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August 31, 2009

Daily Care, School and Daycare

Question from California, USA:

I am a school nurse in a small district. I cover two elementary schools. I have five children with type 1 diabetes at one school (approximately 425 students). I have a newly enrolled five-year-old kindergartner starting next week. She was diagnosed two years ago and has been on a pump for about 18 months. She receives insulin at school for snack and lunch time. Mom said her last A1c was 8.0. I have not had such a young pumper at school. I am only at the school one day a week with an LVN (licensed vocational nurse) covering those days/insulin injections that are needed when I am not there. What is the recommendation for nursing assistance for such a young pumper? Should I push for an LVN for the entire day to monitor and bolus when needed? I am afraid that if I only have coverage at the food times, it will not be sufficient.

Answer:

How wonderful that you are planning for assistance for this child when you – the school nurse – are not available. The diabetes health care community supports training unlicensed personnel such as teachers, school administrators, coaches, etc., to provide both routine (including insulin pump operation) and emergency care in the event the school nurse or another licensed health care professional isn’t available to provide care. This is a model of school diabetes care that is safe and working well in school districts across the country. There are a number of excellent training resources from the pump companies and ADA’s school training modules (includes a module on insulin pumps) that is available at the ADA’s web page on Diabetes Care Tasks At School: What Key Personnel Need To Know.

Hope this helps. For more information call 1-800-DIABETES and visit the ADA’s page on School Discrimination.

CJ