School Nurse Problem please help

My son just started the ninth grade this week and it’s been tough adjusting but today around 2 PM I start getting alerts that his blood sugar was going up and then more alert it’s now HIGH . So I called the school and ask them to please page my son out of class bc he to give himself insulin right away that his blood sugar is reading HIGH so they page the nurse who then goes and pulls him out of class. Well she starts challenging him and told him he needs to calculate how much insulin is to be administered before she will give him any insulin . He is sky high and can’t think and starts fussing at him about it and said your mom must not be telling the truth about you knowing and understanding your care plan and how to use the Sliding Scale for corrections . She starts highlighting his care plan and told him he had to figure out . My son said he could not think . He is also ADD but the issue was his blood sugar is high he can’t calculate it at that point . he is feeling sick and Every minute that keeps ticking by without any insulin it’s doing damage to his body . He tells her he feels sick so she has him so a ketone test and he has small ketones and finally gives him insulin . This nurse is so rude so unprofessional makes myself feel very uncomfortable he doesn’t like he can go to her for anything. And he should’ve got her simply because he is scared about looking at his phone and he has to do his insulin injections in the classroom where they eat lunch due to Covid so he’s giving himself insulin and trying to calculate everything while in a room of his peers who he doesn’t know yet since it’s the beginning of school year. He is also scared to look at his phone to see what his blood sugar are bc he scared to get in trouble with teacher but it’s the job of the school nurse to let those teachers know about my son condition. How should I handle this please help I’m so worried about the safety of my son and Don’t wanna wait until something bad happens we are at day 2 with over 400 blood sugar reading . Thank you for your help !

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The one thing I would suggest is, while it is the nurse’s job to ensure your son follows his treatment plan, you should not leave it to them to tell your son’s teachers about his diabetes. When I was growing up with diabetes (diagnosed in the early 1960s) my parents met with my teachers. Things were much simpler then and the concern was mostly with recognizing signs of lows and what to do if one happened. Your school’s nurse handled the situation very poorly. With current technology there’s much more involved, but even an excellent nurse can’t possibly educate every teacher about every student with a medical issue. You should meet with the teachers and let them know he needs his phone to view his numbers, and how to recognize when they may need to call the nurse.
As far as how the nurse handled your son’s high, my suggestion would be to speak with them and if necessary the school administrator.
I don’t use my CGM’s share feature but I’m assuming it can alert you when his glucose is rising as well as when it’s reached your alert number. Maybe using that feature will give you more of a chance to head off those highs by responding sooner.
BTW, your son may not be the only child in his school with diabetes. I sometimes suggest parents check with the school nurse - HIPAA wouldn’t allow them to give out the other person’s information but if you’re willing you could share yours with other families so both you and your kids could connect. School administration might be able to help with that of the nurse is a problem.

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Hi Crystal @martcl711, I am so sorry this has happened to you and your son. It never should have happened. I taught 7th grade science for 8 years. Halfway through one school year, a student of mine became a type 1. The school nurse, the counselor, and her parents gave me educational information about type1 and went over with me what to look for (high/low blood sugar). I also was given a tube of icing in case of emergencies. She had freedom to go to the bathroom or my lab storage area to check her blood sugar at any time and give herself insulin. This was 1999 - before wonderful cgms. I knew that if her blood sugar was too low or high she would not be able to think straight. This was/is basic info for teachers to know and apply.

I think if you approach the counselor (really fill her in on the incident and your son’s subsequent feelings about it) and meet with the teachers, your son will have a better outcome. This nurse was awful, but most likely the teachers will be very accommodating. I hope this helps.

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Thank you so very much for taking time out of your day to reply and help me out with this . I’m going to go in with him tomorrow morning and talk with each teacher so that I know everyone is full aware and so he feels me comfortable. I usually talk with all the teacher before the start of school but we moved and so meet your teacher night had passed etc so that’s an excellent point and should prevent a lot of this from happening . I appreciate you sharing your views as a teacher who experienced having a type 1 so thank you for that and your advice which is so helpful!!

@martcl711 , @wadawabbit , @homeschoolingmomof5

Ladies,

There are several items in play here:
[1] Crystal, what does does your son’s 504 plan specify about deviations in blood sugar? There are several issues I see here as a retired teacher.
[a] the student should NEVER be in an environment of FEAR, from the teacher, nurse, administration, even the janitor.
[b] does the 504 specify procedure for your notifying the school about deviations? If you call and ask for your son under an authorized 504 action and the person answering the phone FAILS to execute your instruction pursuant to the 504 and harm occurs, where does blame fall? It is the school failing to work with the 504 plan.
[c] a comprehensive 504 plan must include ALL employees designated by the school administration to be responsible for the execution of the 504. This means teachers must be informed of the situation related to the 504, the EAP (Emergency Action Plan) with its various levels as Notice (start hi or low), Alert (Hi or Low impending) and Alarm (action must be taken NOW)
[d] if you son were to need to move from one area to another as in [i] go to the office for a CGM alert phone call, [ii] visit the rest room while in crisis, or [iii] any other time out of a school employees presence, does he have a classmate or paraprofessional assigned to accompany him?
[2] The lad must have a CGM connected to a phone, relaying data to you, Crystal. Does the 504 plan include the student receiving notifications about blood sugar deviations (HIGH or LOW)?
[3] Is laddering of alarms a possibility to notify all of the CGM reports? This would allow your son to act before crisis occurs. He would need to take action in the classroom.
[4] Has the consideration of an insulin pump been explored? There are several with closed loop integration of CGM data to throttle insulin after proper programming.
[5] What has your son’s treating physician done? What is their position?
[6] Where are you with the 504 plan? Explore! You may need to check with the local JDRF chapter, your endo, or an attorney to motivate the school and or the school board to comply with the Federal law requiring the 504 plan.

Now a story: Similar to Crystal, I am a ware of a 2nd grade student transferring over Christmas Break. Student arrives to the new school (this occurred well before CGMs & insulin pens) and joins a class. The teacher was in the dark about the student’s diabetes diagnosis.

About 10 minutes before lunch, the child whips out a meter and the remaining paraphernalia to perform a finger stick. The child also produces a vial, syringe, etc and proceeds to jab a dose of insulin. All without adult involvement.

The jurisdiction had implemented a STRICT policy about drug paraphernalia on campus, PERIOD. The teacher, upon seeing the syringe & vial, went off. The “drug paraphernalia” was seized, the child whisked to the office, police were called, and the child detained for the juvenile legal system, even though the parents produced lawful documentation about everything. The child was de-facto expelled.

The parents sued as a civil rights violation. The Federal consent decree expunged all juvenile records and the parents ended up almost owning the county’s public school system.

BOTTOM LINE: Don’t dally, there is a systemic failure here.

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Thank you for taking out time to reply I spoke with each teacher which made a difference but the relationship he has with his nurse is still broken and I did the 504 plan today . I hoping it gets better soon.

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@martcl711 , this is fantastic.

Two questions:
(1) does the 504 address all the conditions outlined in sample 504 plans like the ones on the JDRF website?
(2) are you, as the parent & ‘mother bear’, satisfied with the direction at the present?

Way to go!

I imagine he will have a hard time trusting her after that experience - I can only hope her behavior changes and she rebuilds it in time. What a very unfortunate way to start the year off!

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I am so sorry you are experiencing this. I have had T1D for 35 years, my son now has it, and I work in our school. I can’t imagine him being treated this way. A few things I have done was get a 504 in place right away, spell out the things that he must have access to, and expectations from the school. We also have a diabetic care plan from the endo, with clear instructions for the nurse. I also can say that having a Tandem pump has been super helpful. My 11yo can dose for corrections in class, and carb count and dose for lunch, independently. He only needs the nurse for assistance, when he thinks he needs her help.
And, I like an earlier reply that asked if you are satisfied. If not, keep advocating for your child until you are.

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I am a RN and T1D and a former school nurse. This should never have happened!! Right now call the school superintendent, the principal , the nurse supervisor if there is one and the offending school nurse, and your endo CDE and arrange a meeting. This school nurse is messing with your child’s healthcare and it is against federal law to interfere with the American Disabilities Act by restricting a student. Your student should have detailed instructions on file on the students care and who should provide that care be it the teacher or student or nurse. If the student is capable to provide self care that needs to be stated. Period. If anything EVER happens again immediately call your state Board of Education and file a complaint with the American Disability Board.
Nurses and doctors are not taught how to manage T1D patients or their pumps and cgm devices!!! So student caregivers, don’t ever assume they know anything. Raise heck until it’s right !!!

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@Kclark550

Karol,

Thank you very much.

There will be a Zoom class in October about 504 plans presented by JDRF Los Angeles

More to follow.

@martcl711 , Crystal, I hope you see this about 504 plans.

Here is the post:

Here is the registration link:

Hope this helps.

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