http://www.diabetes.org/for-media/2013/california-supreme-court-ruling.html
After nearly five years, ration prevails. The California Supreme Court has made the ruling clear that non-medical personnel are capable of administering insulin in schools.
Finally, California’s kids can live a normal and safe life at school instead of being held hostage and endangered by the California Nurses union. Lets hope that the nurses end there power trip and except that diabetics must have the freedom to manage diabetes safely at school.
Thank you California Supreme Court!!!
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As a diabetic for 30 years and a pediatric nurse, I have mixed feelings about this. I know this is an issue in many places. As a diabetic or as a parent of a diabetic child I would want someone/anyone at the school available and knowledgeable to assist my child with their care. However, as a nurse and supporter of the ANA, I know that insulin is a powerful medication and even as a hospital nurse is something that has to be double checked with another licensed nurse. I guess teaching the basics to a lay person is better than having no one available at all.
It seems to me that the real problem is the school systems and the states do not want to pay for having a nurse at every school. I was recently at a pediatric nursing conference where this issue came up, and the numbers were ridiculous as far as the number of nurses per number of students in that state. On average, there was 1 nurse for 8 schools, which was approximately 1000 students.
To me, the ideal would be a nurse at every school that has a child with medical needs. Diabetes is not the only medical issue kids at school have.
Common sense prevails
I agree PedsRN, I too am an RN, diabetic same as you for close to 30 years. What happens then when some lay person screws up and ends up seriously hurting a child? I agree the ideal solution WOULD be more nurses at schools, versus one nurse covering several schools.
Christy, PedsRN,
While I can understand where your concern comes from, the reality is clear: the budget is not there to make a nurse per school a reality in many places. So, to ignore the reality and force families into arrangements that ultimately put them in positions where they need to begin to compromise their jobs and other things in order to give their children their insulin shots until they are old enough to give it to themselves made no sense.
On a personal level I am glad with the ruling and I have to trust that families will make sure that there is a properly trained person per school to ensure that insulin injections can be administered in a safe way, that is mindful of the economic times we live in (not enough budget to assure one nurse per school in many places).
This is great news for all the families who have a kid with T1D in school!
Isn't there a lot of demand for nurses now? I had read that a couple of years ago but, if schools can't compete with demand, because taxpayers are idiots, there has to be another solution for kids who are learning how to take care of themselves. I think this is the right decision. I was fortunate enough not to be dx'ed until I was 16 and moved quickly to take care of myself. I know it's a lot harder for kids but I think that it's important to share the responsibility for helping them with the grindy chores of remembering and calculating shots more effectively. I suspect that 90-95% of teachers will be able to help the kids and families because that's what a lot of teachers do. I've heard bad stories but would like to think they are exceptions rather than the rule.
So, it ok to have a teacher who was trained by a nurse with little or now experience managing diabetics on a daily basis?
I have volunteered for JDRF for many years and discussed their school situation with many parents of T1D children. The stories I have heard make it very clear, a trained person who has a clear understanding and knowledge of D management is better than a nurse that is not at the school or the nurse who locks up the insulin and meter because it can only be touched by the nurse. D's, as you well know, have to find a way of managing D 24/7 and in many cases the nurse has been more of an obstacle in the school instead of a help with daily and hourly management needs of the D.
I have heard so many stories about teacher, staff and nurses putting diabetics in danger in the last 5 -7 years it is scary. The nurse w/o a clear understanding of daily D management is no safer than the lay person who has been trained to help D's in school on a one on one basis.
I know this sounds like a bash, but the last story I heard was about an 8 year old who did not feel well and was sent, alone, to the office to see the secretary. The result was not fun, and fortunately the secretary called the parent ASAP and with instruction over the phone helped avoid a real dangerous low.
More nurses in the schools would be great, but in my 42 years as a T1D I can't count the number of nurses I have met in clinics over the years who know how to manage a T1D past the number of fingers on my two hands. Typical example, I had out patient surgery yesterday and after asking questions about sedation and D management there was not one nurse in the clinic who knew enough to get an read my BG with a meter or how a T1D should be managed with sedation and prep for a guaranteed successful outcome. I elected no sedation, not fun, but I was able to make sure no mistakes were made and he surgery, although not comforting, was successful.
Managing T1D in school needs to have a team who is all there all the time, not just part time, or half informed.
Unfortunately this is an issue, almost nation wide. I can speak as a school district administrator and one who had build the budget and pay the costs each day, week, month and year. It is nto black and white ever.
So first, I worked in a district that allocated one nurse for one large middle school and two elementary schools. For many reasons, it was what we could afford. It was not a matter no wanting to pay, it was what was affordable. It was absolutely dangerous I am afraid. I did not like it and for me it was hard to stomach. Still what was the choice? We were running stripped bare to the bone. Our kids were form very needful homes, and we did not have enough money to teach them let alone properly educate them. The outcome was a question of what to cut? Do we cut the reason for being in business, education? Or do we work out a different plan. We chose at that time to underfunded everything. Teachers were not paid enough, After school activities were underfunded, we did not have enough administrators, heck the only thing we had enough of school lunch funds. So nurse staffing also suffered and again, I was not comfortable doing what we did.
Now to be fair some elementary schools had as few as 250 kids attending them. One can get away with less when you have less kids. Using sectaries or trained aides did work. We had almost no issues. You can say hey you were lucky. Perhaps we were, but it worked.
Ont he other hand I went to a district with elementary schools with a population of 600 Plus. In this district we had more money and each building was staffed with a nurse. We hired nurses for field trips etc. However we had a terrible time finding school nurses. we were paying lower 1/3 market wages but that really was pretty good money considering each nurse got 10 weeks a year with no work, they only worked days and their case load was well know. I mean one thing different, is that a school population is pretty stable. Yes kids do change meds, but mostly it is routine.
Getting, keeping and training nurses was tough. It required a special person in their career, and most nurses simply did not want the work. Nurse also said pay us more, but we have to understand nurses should be compensated in accordance with what we pay teachers up to a certain point. So in this district a teacher would start at around $30,000 while a nurse would typically get about $36,00. However on the higher end, a teacher with a master degree and several hours toward a doctorate might make $71,000. a higher paid nurse might make $49,000.
Ok so my take away is this. The law is a wonderful thing. Still schools have to seek to find and afford school nurses. Regardless it is not a black and white issue. Like most things it is all gray.
There is a HUGE demand for nurses unfortunately like PCP's the demand is higher than the number of people going into the field. The nursing population is aging, and the nursing field is experience a major shortage. I know obviously SOMETHING needs to be done, and like so many things there is not a clear cut answer to the problem either, however people are posting us nurses know nothing about diabetes management, I kinda cringe then to wonder just how knowledgeable the general lay public with absolutely NO medical knowledge is going to fare. Let's face it we see it EVERYDAY, the lack of knowledge and ignorance regarding diabetes. Like I said I don't have an answer in a perfect ideal world there would be enough nurses to cover schools. I just really hope some kid doesn't get seriously hurt because some teacher's aide has received some crash course in diabetes management and screws something up. LOL AR you have a LOT more faith in teachers than I do of some of the ding bat ones I've seen. YIKES.
I think the school districts will have weigh the benefits of this rule. It will only take one lawsuit to blow this whole theory to heck. Who determines if this person is properly trained and what responsibilities still falls on the school to ensures this happens. I imagine the parents could sign something to release the school districts and individual from any liability. Should be interesting to see how this is implemented.
Canadian Diabetes Association provided this link http://www.diabetes.ca/documents/about-diabetes/Kids-Living-with-Diabetes-at-School-July-2013.pdf
Please note : The revised position statement will not be released until early to mid-September (to coincide with the beginning of the school year)
We’re also preparing a national advocacy campaign on this issue and look forward to working with determined and committed advocates "
@ The TurtleMoves ...you are a member of the FB Group : " Advocating for type 1 Kids in BC ( Canada ) ?? ..it is posted there :)
Typically a school will not just shove this to anyone. Usually it is one person who has the responsibility for the entire school. And that person will be a trusted individual who can do he task.
This also shows up in field trips. The original law meant kids could not go on field trips even if their parent went, unless a nurse accompanied them. That is an awful thing for a child. Even a school with a nurse cannot cover all field trips all the time, if a nurse has to attend.
Now, I often used to seek out part-time nurses for field trips, but that is hit and miss. So if a school has a choice. Keep a nurse in the building or send that nurse on the bus to insure they service the field trip, the school will keep him in the building and those diabetic children will not attend the field trip.
So I really support the change, because it reestablishes sanity in the important educational process of taking field trips. As I said under the former provision a nurse had to be present, and that usually meant those kids do not go. This change makes it possible for the parent or other care giver to go and take care of their child.