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RE: [IPp] First week of school & @#$#$#@^%#@ Nurses!

Dear Allison,

And that is what is so great about this POP list, different ways of
looking at and dealing with things.  I am just so fired up about the
school system right now (down school, down) that I am not able to be
objective like you.  No fire cloak required.....lol.

Cindy, pump mom to Jessy (8) dx 1/02, Julie (3)non diab. and Trevor
(1)non diab.>From: "Allison Kane" >Reply-To:
email @ redacted >To: >CC: >Subject: RE: [IPp]
First week of school & @#$#$#@^%#@ Nurses! >Date: Wed, 21 Aug 2002
06:54:16 -0600 > >If your doctor signed the IHCP then they are considered
doctor's orders. The >school doesn't need something separate from that.
We have our endo sign our >504 plan each year. > > > Monday AM, school
started at 7:25 and his blood sugars had been > > surprisingly > > good
at 6:15 even though he'd still been awake at 12:30 being upset. > > At
8:30 the hospital faxed me the signed Health Care Plan I'd completed. > >
I faxed it to the school. Unfortunately, at 9AM I was paged by my son > >
with blood sugars of 339. Then the nurse called and complained > > she
didn't > > have dr. orders. > >IMHO, based on what you have written (I
wasn't there), it doesn't seem that >the nurse was out of line. She
doesn't deal with diabetes every day and it's >your job to educate (not
berate) her on a daily basis and help her see what >is right for your
son. I don't disagree with a little more control by the >school the first
week or two of classes. Our kids are going to be high and >low the first
couple of weeks. Your going to be doing basal/ratio changes >due to the
new schedule. Things are going to be changing alot the first >couple of
weeks. > >The schools have to protect themselves legally. They are
required by law to >make accommodations and they (most of the time) live
by the letter of that >law, not the spirit of it. If your 504/IHCP says
he tests at 8:30, then they >are going to want him to test at 8:30 every
day. Does your son have a watch >with alarms? If not, I highly recommend
one. > >I know I'm being the devil's advocate here, but you will get
further with >the school (who sounds like they are more than willing to
make >accommodations) by being THEIR advocate as well. Helping them help
you, >rather than fighting them and being rude ("repeatedly requesting
the she >please shut up"). > > > As I'm repeatedly requesting that she
please shut up and put him on the > > phone, > > she instead hands the
phone to the 7th grade principal who conviently had > > just walked down
the hallway. She then proceeds to tell me that he's > > obviously not
prepared for self-care in the classroom, didn't know what to > > do, > >
and had forgotten to test at 8:30 instead of 9 (big deal!!!) > > and will
need > > to do > > all blood sugar readings in the nurses office for a
few months. > >I am surprised that the school accepted the liability to
calculate the >boluses. Not many schools (districts) will do that. Again,
I think you are >being a little hard on the nurse. Again, she doesn't
deal with this every >day, and doesn't know your "rules." I also think
that her adding the two >numbers together is not a "mess up", it's not
like she calculated the wrong >amount. You just wanted two boluses so you
could see the numbers later, and >a verbal request is not likely to be
remembered by someone who deals with >hundreds of kids a day, especially
on the first day of school. You can't >just change the "rules" on them
like that. And it won't do you any good to >get upset about it. > > >
Nurses messed up > > helping him > > calculate his lunchtime correction
and bolus. He did the calculations > > correctly, but she then added up
both answers and told him to punch that > > in as one normal bolus. My
verbal orders to them that AM had said to do > > separate correction
bolus, so I could identify it later from the pump for > > logging, > >
and then to do a Dual Wave bolus for lunch when eating pizza. > >I agree
with the nurse here. Again, it's a liability issue. Whenever you >son's
bolus ratio's or corrections (times and ratios) change, you will need >to
either change the IHCP or an easier method, to add an addendum with the
>change, signed by the doctor. I know that we make these kinds of
decisions >every day, we change basals, we adjust bolus ratios,
correction ratios, >determine what times our kids should test, etc. But
this is not the job of >the school nurse. And she (the nurse) can only do
what the 504/IHCP says she >can do. If you IHCP says correct over 250,
that is what she is legally >allowed to do. Make her like easier by
keeping your 504/IHCP up-to-date. > > > > > Today, he was 84 at home, but
then 284 two hours later, and > > spent the day > > between 214 and 275.
They did the correction right, the bolus > > right, but > > then called
to complain that he shouldn't have done a correction unless > > he was
over 250 (their plan they wrote last year). She wanted NEW > > Dr. orders
if he was to do corrections at a lower number. > >Try to work with the
school rather than fighting with the school and you >will have a much
easier time of it. > >I speak from experience. I can tell you horror
stories of my own, and I have >learned that playing the game will get you
much, much further than fighting >against them. > >Take a deep breath and
remind yourself that you have accommodations for your >son. Your son IS
allowed to test in the classroom. Your school nurse is >willing to
calculate corrections and basals. You have SOOOOO much more than >many
parents do. Your glass looks half full (not half empty) from over here. >
>Putting on my fire resistant cloak, > >-- >Allison >Mom to Tarek, age
10, IDDM, dx 11-16-1998 >Pumping DTron since 1-12-2001 >Denver, Colorado
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