someone at the school who could administer insulin.

    Did you know there are many many states with no nurses in the schools? I feel like we are living in luxury now here in IL! But it would be fine if we had to train the secretary, too.
     
  18. Amy C.

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    Texas has this -- but they are all Unlicensed Diabetes Care Assistant. Here is the link to our law: Link.

    California is trying to do the same thing. If non-nurses are not specifically allowed to be trained to give insulin, administrators and nurses can say that only nurses can give insulin -- even if there isn't a nurse on the campus.

    What good does this do the children?

    Other school personnel can be trained to manage the daily diabetes tasks. We all learned how to do it.

    This law is working well in Texas.

    Children with diabetes should be able to attend school and have their medical needs met. Not all schools can afford a nurse and this is a good compromise.
     
  19. KHM

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    This is a really emotional issue from a lot of standpoints. What is needed are choices for parents of CWD in public schools---

    I know that the availability/staffing level of actual nurses in school health rooms vary by state. What's more, there can be differences on a District basis as well. Lots of entities make different decisions.

    My kids attend public schools in Montgomery County, Maryland. The nurse to school ratio is about 1:4, each nurse supervising a health room technician. The nurse is able to "delegate" certain responsibilities based on her judgement to those technicians---mostly CNAs. CNAs are often delegated the responsibility of administering insulin using an auto injector; they are prohibited by state law from measuring insulin from a vial and administation by syringe. School nurses may do that, but they may NOT draw a dose of insulin from an autoinjector cartridge using a syringe....curious, right? Because we have a really leaky NovaPen Jr., we typically draw our doses from that cartridge.

    Secondly, the health room technicians are absolutely prohibited from making any clinical judgements. So if my daughter shows up in the health room with a bg of 240, that's an action point if symptoms are present...so if she's not articulating symptoms, the tech can't make any judgement about her condition or sending her back to class. The nurse has to do that. And the nurse is not always there.

    My daughter is the only T1 in her school. In the four years that school has been open the Principal and staff have had one T1, a well established pumper. In that same school works my neighbor and good friend, the mother of a T1...I would be very happy to empower her to provide certain aspects of my DD's care to that person but for the most part, my daughter is in a school where most days she's a phone call away from a nurse.

    My daughter's not stable at all. I do have the option of sending her to one of the county schools that do have fulltime nurses on campus---those are schools that have great need for other reasons: schools with high proportions of physically and emotionally challenged students. In short, sure,there's a nurse but how much time will the nurse have to attend to my daughter who is dropping fast when she is busy doing a complicated ventilator procedure for students who require that care daily?

    I'm just saying: a lay person can be a GREAT diabetes caregiver at home and at school. As parents, we know not only the disease better than most nurses in the general population because we have a powerful motivation. Its that motivation to provide exceptional diabetes care that matters..not the credential.

    We've ultimately decided that until Lindsay is able to give her own injections, I will go to school and give the injections myself. If/when she goes on a pump, we'll be able to do much more telephone management. We all need the freedom to make the choices that work for our families and our lives. Opposing legislation that would allow lay people to care for CWD because of credentials will not advance the quality of care in schools.
     
  20. Mom2rh

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    Keep in mind that if you insist that ONLY a nurse is qualified to care for your child, you are preventing your child from participating in after school sports, field trips, other extracurricular activities.

    You are a parent with a newly diagnosed child I want to empathize with you. We have ALL gone through what you are experiencing...it is overwhelming and frightening as well as frustrating...and a million other things. Let me reassure you that even though the learning curve is steep...this will all become your new normal. I don't think diabetes ever gets easy...we just all get better at figuring stuff out...and coming here to get answers when we can't figure it out on our own. We accept a new "normal" after a time. As others have said, you will soon be the very best expert on your child's diabetes, making dosing changes and figuring out complicated formulas...adjusting things daily depending on sickness, activities and sports and special occasions etc. Finding someone at your school willing to help your child, whether a teacher, aide, nurse's aide, whatever, is the best thing for your child.
     

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