When we moved to our new school we were somewhat worried to find out that our son would be the only student with Type 1. However our fear subsided when we met the nurse. She too had Type 1 diabetes! She immediately showed our son her pump and he showed her his and they were quickly on the same page.

For the first few weeks at the new school we felt everything was fine. Our son is quite mature for his age and tends to take care of himself well but we soon found him returning home quite high each day. After some questioning we finally realized that the nurse was correcting his “low” BG ratings with juice. This of course is fine, however, for her “low” meant anything in the 80′s and so our son would be taking in juice and rocketing up to the high 100′s.

We really should not have assumed that just because she had Type 1 that she would manage it the same way we would. In fact, it’s probably safer to assume that everyone with Type 1 manages themselves in different ways primarily because the disease experience is different for everyone.

We’ve decided to manage our son a bit lower with the hopes of averaging around the 90-110 range with an A1C of around 7.0. We do this because we’ve found that our son, when he experiences lows, still does a really good job of identifying it and treating it quickly. He also seems to be able to go pretty low without any real negative effects (like in the 40′s). Of course we don’t want him this low, ever, but having him in the 70s appears to be just fine.

Others however may find themselves completely out of it even in the 60′s and so they tend to manage themselves higher.

After realizing what was happening we simply had a conversation with our nurse and explained what we were trying to do. We also had our son’s doctor reiterate it with a short note explaining not to undertake any ‘corrections’ unless he was under 70.

Once again, open and honest communications has helped to ensure our son’s days are smooth and healthy.

The California Nurses Organization obviously was quite pleased with the decision as it now appears that only licensed nurses will be allowed to administer insulin injections in California public schools (except in cases where either the individual self-administers or a parent administers).

What do you think about this?

Our own opinion is that this not only severely limits choices that a school and parent has for medical treatment, but it also binds schools to another layer of fiscal costs in a time when our schools (especially in California) are truly suffering.

In our own school, nurses are only on campus and available about 20 minutes each day during lunch. That’s all! Also, the actual nurse who arrives changes each day and we do not have a clear understanding of their schedule so we don’t know who to expect on any given day. Though some of the nurses have been fantastic – caring for our son and another child with diabetes and being proactive to ensure they eat everything in their lunch – others have been downright irresponsible. We have had a number of occasions where my wife (who has been showing up to train all these nurses) has had to hunt the nurse down or has had to keep them there in the office rather than running out “to a meeting”. It has been clear that if my wife was not there these individuals would have left campus without administering insulin.

The reason why there is such a turnover of nurses and limited coverage has not clearly been explained to us, but it is clearly a result of the difficult financial state of our district (the largest in the State) along with a rise in diabetes incidences.

Though we certainly appreciate a well-trained and caring nurse, it has become very evident that just because one holds a nursing license it does not explicitly equate to “well-trained” and “caring”. We would actually be much better off training a single, responsible, caring individual on how to calculate dosage and how to administer insulin rather than rely on the bevy of inconsistent nurses we have now.

Our own view is that this decision is simply a means of maintaining job security for the nurses rather than in any interest for the well-being of our children. Given that there is clearly a lack of adequate nurses in our country these days, this decision can only be seen as narrow and wrong.

I am sure that both the American Diabetes Association and the California Department of Education will be fighting this. We should lend our support.

Read more here: California School Nurses Org Applauds Court Ruling

As a parent it is your responsibility to ensure that the school is willing and capable of helping your child manage their diabetes.  If your child is in a public school in the US, they are required to provide you with services that ensures your child can experience school like every other child.  (Learn about a 504 plan)

Here are some initial steps that we took to ensure our relationship with our school was a positive one:

1. Tell Your School:  Seems obvious, but this is the first step.  Walk into the administrative office and let them know that your child has been diagnosed with Type 1 diabetes.  They are either going to know immediately what you need to do, or they are going to be lost.  This will help you understand how active you’ll need to be.
2. Meet with your Nurse: We then went to our district nursing office (as the nurse to our school wasn’t there).  At the office they explained all the forms we needed to get filled out so that the nursing staff would understand what their responsibilities were.
3. Meet with your Teacher: Like your administrative office, your teacher is either going to understand the situation immediately or need your help.  Regardless, you should put together a single page document that outlines what Type 1 diabetes is, what the dangers are, and how to look out for signs of trouble with your child.  It will be your teacher that is next to your child day-in and day-out.  It is absolutely necessary that you help them learn about this disease.
4. Document Requirements: Your doctor will have given you an insulin routine to follow and guidelines for insulin dosages and snack restrictions.  You’ll need to write these requirements down in an easy-to-read document that can go to your nurse(s), your teacher and any other school personnel looking after your child.  (These documents are also great to use for babysitters, parents and family, as well as close friends who spend a lot of time with your child).  It is critical to also document all the telephone numbers where you can be reached in case something should happen.
5. Be There: We spent the first few weeks with one of us meeting our son at lunch time to ensure that he ate his meal and got his insulin injection.  Because our school has a rotation of nurses, we spent time with each one and explained our son’s situation.  It took a while, but pretty soon, we became just observers and eventually handed off responsibility to the school.

We were “fortunate” in that there were a couple of other children at our school with Type 1 diabetes (even another in our son’s class!).  This made us more comfortable knowing that the school was experienced, but it also helped our son as he was not alone on his trips to the nurse’s office each day.

It was, and still is, scary handing over such a major responsibility to someone else.  But like with all of the life-aspects of diabetes, we felt it was important for all of us to lead as ‘normal’ a life as possible.  Being proactive, helping educate your school and seeing the management in action will help you eventually let go.