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tiny vent - school and changing ratios

Discussion in 'Parents of Children with Type 1' started by spamid, Oct 28, 2011.

  1. spamid

    spamid Approved members

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    GRRR! I think my child's HS nurse and I may butt heads more often in the future. I love our school, and we have two full time nurses assigned, they also want the kids to be as independent as possible. Went in this morning to tell nurse to change my DD's lunch ratio, due to highs after school. Nurse says, "we need new doctor's orders."

    Me. Surprised, but polite. "No you don't. Our care plan says parents can change doctor's orders as necessary." Plus our endo is 100+ miles away.

    Nurse is nervous, says no doctors in our area do this (note that we have no pediatric endo's in our immediate city). We do have some south of here, and some that travel here from the Ft Worth area.

    She changed the ratio, after she had me write something that said I wanted to do this. Really? Don't you think I know my own child? I understand they are trying to do their jobs and keep my child safe as well, the amount of paperwork and restrictions on medications is just ridiculous now. I have nothing but support for the nurses, and am glad they are there. But I know my child. We are not new to this, been doing this for 6+ years now, and my child is extremely self sufficient.
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    Just my impression, but I think I can understand where the nurse is coming from. It doesn't seem unreasonable, if she is drawing up the insulin and/or giving the injection, for her to have a change of ratio in writing. Not from the endo, but from you.
     
  3. Amy C.

    Amy C. Approved members

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    In the state of Texas, if your child is capable of self managing, she doesn't need the nurse to help her do injections. I would imagine that most Texas high school students who are Type 1 don't visit the nurse at all.

    This is from the Health and Safety code:


    Sec. 168.008. INDEPENDENT MONITORING AND TREATMENT. In accordance with the student's individualized health plan, a school shall permit the student to attend to the management and care of the student's diabetes, which may include: (1) performing blood glucose level checks;(2) administering insulin through the insulin delivery system the student uses;(3) treating hypoglycemia and hyperglycemia;(4) possessing on the student's person at any time any supplies or equipment necessary to monitor and care for the student's diabetes; and(5) otherwise attending to the management and care of the student's diabetes in the classroom, in any area of the school or school grounds, or at any school-related activity.
     
    Last edited: Oct 28, 2011
  4. spamid

    spamid Approved members

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    She is capable of self managing, she goes to the nurse now more out of her wanting to than anything else (not letting other kids see what's she's doing). I think she will get more comfortable as she gets older. I understand the nurse needs the changes in writing, that's not a problem. My concern was that she wanted the changes in writing from the endo, not me. Just a small thing, as I said, I'm glad my DD is doing well, and the school is supportive. I do still HATE this disease.
     
  5. Charliesmom

    Charliesmom Approved members

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    Your doctor can fax stuff the nurse if necessary.

    I actually had to have our endo fax in new orders because I needed the range changed. His IHP says parents can change I:C ratio between 1: 20-65.
     
  6. akgiauque

    akgiauque Approved members

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    This is not about you it is about the nurse covering their bases and protecting themselves. They may or may no remember every kids exact plan and are inclined to request a physicians note as a general practice. Our school nurse told us of a parent that informed her to tripple the dose of ADD meds the script had on the bottle. She checked with the doctor just to be sure and he was directly opposed to the change. He was at the highest dose and mom was tired of his behavior so decided to chang it on her own. The point is some parents do crazy stuff without understanding the consequences. As parents of diabetic children we know our kids better than anyone and I hope we will do what is right. But most nurses see diabetes as any other illness or disease and as a public employee with all of the suit happy folks out there they are documenting every change to medicine as it occurs. If it has not been that way and you ask why now? Maybe a new supervisor told them to do it, some training they got this fall changed procedures or another nurse two counties over has been sued. Whatever the reason they feel compelled to document changes and I respect their right to question changes.

    As for paperwork I agree it is rediculous but part of the reason for the tracking is lots of kids are:
    1. on prescription meds
    2. coming to school high on moms/ dads prozac or oxycodone. Or worse yet taking 25 cold and flu tabs of assorted types and having a heart rate of 240 in school.
    Crazy stuff out there and even crazier people.
     
    Last edited: Oct 28, 2011

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