Stupid Nurse !!!!!!!

Ugh, I have been unhappy with my sons school nurse since the start of the school year! But this is her 3rd strike. Yesterday Jace had a substitdue teacher in his classroom. When he tested in the afternoon he was 80. The sub had him go to the nurse ( I have no clue why?) the nurse then gave him and Airhead candy( what we use to treat lows)
She treated and 80 !!!!!!!!!!!!
Why in the world would she do this when his 504 clearly states that only numbers under 70 should be treated????????????????
I asked Jace why he even ate it since he knows that 80 is a good number. He said the nurse told him that she didn't want him to go low !!!!!

Other times she has injected him with the pen without dialing anything up and has gave him wrong doeses!

I've written letters to the superintendent and principal with no responce.

What do I do now?

 

While I might not be thrilled with this, I'm going to be honest and say that I think you are overreacting.

It took 3 players to make this happen: The sub, who was probably erring on the side of caution, the nurse who probably assumed that if he came to her office that he was feeling low even if the meter was reading 80, and you son who, though he is young, could have said I don't feel low or I'll take it and treat later if I feel that I'm going lower. Just mho.

 

And this is why YDMV is so true...

We don't have all the details - last insulin dose, going to gym or recess, fast drop?? etc... Personally, I would have pumped him up a bit too from the 80, but depending on the other info, may have chosen a slower acting carb (few crackers etc.)...

It's important that you be able to trust the nurse and that the 504/DMMP be followed.

 

Were they going to go out for PE? Recess? Could that be why?

 

Why not just put a call into the nurse and directly ask her why she treated an 80 when the plan did not call for it? I bet there is an explanation somewhere.

 

I did speak to the nurse, who called after treating.
I asked if he said he felt low and she said "no, he felt fine" exact words !
I honestly don't think she can handle his D care.
She is young and has never delt with a student with D.
I also get the feeling that she's not really interested in learning about D managment.
This happened at 2:00 there were only 30 mins left in the school day.
And I feel that if she was going to "break" his 504 plan I should have at least been called first !
I guess I' just scared that one day it will be a big mistake.
And I thought he had a 504 for a reason !

 

In the arena of picking your battles, I wouldn't pick this one. Treating an 80 30 minutes before getting out of school isn't that big of a deal. I would definitely be addressing the mid-dialed doses, etc.

 

I have talked to the administrator in the building about these other issues. She was the one who had me write the letter to the superintendent and principal. I am now writting another letter about this last mistake.


And on a side note: This nurse actually called a parent to come to the school because their child had a knot in her drawstring pants

 

I'm going to going with Sarah on this. I understand the frustration of the 504 not being followed to the letter of the law but I always lean on it's better to be safe than sorry. YDMV obviously, but in school, we'd treat an 80. I guess my point is that if his threshold is 70 and the number was 71 and she didn't treat it, how would you feel? I think there is a gray area with D care sometimes and to work as a team with your nurse, you have to cut some slack bits not like she treated a 230 or didn't treat a 60. KWIM?

 

I wouldn't react too much to this one, honestly. I think she was probably worried that he might be dropping (let's face it, we *do* know that meters have that +/- 20% fudge factor) and erred on the side of caution.

Our DMMP gives ranges and how to treat each range. For a number like 80, we would likely 5 carbs only -- perhaps something like that would make sense in a situation like this? I know with our school nurse, she will often go over the numbers with me when she's not sure which way to go -- either over the phone (if its urgent), or when I go to pick him up at the end of the day (if it's not). (And in a weird coincidence, she just called me as I was typing this -- his pump lost its prime and she reprimed it on her own).

Anyway, try not to go "scorched earth" on the relationship -- you want to be able to work with her, even if she has made some mistakes.

 

I know this has nothing to to with D but just noting that in some schools, administrators can not touch the front of a child's pants. When Max was in preschool, we were told to send children in pants that they could pull up on their own, that staff was not alowed to fasten the front of the pants. Not saying that's what happened in your school, but you never know. It's like the rule in some schools that don't allow hugging in fear it would be considered "touching".

 

Okay, if that had been the only mistake then I wouldn't make it a big deal. I personally would treat an 80 at thirty minutes left before the bus but that's me.

However, it appears there is more going on and this was the last straw. We are are the only advocates for our kids, so I would call at every mistake from here on out, let them know, nicely, that you are aware and ask that they please make sure they are following the 504. I made a "cheat sheet" that is very simple for the nurse and school personnel to refer to at any given time.

I feel your frustration. We had 2 great years at school and very little problems, this year we weren't as fortunate. Small things that happened I wrote notes but for the most part didn't follow up thinking the notes would work. When those weren't working I called the care giver directly and when that didn't seem to be working I couldn't take it anymore and then I didn't let up. The principal didn't appreciate the daily calls but quickly fixed our problems and then reviewed the agenda book that came home with our son and all the notes I'd written and documented phone calls that I had made to the care providers.

Hang in there, you are not alone.

 

I would let the 80 go and go talk to her about it. If one of us parents wrote and said " oh no I made a mistake and treated an 80" everyone would respond " don't worry about it", " we all do it", etc etc. We seem to be able to give ourselves slack and not school nurses.

 

Dosing insulin incorrectly is a serious issue and I would insist on immediate correction on that.

As for treating an 80, I wouldn't push that too far. So, they might say that his ending number after the treatment is 10 BG points higher than if he was 70 and treated.

I would address the serious issue you have and it's serious to dose insulin incorrectly. And, this nurse has done that more than once.

You will have much more credibility and get better results if you present the hard facts of what can happen with incorrectly dosed insulin.

 

Same here. Our nurse kept insisting that Kieran wear t-shirts when he was on injections. I finally figured out that she wasn't allowed to touch or remove his clothing to give him a shot (why she couldn't have explained this is beyond me, but WE!). So we had to have it written into his plan by his doctor that the nurse was able to touch and remove clothing as necessary.

With regard to the main issue at hand, I'd let it go with a friendly reminder. But, I would keep track of it (emails, written notes etc...) so that if you have any further issues you'll have full details.

 

Maybe she was afraid he would drop on the school bus home being an 80.

Honestly, I think she was being cautious, and I wouldn't be upset.

 

This really was the last straw !
The last time she gave him the wrong dose the administrator spoke to her and the nurse had had she was disstracted by children in the outter office. So now she is to close the door when Jace is in there to get his shot.

Also the nurse in Jace's school last year was amazing, so I'm sure that my standards are high. But I still talk to her and she agrees that the mistakes this nurse is making shouldn't be made.

The last time we had an issue I told my-self I would give her one more chance. And this is it.

And as far as cutting her slack? I just can't
I can yell at my kid because it's MY KID !
I can make the choice to treat an 80 for MY KID !
It's not her place to do that. I don't have enough confidence in her to call the shots ( as where last year the nurse was able to teach me tricks and tips) All she needs to do is follow the 504 ! That's it !
I am a stay at home mom and 3 minutes away from the school. She knows this and has called me before to come to the schol for much less

I think I'm just feed up with her in general and this just made me snap. Sorry
But I don't vent much so I can have just this one right?



BTW- we aren't in a bus district so I pick him up !

 

I guess my thought is that we have often said that we don't want the nurses to have to go letter-by-letter to the 504 - often that means when we change an I:C it would need a new 504, we need a number of other things, a change. I think that a 504 should protect our childrens rights and give flexibility for situational decisions - on both the part of the parent AND the school, within reason. Again, I'm not saying that the misdoses of insulin aren't bad - they are. But, I guess I just wouldn't consider this the "final straw". I don't think she is stupid for treating an 80

 

There's plus or minus 20% error with meter readings. Therefore 80 could have been up to 16 points lower. If this sound like nitpicking, it is not. The 80 reading really could have been a BG under 70. Possible meter error SHOULD be taken into account when deciding whether or not to treat a low.

So the nurse not only did the right thing, she did it within the written guidelines.

Sounds like she screwed up in the past, but I don't see it here. At all.