[IP] Re: School management of boluses by parents
Antonio wrote to Helen in Illinois who's advocating that parents of kids on
pumps be allowed/authorized to determine bolus doses in school:
Unless I'm missing something, it seems that the applicable regulations
DO allow a parent to make changes as needed to a child's "medication"
dosages. I think that a doctor's order stating something general, like
"Insulin dosages to be determined by parent according to food and
activity." Would suffice and cover all involved. I think that the
doctor would rather write this than be called every time an insulin
dosage needs adjustment.
Helen - As a nurse and a pumper, I applaud you. You are on the cutting edge
here since most medications ARE prescribed with a certain dose, time and
expected reaction. We know Type 1 diabetes and the tools we now have to work
in managing it, it unique. In order to determine our "dose of the moment," we
must take many factors into consideration (too long to list here but we all
know what the complex thinking process is that we use to determine a bolus).
I agree with Antonio's response to you and believe the reply you got from the
Illinois Department of Professional Registration regarding a parent's ability
to determine insulin dose with physician authorization - "the department
would never issue a statement that a physician cannot do this."
I think what the school and school nurse are dealing with is potential harm
(low BS or worse) to your child and also liability in the event there's a "bad"
response to a dose. The issue with nursing and the school seems to be
documentation - in other words, a WRITTEN order specifying "dose, time, side
and an emergency number." Perhaps each time you determine a dose, you need
to fax a written order to the nurse for your child.
Helen - please keep us posted. You are a remarkable mother, advocate,
researcher and teacher. I applaud the work you're doing - for your child and
all of us. Jill T Peaks Island Maine
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