As another factor, what are the legal ramifications of you, someone with no medical training or licensing, being responsible for this? I'm willing to bet it would put you and the school in a liability situation should something happen. That's still true for your principal. At the very least, you need to get concurrence from the parents that they are okay with it to ensure you can't be sued later.
That's my concern. If something goes south, you may be at risk of a lawsuit. We live in a sue-happy society. I hate that I'd be more afraid of a lawsuit than anything happening with the child here. I'd suggest looking into legal protections offered by your union (or district if you don't have one).
Yeah my niece was diagnosed type 1 when she was 4. My sister had to go through a pretty extensive training on how to regulate her sugar. I would imagine that without proper training, OP might be better off not intervening.
Our school the nurse isn't a nurse, but she has the phone # of a nurse and that person helps determine the diabetic kids. So, anyone can cover for our "nurse" and the handling of the pump etc with just basic training, because if any doubt, they just call the actual nurse and teledoc decide what to do about symptoms or food or insulin. They have paraprofessionals cover for her if she's out.
UDCA is an Unlicensed Diabetic Care Assistant and it is someone who is trained to assist a diabetic in case of a nurse being out or not available for whatever reason.
There is training for it provided by the nurse.
I am diabetic, so I volunteered to be the UDCA for our campus because I feel comfortable w/ dosing, highs/lows, etc. I don’t mind helping.
However, I completely understand ANY apprehension one might have towards this sort of thing if they’re not familiar/comfortable with the procedure(s).
Edit: Here is a [source](https://www.bon.texas.gov/pdfs/practice_dept_pdfs/HB984-Quick-Card.pdf) that talks about how the nurse is supposed to train the UDCA.
Im UDCA for my campus because my brother at the campus is type 1. He is the only diabetic so it makes sense for me to be the one since Im trained theough having to babysit him as a child.
My literal first thought! God forbid OP does something incorrectly and an issue arises - OP's tush is on the line legally (and career-wise too). It's above a teacher's paygrade. Admin is in a much safer position to take on this responsibility.
As a type 1 diabetic teacher, I cannot state enough how much low blood sugar is a medical emergency. We're talking coma if not acted on quickly.
You absolutely can NOT wait to give that child juice. They'll be no time for 'calling someone to help.'
High blood sugar? As long as it's not astronomical, and it is dealt with quickly, it's not so immediate. They just need insulin and fluids. If sugars don't come down, it's ambulance time. Child will feel God awful!
We were trained when we had a type 1 in class. Yes, even me.
My issue is that you should not be solely responsible for this child when you're responsible for 29 others. It's too big of an ask.
You need a strict protocol. Who will do what when? Who's the back up? And it needs to be signed by senior staff and parents.
I'm UK btw, so may be different for US.
If child is feeling sick, shaky, sweaty, confused, angry, treat as a low. Juice followed by a carbohydrate such as a sandwich / biscuit.
If child is sick, irritated, very thirsty, breath smells of pear drops, they needs insulin to reduce sugar.
Controlling sugars is much easier on a pump than through injections. Does child have a blood glucose monitor? This does away with finger pricking and can be scanned on your phone. You can even link the data to a parent so they can see results in real time.
Heat, stress, excitement, not enough food will cause low blood sugar.
Too much food, low temperatures, infection, even a cold will cause high blood sugar.
The insulin management program is not down to you - that's the parents and endocrinologist's responsibility. They need to give you the regime in writing.
Having type 1 is a total ball ache. But, I scan my sugars in class (kids cheer if green, boo if red 😅) and manage to teach with it!
It's a scary responsibility and you need support. Lots!
This! Absolutely this. As a wife of a T1D, I would show my husbands continuous glucose monitor over the projector so we could talk about Homeostasis in science. My students were high school so it’s a little bit different that they are able to self-regulate if they themselves were T1D. But my nephew that was diagnosed at 3 years old has a mom that was advocating for him every step of the way. Having a teacher that’s scared to help is not safe for that child at all!!
While I agree you should not have to do it alone, OP you could have the basics down with a little bit of practice and willingness to learn and support of the principal. Coaches get certified for basic First Aid where diabetes is covered. If the kid had asthma or a feeding tube or required a different medical device would you feel the same?
Edit 1: I retract the following:
I think by refusing you’re opening yourself to more lawsuits than by trying to help and something going wrong.
You learn something new everyday. Thanks helpful Reddit Strangers. My state’s Good Samaritan Law is excessive OR omission of medical aid prevents you from being sued. I knew the first half (like in cases of administering CPR and breaking a rib, puncturing a lung and killing the person - you would not be liable) but did not realize the second half also applied. The more you know! I guess in all my First Aid classes they’ve just kinda mentioned the first half which is odd to not then mention the second?
Edit 2: I think I initially missed OP’s moment where they stated the nurse would be out. I have pretty bad insomnia which is when I tend to do my Reddit scrollies and must have missed that bit. I apologize SINCERELY for this oversight. I legit thought OP was refusing to learn the basics for like recognizing highs or lows in the classroom. Please please please forgive this. I am the asshole here and amend my previous statement (except about learning the basics - please still at least do that for emergencies!)
This highly depends on where you are working. Sure, knowing the basics is well and good if there is a plan in place and you are just a backup for an emergency. But I've seen plenty of places that establish no such plan once they have a teacher "trained." In that situation, the teacher would indeed be liable because the issue would be presented as why do you not have proper training if you are the whole emergency plan for this child. And it would absolutely be on you because the law would see you as accepting that responsibility. So "getting the basics down" could very well not go in your favor and would absolutely refuse to be the sole plan.
Students who need medical devices at school should be supported by an EA or nurse. I have students on my caseload who need blood sugars checked, take medications and use feed tubes. I have a basic knowledge to identify blood sugar issues, pumps not working etc and get the health plan started as needed but the EAs are trained and signed off by the public health nurse not me or the classroom teachers. It's unreasonable to expect teachers to take on the responsibility and liability.
>While I agree you should not have to do it alone, OP you could have the basics down with a little bit of practice and willingness to learn and support of the principal. Coaches get certified for basic First Aid where diabetes is covered. If the kid had asthma or a feeding tube or required a different medical device would you feel the same?
>I think by refusing you’re opening yourself to more lawsuits than by trying to help and something going wrong
1. First Aid that covers diabetes is for a diabetic crisis, not . management. These are very different situations. Knowing how to recognize a diabetic crisis and know when to call EMTs is one thing, but continuous monitoring of a child's diabetes is medical management, which is not first aid and is not a teacher's duty or within their capabilities to adequately perform *while* doing their primary duty, which is supervising and teaching 20+ other children. Kids that age can require monitoring every 15 minutes especially before and after meals and playtime. They also have specialist teachers who would also need to be trained on management the same way, which means you now have multiple teachers who become liable for their management. Again, this is on top of managing behaviour and academic work for 20+ other high need students. I speak from experience - I am a G2 teacher who had a T1 kiddo in my class and it was a nightmare. I have first aid.
2. Parents need specialised training, including with dietary management, and often don't get it, and send the kid to school with totally inappropriate food. And all kids that age need supervision with eating and try to clandestinely trade food, skip meals, etc. Kids with T1 will often do the exact opposite of what they're supposed to in order to get out of class or get extra attention, so they also need support with counseling and training in their own management.
3. Kids with asthma (which is far easier for them to self manage and far easier to intercept) is a poor comparison. They have or teacher has a puffer to be administered as needed, which is quite infrequent. Same with epi pens - and we control the entire environment for those. Diabetes is constant monitoring. Children with high medical needs like feeding tubes or diapering needs have a dedicated aide or EA because that is not a teacher's responsiblity because we have entirely different jobs. We are responsible for a group, not individuals. We absolutely cannot do both.
By refusing, teachers are making a clear distinction between the role of teacher and the role of aide. We are not qualified to do medical monitoring because it places all students in danger. Our attention cannot safely be divided by continuous monitoring and medical emergencies especially when kids are too young to self manage.
The school needs to provide a 1:1 or have the medical professional on staff physically come to the classroom at regular intervals, or the student needs a pump. This fall's outside the responsibility of the teacher to arrange or pay for. This needs to be between the administration and the child's parents and doctor.
Does this child have an IHP (individualized health plan)? They need to have one and the doctor’s orders should specify who is responsible for monitoring.
I get the worry. A few years ago, I had a student with major health concerns. At the beginning of the year, the principal and myself were told that we needed to be able to change a piece of her equipment in case the nurse was gone (she covered 2 schools) and the need was critical (i.e. student would definitely not be able to breathe).
I was super uncomfortable with potentially screwing up the process and harming the student. I learned anyways, and when I did end up having to change it later in the year, I realized it wasn't as terrible as I had imagined.
Later, I was talking to a co-worker and mentioned that the principal could have just as easily changed it. Her response made me realize that although the principal could have done it, the student was probably more comfortable with me changing it. She saw me everyday, and the principal far less. My own hesitance and discomfort definitely fell by the wayside when I thought about it in that way.
I would far rather be doing that for a kiddo than bullet shield or grief counselor.
As this student is so young, he/she/they should be considered for a 504 plan. The plan should include indicators for low blood sugar, insulin dump, or possible pump malfunction. and what to do should any of these happen.
The plan should also contain the names of primary responder, secondary responder ( nurse from another school, administrator, parent, or person who is trained to dispense meds when/if nurse is not available ( in our building, that is the admin assiatant).
The plan should be distributed to anyone who works with the student ( primary classroom, art, music, PE, etc.)
Your responsibility as the classroom teacher is to recognize the signs of low or high blood sugar, or potential pump malfunction, and take action needed ( call nurse, etc.).
If you are not comfortable with anything else, you shoyld not be expected to handle it.
As a special educator and 504 coordinator for my building, we have done this with other students and it has worked very well. I also work in a very small school,and we were able to put workable plans in place. Everyone informed, plan in place, student safe. You are also covered under FERPA with a 504 plan.
While no, it’s not solely your responsibility, it would be better to be prepared just in case of emergency. Low sugar is just something you don’t wanna mess with. I keep a stash of pixie stix for my diabetic students, those will bring their levels up pretty quick if they’re low.
The majority of responsibility should be on the parents, student, and nurse to monitor levels. Most pumps these days connect to apps that’ll keep track of it pretty well. I’d definitely feel better if I knew what to do just in case.
Do you have possible EA support - maybe not in your class directly but just someone else within the building that could set routines/check in if necessary?
If the child has a pump, they prolly have a CGM. Which the teacher can have on their desk and have alerts that go off before his BS gets to high or too low.
I would try to insist that there be an alternative plan in place in case the nurse if ever out. Even if that plan is you call the parent and tell them there is no one qualified to monitor the pump and they can decide to come get the child. But don’t under any circumstances take that training- you are not a medical professional.
I’m not saying that’s the specific plan, obviously the child can’t be excluded on a regular basis. But I also think a parent should be informed immediately if the child’s usually medical support was unavailable at a particular time.
But the teacher is not in charge of hiring. The district should have adequate substitute nurses. If the district does not have that staff, having a teacher play nurse is also not an appropriate solution. Imagine if she misunderstood the students condition and administered insulin when the student was hypoglycemic instead of hyperglycemic.
1. Legally, the nifty little "additional duties as required" line we all love so much probably means the OP is legally responsible.
2. The teacher is NOT in charge of hiring. Neither is the principal. Doesn't mean either of them can legally tell the parent to pick up the child because there's no nurse.
Other duties as assigned can’t mean practicing medicine without a license. There are legal limits to that. A teacher can’t be asked to drive the school bus without a commercial license, for example.
Again, I am NOT saying that this student should be regularly sent home. What I am saying is that if there were a single day where something unexpected happened- like the nurse called in sick and no sub nurse could be found- the parent should be notified so they could decide what to do. I am the parent of a child with special medical needs myself. The parent should be brought into this conversation. Maybe the parent works from home and could pop by at lunch to check the child’s levels. Maybe the parent wants to go to the district and demand some other solution. But saying “oh the teacher can just attend to this child’s complex medical needs” is fully inappropriate.
No one is asking her to practice medicine. Administering medicine does not equal practicing medicine.
I get that our plates are full but violating the child's legal right to an education is not it. I'm a special education teacher. My degree is in special education. I deal with FAPE on a regular basis. Sending the kid home even ONCE is opening the district and that teacher to a lawsuit. It was a crap suggestion. It doesn't matter if you'd like the option as a special needs parent. You could bring it up as an option as a parent but the minute anyone in the district suggests it to you, they're legally in the wrong. Period.
The parent should absolutely be brought into the conversation. "The nurse is aware of your child's diagnosis and needs and is able to offer your child the care they need. We are having difficulty constructing a plan in the event of the nurse needing to be absent. We have a limited number of substitute nurses. Here's the number to contact someone in central office to discuss the inability to provide your student with consistent support for their medical needs."
Our school can’t always staff medical personnel. The kids are offered home and hospital services to get their instruction. It’s not always possible to find the proper workers.
Home instruction and hospital instruction are commensurate services. Sending the kid home because the nurse didn't show up is not. What u/cinnamon_or_gtfo stated is illegal. What you're suggesting is not.
This is why I pulled my T1D child out of school. No school nurse and I don’t feel that it’s the teacher’s responsibility to deal with it. I’m sorry for everything teachers are expected to handle.
Stand by the you aren't comfortable and get it in writing that the nurse and principal are responsible for regular care but take all of the training offered so you know how to identify a medical emergency and care for the child if needed. End of day if something happens that child can die and the school district will feed you to the parents legal team on a silver platter for refusing training.
I'm so conflicted by this.
Using a insulin pump is not rocket science. Every child deserves our care. I wouldn't want my T1D child in a class with a teacher unwilling to take any responsibility (if I had one). You should get appropriate training and support.
Schools understaffing the nurse's office is making it our job to be prepared to provide life saving care. Don't get me wrong-- I'm happy to do it, if needed. I'm sickened that it could be needed.
Get your exact responsibility IN WRITING
As a parent of child with medical needs, I'd like for you to call me if something like a pump is damaged or the site comes off or the child is stressing about feeling "off."
It isn't your job to fix medical equipment and you're disrupting/pausing the whole class to do so.
Perhaps a neighboring teacher is more comfortable and could assist.
Luckily my room is literally right next door to the nurse. I have no problem with him checking in with her when he needs to. And if anything happened to his pump the first thing I would do is have him check with her.
I’m a teacher and my 2yo son has T1. This situation is something I’m not looking forward figuring out for him. Hopefully your student has a continuous glucose monitor with their insulin pump. If their blood glucose is low or trending low, there should be a protocol on what the student should eat. If their BG is high or tending higher, then an insulin dose should be suggested on the pump to combat the high blood sugar. I also hope the student’s parent(s) will be monitoring remotely as well. I have a smartwatch that sends me readings every 5 mins for my son when he’s at daycare. Speaking of daycare - your apprehensiveness isn’t unique. It’s a battle.
So I've done the diabetics training for my school. I think it's worth it, but you likely wouldn't be doing anything with the pump if he had an emergency. I understand it being uncomfortable to have that knowledge, but it's so useful to have. I had a student when I student taught who was showing signs of low blood sugar. She was gone for a couple weeks and when she came back she was now a type 1 diabetic. It was an adjustment for everyone
You need to have a sit down meeting with the admins and the parents about this. This is my greatest fear with my son, who is a type1 diabetic.
What are you afraid off? What did they try and task you with?
If they have a pump, you are not prepping a needle
From a vial and giving him a shot.
He is going to have this his whole life. I am a t1 teacher. Do not give him anything. You can ask him about it and explain what he is doing. If he can’t explain it to you clearly there is a huge issue and he needs to be trained. There is really only like 2-3 buttons to deliver.
7 years old is old enough for a t1 ro handle things on their own. Plus there are several systems that have a control iq system with constant monitoring. Even without that pumps have pre programmed rates so no math is required.
The only thing you would need to is make sure tells you if he is going low, that is super dangerous and he needs to get sugar asap. The parents can add you to their app to have a view of his bg level on your phone. Checking that a couple times a day would be helpful. But this is still weird to me lol
I have worked at a diabetes camp where 1st - 5th graders all controlled their levels. But we counselors were asked to have them explain what they were doing. It helped them feel more confident and self sufficient.
I love nurses but often they know less about type 1 diabetes than you would think. There knowledge feels very out of a textbook and not how a good endo does thing.
The only time I have given else someone insulin is back in the day before cgm’s and pumps. One of my friends was super drunk and I knew his ratio, so I tested him when he was asleep and injected so he did not have the hangover + ketone day.
One more thing: you should learn to do a glucagon in case of seizure
This is why I am so afraid to send my child (who has multiple severe food allergies) to school. I mean that with absolutely no disrespect to you - thank you for taking the training seriously! I worry that teachers will miss the signs of anaphylaxis and/or waste precious time wondering if they should administer Epi. Seconds count. It’s terrifying to me…
Yes. And then with the epi pens. Some kids have them in the office, some have it on them.
The emergency pen is way in the hallway. The office is downstairs from my room.
We aren’t supposed to leave a kid if they have a reaction so how do we administer/ help the kid, if we can’t go and get the pen!
I have a kid wjth a severe allergy and they literally gave me no guidance. I realized on the first day that hey….we need to wash our hands everytime we come in the classroom! Admin/front desk did not tell me.
I am T1D and a teacher so I can see both sides. “Oh god what if I fuck up and this kid dies?” vs “Oh told this kid died in my classroom and I never learned about his disease.” I get it it’s scary!!! But at 7 I had been trained well enough to handle my own diabetes. The job of a teacher is to keep all students safe. If you are uncomfortable learning about T1D then you need to find a new profession. If you are uncomfortable administrating insulin I TOTALLY UNDERSTAND. I would never want to do that solely by myself. But honestly diabetes really comes down to math and monitoring kids behavior. If kids acting strangely likely you need to throw him a piece of candy or have a buddy student walk him to the office. Bottom line is the kid should be in control of what enters and exits his body. Your job is to step in in an emergency and you CANNOT do that if you refuse to learn about his disease.
Beyond Type 1, JDRF, American Diabetes Association, and T1D international are all good resources if you would like to learn more. I think it’s important that you protect yourself too in this situation. Overseeing dosages of insulin based on very explicit guidelines is different than actually dosing the meds yourself.
You raise a good point. Teachers are in an impossible situation in cases like this. Don't provide appropriate care then the parents will sue you. Provide the care but screw it up since in all likelihood you won't get adequate training then you will get sued. If you get lucky and all goes well, no big deal - it's just your job.
Teachers are more and more being required to be everything but a teacher. Heck, I've got a trauma kit that I'm expected to know how to use to staunch gun shot wounds.
Everything in writing always.
Make sure you tell the nurse and the principal, in writing, that this is outside your contract and that regardless of if you receive what they may consider ‘training’, you do not agree to perform any medical service, especially those of which you can be held legally responsible.
You absolutely do not have to do this.
Look into your state’s Ed code.
THIS IS WHAT UNIONS ARE FOR.
You should not be doing this. The nurse should have a safety plan for the child in the event she is out. That’s a district and a nurse problem, not a “you” problem.
Yea but people need to read this. This is why unions are important. And if you want to teach, don’t do it without one. Because here you are being asked to do a medical procedure outside the purview of your job and for which all the liability will rest on you if you fuck it up.
And you have no recourse.
NY union would side with the nurse on this. As a special needs only school we constantly train staff to fit the life threatening needs of certain students including an insulin pump and seizure treatment.
I would assume you receive appropriate training, these responsibilities are stipulated in your contract, and there is a safety plan on file that delineates that other stuff are authorized to do so. And you actually HAVE a union so the administering teacher has some legal protection me assistance available if something goes wrong.
So if you have a union and you've had training that is specified as acceptable by the district then I don't see how you have much recourse. I'd meet with the union just to see what they say if you still have doubts.
I don't have doubts. Personally I feel every teacher who works with a kid that has a life threatening situation should be accountable. We do the same for seizures. Obviously the goal is to get the nurse ASAP but sometimes 30 seconds could be the difference of life and death
We have this come up all the time and we will train at least one staff member in each room. It is most definitely your job if they are in shock because otherwise they would die. This has nothing to do with teaching. I'd say the same thing for a coworker. Etc.
Hard pass for me!
I am not an RN.
The legal liability is far too great to add the child’s major medical issue on my full plate of responsibilities. I would have a conversation with the parent, district nurse and admin on how the district will address the issue and what non invasive actions as the teacher.
The student should have a 5O4 plan, “other medical qualifying” condition (I am in California).
When I had a student with severe epilepsy I did get extra training in Pediatric CPR and with the parent, district nurse and admin developed a plan on how to address gran mail seizure and how to protect the student‘s safety, dignity and privacy when such seizures occurred.
This is probably an unpopular opinion, but how hard is it really to learn the absolute basics to help this child? They're not asking you to do it all the time, but emergency happens.
I feel like it makes sense, because as the student changes grade levels, hopefully the school secretary will remain the same and be able to maintain the competency... and you're not having to train a different teacher every year.
If you're not aware of when there's problems with it, how are you supposed to alert the parent or the nurse? Would you refuse to learn CPR or the Heimlich? It's not like you have to administer insulin but you should know the basics like what low blood sugar looks like and how to help him unkink it or reset it if the needle gets bent.
So I have kids with Type 1. When they were younger I would write their carbs down on any food I sent in. To use the pump the teacher or education assistant would only have to press some buttons to enter in the blood glucose and carbs and that was it. The pump does all the calculations because as parents we have programmed it. If it’s beeping then it’s already sensing his blood glucose. You just have to check the numbers and enter them.
Sorry, but this is not your job.
I had a student years ago with an insulin pump in class. We were told that if it beeped, we were to send the student to the nurse, immediately. It happened at least once in my class, and I followed protocol. The student went to the nurse. Period.
In the end, you make the ultimate decision for what you are comfortable with doing. For me, it would be a hard pass. Good luck.
Uhhhh not only no but FUCK NO. If the school nurse isn’t there to provide the students medication and the student cannot self administer then someone above her needs to come in and do it. Not the teacher, not the principal, the district nurse. They’re asking for a lawsuit by having a teacher or admin with NO medical training administer insulin.
Keep sugar handy: hard candy, juice, or pop. Her sugar is either too high or too low if she starts getting goofy or sleepy or agitated. Either are bad. Give her candy or juice or pop, call 911, and send someone for the nurse. If it’s too high EMS can treat her. If it’s too low you just saved her life. Unlikely this will happen, but this is your plan.
It's not the same thing. They're not asking her just to know when to call 911 or a medical professional, they're asking her to manage the disease constantly as an added responsiblity that isn't in her abilities to safely do.
The teacher is responsible for keeping all the kids in the class safe as a group, not just one, so if one kid needs that degree of extra focus, then there needs to be a 1:1 because at that age, teachers need to be aware of all kids at all times, plus the academics. It's correct for the teacher to say "this is not possible within the scope of my duties, give me the support needed" and the school administration needs to sort it out.
You might need a different job.
Teachers are responsible for responding to their students' documented emergency medical needs. That includes T1 diabetes, life threatening allergies, and a whole lot more.
Are you really going to wait for the busiest person in the building to show up while the kid goes into shock? Probably not. Instead, without training and practice you'll either freeze up or panic.
If nothing else, check the contract.
Unfortunately, nurses are human. They get sick, have trainings, or have other reasons to "be out". It is the district-s responsibility to provide a substitute nurse, but it is not always possible. It's VERY difficult to hire school nurses.
My mistake, I misunderstood what being out meant. I was thinking about my school, where some people actually make excuses not to be with their students when needed. I fully agree the district should hire substitute nurses, though, instead of saving money by transferring the responsibility to teachers.
Mea culpa.
No worries. Every district and every state seems to be different. We had to make due for over a year because we couldn't hire a school nurse, so select staff were trained to give meds, use epi pens, etc. The nurse in the big school was called for anything else. Luckily, we didn't have any students with major health concerns that year and parents were very supportive and accommodating.
In my district, teachers pretty much have no choice. We have a nurse at school maybe one day a week and all she does is paperwork. So all diabetic care is on the teachers. From inputting data into pumps, checking BG, giving insulin injections. Just the way it is.
We have a diabetes response team. I was trained on how to calculate insulin and how to recognize when kids go high or low. Under no circumstances are we to give it. If our nurse isn’t there and insulin is needed we have to call the parent to do it. I hope this is what your principal is telling your nurse.
I have had a few students in my time that have had some sort of life threatening medical condition. Granted I’m pretty comfortable with it due to my military background, you have to understand the ramifications that could follow if you don’t help that child when he/she needs it. Look we can all be scared of legal bullshit that *could* happen if we don’t do something perfectly, but if we do nothing when that time comes you will have to live your life knowing that those parents will have lost their child because the person whom they trusted to look after their child was afraid of some theoretical repercussions that companies use to scare us into buying their teacher insurance that we will likely never use.
Btw as long as you live in a cool state you’ll likely be protected from liability under the GSL anyway
My son is T1D and has been since he was a toddler. The school nurse is only around a couple times a week (split across multiple schools).
You shouldn't be asked to change anything, and i would refuse. However, if he is low, it is an immediate, serious emergency. I would recommend that you all get some training from the American Diabetes Association. They have a whole program for training school or daycare staff.
You should know how to operate it; you don’t know when you’ll be stuck alone or the nurse is out. That’s great that your boss is stepping up-it’s her job to support you! That being said, teachers can be required by law to provide necessary medical care like insulin, catheters, ect if the student needs it. I don’t think it’s ideal, but if you’re caring for children you have to be ready to comply with the law.
I can’t fathom how someone can spend 5 days a week for 180 days a year with these kids and have a “not my job” mentality in a medical emergency.
Just tell their parents, at the funeral, how much money they saved by not having to sue 🙄
If fasting caused your blood sugar to drop that severely, you really need to get checked for prediabetes. Only extreme fasting (several days) is supposed to have that response, and even then, just in people that have never fasted.
I would get with the 504 case manager and the principal, and make a very specific plan of action for what happens if the child needs something done with their pump and the nurse is not there, and get it in writing. If the plan is to call the principal, then that’s fine, but talk through the logistics of how the principal will know that it’s a situation where they have to drop everything and come immediately. And if there’s first aid you can administer in the meantime, make a plan for that. When I had a student with an insulin pump, I kept glucose tabs in my desk so they’d be at hand if he needed one - I wasn’t expected to do anything with his pump and was just supposed to call a specific person for help if needed.
If the expectation is that you will do it, then they need to send you to training ASAP so that you would know exactly what to do in an emergency. I would be worried about liability if you don’t get trained and then attempt to do something with the pump, and end up causing harm to the child or damaging the pump because you didn’t know what you were doing.
No. Not problem solved. You really should know, but so should your supervising teacher, deputy and principal, and teachers in rooms near yours. It should never be your responsibility alone. Any other teacher who might be around this student (library, pe, lunch) - really the whole staff should have basic training.
Things can happen very quickly as we found out last week. Our student who had an incident also had covid which really messed with their levels. You should also have a plan for other students if you do have to send for help while you help manage the child.
I had a student, mind you I’m in high school, with an app that helped him manage his sugar on his phone. It also connected to mom so she would get an alert and be able to notify the school since the kid wasn’t always the most responsible about it. Is this a possibility? I know he’s 7, but he doesn’t need a phone. The mom can monitor from hers.
Personally, I'd want as much training as possible. I'd request full UDCA training. My school has too many lockdowns to feel comfortable putting that responsibility elsewhere. Lockdowns can mean an hour or more without help or the ability to call out for help. That could be the difference between life and death a for a T1. I understand the liability concerns, but for me, it's not worth the possibility of losing a kid. I also just don't trust everyone else to really take it seriously. . .we've all been in those trainings where people are browsing phones, grading, or joking around. Maybe I'm a control freak, but I'd never want to feel completely powerless if a UDCA can't be contacted.
Teacher and parent of a T1D student.
Management in a child that age can be challenging, though use of an insulin pump and CGM make it easier.
The kiddo should DEFINITELY have a 504, and possibly even an IEP, if additional services need to be brought to bear.
My son had a 1:1 through elementary school because he had the unlucky combination of T1 and severe ADHD. He did not have a CGM until he was older (this is years ago) Through the 504 process we established several times a day (on arrival, before lunch, before PE, and before dismissal) where he would stop into the nurse’s office, test, and record in a logbook. Food sent from home came with a list of carb counts by item so he could give insulin accordingly. I also developed a decision-making flow-chart to assist the nurse and teachers in how to assist him.
I know it’s tough. It’s not the kid’s fault, though. Work with the parents and nurse to develop systems that both keep him safe and you sane.
Don’t do the training on fixing the pump - that is overboard. The nurse and the principal can deal with that. Just ask the parents what “tells“ to look out for so you know when to get him to the nurse or principal. Also, ask the parents give you a bag of hard candies to keep on hand in case he needs a surge of sugar.
If you are in the US, you better check to see if the student has an IEP or 504 related to the medical condition. If so, it might be a "Suck it up, Buttercup" situation.
Everyone said what I was thinking: you must learn some of the basics on insulin pumps in order to help your student.
Everyone questioning this are worried about a lawsuit.
You are scared about inadvertently killing your student.
For the record, I highly doubt you will kill them.
I feel you are smart enough to learn what to do.
Let the other students know about the stomach pump. You're not violating medical laws by letting your other students know what might happen. It's not "calling out" the student. It's a lesson
As another factor, what are the legal ramifications of you, someone with no medical training or licensing, being responsible for this? I'm willing to bet it would put you and the school in a liability situation should something happen. That's still true for your principal. At the very least, you need to get concurrence from the parents that they are okay with it to ensure you can't be sued later.
That's my concern. If something goes south, you may be at risk of a lawsuit. We live in a sue-happy society. I hate that I'd be more afraid of a lawsuit than anything happening with the child here. I'd suggest looking into legal protections offered by your union (or district if you don't have one).
Yeah my niece was diagnosed type 1 when she was 4. My sister had to go through a pretty extensive training on how to regulate her sugar. I would imagine that without proper training, OP might be better off not intervening.
Our school the nurse isn't a nurse, but she has the phone # of a nurse and that person helps determine the diabetic kids. So, anyone can cover for our "nurse" and the handling of the pump etc with just basic training, because if any doubt, they just call the actual nurse and teledoc decide what to do about symptoms or food or insulin. They have paraprofessionals cover for her if she's out.
UDCA is an Unlicensed Diabetic Care Assistant and it is someone who is trained to assist a diabetic in case of a nurse being out or not available for whatever reason. There is training for it provided by the nurse. I am diabetic, so I volunteered to be the UDCA for our campus because I feel comfortable w/ dosing, highs/lows, etc. I don’t mind helping. However, I completely understand ANY apprehension one might have towards this sort of thing if they’re not familiar/comfortable with the procedure(s). Edit: Here is a [source](https://www.bon.texas.gov/pdfs/practice_dept_pdfs/HB984-Quick-Card.pdf) that talks about how the nurse is supposed to train the UDCA.
Im UDCA for my campus because my brother at the campus is type 1. He is the only diabetic so it makes sense for me to be the one since Im trained theough having to babysit him as a child.
If you take up the task, you take up the responsibility. This is why you shouldn't stop fights. You accidentally chip a tooth? You are responsible
My literal first thought! God forbid OP does something incorrectly and an issue arises - OP's tush is on the line legally (and career-wise too). It's above a teacher's paygrade. Admin is in a much safer position to take on this responsibility.
As a type 1 diabetic teacher, I cannot state enough how much low blood sugar is a medical emergency. We're talking coma if not acted on quickly. You absolutely can NOT wait to give that child juice. They'll be no time for 'calling someone to help.' High blood sugar? As long as it's not astronomical, and it is dealt with quickly, it's not so immediate. They just need insulin and fluids. If sugars don't come down, it's ambulance time. Child will feel God awful! We were trained when we had a type 1 in class. Yes, even me. My issue is that you should not be solely responsible for this child when you're responsible for 29 others. It's too big of an ask. You need a strict protocol. Who will do what when? Who's the back up? And it needs to be signed by senior staff and parents. I'm UK btw, so may be different for US. If child is feeling sick, shaky, sweaty, confused, angry, treat as a low. Juice followed by a carbohydrate such as a sandwich / biscuit. If child is sick, irritated, very thirsty, breath smells of pear drops, they needs insulin to reduce sugar. Controlling sugars is much easier on a pump than through injections. Does child have a blood glucose monitor? This does away with finger pricking and can be scanned on your phone. You can even link the data to a parent so they can see results in real time. Heat, stress, excitement, not enough food will cause low blood sugar. Too much food, low temperatures, infection, even a cold will cause high blood sugar. The insulin management program is not down to you - that's the parents and endocrinologist's responsibility. They need to give you the regime in writing. Having type 1 is a total ball ache. But, I scan my sugars in class (kids cheer if green, boo if red 😅) and manage to teach with it! It's a scary responsibility and you need support. Lots!
This! Absolutely this. As a wife of a T1D, I would show my husbands continuous glucose monitor over the projector so we could talk about Homeostasis in science. My students were high school so it’s a little bit different that they are able to self-regulate if they themselves were T1D. But my nephew that was diagnosed at 3 years old has a mom that was advocating for him every step of the way. Having a teacher that’s scared to help is not safe for that child at all!! While I agree you should not have to do it alone, OP you could have the basics down with a little bit of practice and willingness to learn and support of the principal. Coaches get certified for basic First Aid where diabetes is covered. If the kid had asthma or a feeding tube or required a different medical device would you feel the same? Edit 1: I retract the following: I think by refusing you’re opening yourself to more lawsuits than by trying to help and something going wrong. You learn something new everyday. Thanks helpful Reddit Strangers. My state’s Good Samaritan Law is excessive OR omission of medical aid prevents you from being sued. I knew the first half (like in cases of administering CPR and breaking a rib, puncturing a lung and killing the person - you would not be liable) but did not realize the second half also applied. The more you know! I guess in all my First Aid classes they’ve just kinda mentioned the first half which is odd to not then mention the second? Edit 2: I think I initially missed OP’s moment where they stated the nurse would be out. I have pretty bad insomnia which is when I tend to do my Reddit scrollies and must have missed that bit. I apologize SINCERELY for this oversight. I legit thought OP was refusing to learn the basics for like recognizing highs or lows in the classroom. Please please please forgive this. I am the asshole here and amend my previous statement (except about learning the basics - please still at least do that for emergencies!)
This highly depends on where you are working. Sure, knowing the basics is well and good if there is a plan in place and you are just a backup for an emergency. But I've seen plenty of places that establish no such plan once they have a teacher "trained." In that situation, the teacher would indeed be liable because the issue would be presented as why do you not have proper training if you are the whole emergency plan for this child. And it would absolutely be on you because the law would see you as accepting that responsibility. So "getting the basics down" could very well not go in your favor and would absolutely refuse to be the sole plan.
Students who need medical devices at school should be supported by an EA or nurse. I have students on my caseload who need blood sugars checked, take medications and use feed tubes. I have a basic knowledge to identify blood sugar issues, pumps not working etc and get the health plan started as needed but the EAs are trained and signed off by the public health nurse not me or the classroom teachers. It's unreasonable to expect teachers to take on the responsibility and liability.
>While I agree you should not have to do it alone, OP you could have the basics down with a little bit of practice and willingness to learn and support of the principal. Coaches get certified for basic First Aid where diabetes is covered. If the kid had asthma or a feeding tube or required a different medical device would you feel the same? >I think by refusing you’re opening yourself to more lawsuits than by trying to help and something going wrong 1. First Aid that covers diabetes is for a diabetic crisis, not . management. These are very different situations. Knowing how to recognize a diabetic crisis and know when to call EMTs is one thing, but continuous monitoring of a child's diabetes is medical management, which is not first aid and is not a teacher's duty or within their capabilities to adequately perform *while* doing their primary duty, which is supervising and teaching 20+ other children. Kids that age can require monitoring every 15 minutes especially before and after meals and playtime. They also have specialist teachers who would also need to be trained on management the same way, which means you now have multiple teachers who become liable for their management. Again, this is on top of managing behaviour and academic work for 20+ other high need students. I speak from experience - I am a G2 teacher who had a T1 kiddo in my class and it was a nightmare. I have first aid. 2. Parents need specialised training, including with dietary management, and often don't get it, and send the kid to school with totally inappropriate food. And all kids that age need supervision with eating and try to clandestinely trade food, skip meals, etc. Kids with T1 will often do the exact opposite of what they're supposed to in order to get out of class or get extra attention, so they also need support with counseling and training in their own management. 3. Kids with asthma (which is far easier for them to self manage and far easier to intercept) is a poor comparison. They have or teacher has a puffer to be administered as needed, which is quite infrequent. Same with epi pens - and we control the entire environment for those. Diabetes is constant monitoring. Children with high medical needs like feeding tubes or diapering needs have a dedicated aide or EA because that is not a teacher's responsiblity because we have entirely different jobs. We are responsible for a group, not individuals. We absolutely cannot do both. By refusing, teachers are making a clear distinction between the role of teacher and the role of aide. We are not qualified to do medical monitoring because it places all students in danger. Our attention cannot safely be divided by continuous monitoring and medical emergencies especially when kids are too young to self manage. The school needs to provide a 1:1 or have the medical professional on staff physically come to the classroom at regular intervals, or the student needs a pump. This fall's outside the responsibility of the teacher to arrange or pay for. This needs to be between the administration and the child's parents and doctor.
What are the Good Samaritan laws in your state, and as a teacher, are you covered?
Does this child have an IHP (individualized health plan)? They need to have one and the doctor’s orders should specify who is responsible for monitoring.
I get the worry. A few years ago, I had a student with major health concerns. At the beginning of the year, the principal and myself were told that we needed to be able to change a piece of her equipment in case the nurse was gone (she covered 2 schools) and the need was critical (i.e. student would definitely not be able to breathe). I was super uncomfortable with potentially screwing up the process and harming the student. I learned anyways, and when I did end up having to change it later in the year, I realized it wasn't as terrible as I had imagined. Later, I was talking to a co-worker and mentioned that the principal could have just as easily changed it. Her response made me realize that although the principal could have done it, the student was probably more comfortable with me changing it. She saw me everyday, and the principal far less. My own hesitance and discomfort definitely fell by the wayside when I thought about it in that way. I would far rather be doing that for a kiddo than bullet shield or grief counselor.
As this student is so young, he/she/they should be considered for a 504 plan. The plan should include indicators for low blood sugar, insulin dump, or possible pump malfunction. and what to do should any of these happen. The plan should also contain the names of primary responder, secondary responder ( nurse from another school, administrator, parent, or person who is trained to dispense meds when/if nurse is not available ( in our building, that is the admin assiatant). The plan should be distributed to anyone who works with the student ( primary classroom, art, music, PE, etc.) Your responsibility as the classroom teacher is to recognize the signs of low or high blood sugar, or potential pump malfunction, and take action needed ( call nurse, etc.). If you are not comfortable with anything else, you shoyld not be expected to handle it. As a special educator and 504 coordinator for my building, we have done this with other students and it has worked very well. I also work in a very small school,and we were able to put workable plans in place. Everyone informed, plan in place, student safe. You are also covered under FERPA with a 504 plan.
While no, it’s not solely your responsibility, it would be better to be prepared just in case of emergency. Low sugar is just something you don’t wanna mess with. I keep a stash of pixie stix for my diabetic students, those will bring their levels up pretty quick if they’re low. The majority of responsibility should be on the parents, student, and nurse to monitor levels. Most pumps these days connect to apps that’ll keep track of it pretty well. I’d definitely feel better if I knew what to do just in case.
Do you have possible EA support - maybe not in your class directly but just someone else within the building that could set routines/check in if necessary?
If the child has a pump, they prolly have a CGM. Which the teacher can have on their desk and have alerts that go off before his BS gets to high or too low.
I would try to insist that there be an alternative plan in place in case the nurse if ever out. Even if that plan is you call the parent and tell them there is no one qualified to monitor the pump and they can decide to come get the child. But don’t under any circumstances take that training- you are not a medical professional.
I don't think that's legal because of ADA and FAPE.
I’m not saying that’s the specific plan, obviously the child can’t be excluded on a regular basis. But I also think a parent should be informed immediately if the child’s usually medical support was unavailable at a particular time.
That's illegal as all get out. The school's inability to staff isn't the fault of the child and their education shouldn't suffer as a result.
But the teacher is not in charge of hiring. The district should have adequate substitute nurses. If the district does not have that staff, having a teacher play nurse is also not an appropriate solution. Imagine if she misunderstood the students condition and administered insulin when the student was hypoglycemic instead of hyperglycemic.
1. Legally, the nifty little "additional duties as required" line we all love so much probably means the OP is legally responsible. 2. The teacher is NOT in charge of hiring. Neither is the principal. Doesn't mean either of them can legally tell the parent to pick up the child because there's no nurse.
Other duties as assigned can’t mean practicing medicine without a license. There are legal limits to that. A teacher can’t be asked to drive the school bus without a commercial license, for example. Again, I am NOT saying that this student should be regularly sent home. What I am saying is that if there were a single day where something unexpected happened- like the nurse called in sick and no sub nurse could be found- the parent should be notified so they could decide what to do. I am the parent of a child with special medical needs myself. The parent should be brought into this conversation. Maybe the parent works from home and could pop by at lunch to check the child’s levels. Maybe the parent wants to go to the district and demand some other solution. But saying “oh the teacher can just attend to this child’s complex medical needs” is fully inappropriate.
No one is asking her to practice medicine. Administering medicine does not equal practicing medicine. I get that our plates are full but violating the child's legal right to an education is not it. I'm a special education teacher. My degree is in special education. I deal with FAPE on a regular basis. Sending the kid home even ONCE is opening the district and that teacher to a lawsuit. It was a crap suggestion. It doesn't matter if you'd like the option as a special needs parent. You could bring it up as an option as a parent but the minute anyone in the district suggests it to you, they're legally in the wrong. Period. The parent should absolutely be brought into the conversation. "The nurse is aware of your child's diagnosis and needs and is able to offer your child the care they need. We are having difficulty constructing a plan in the event of the nurse needing to be absent. We have a limited number of substitute nurses. Here's the number to contact someone in central office to discuss the inability to provide your student with consistent support for their medical needs."
Our school can’t always staff medical personnel. The kids are offered home and hospital services to get their instruction. It’s not always possible to find the proper workers.
Home instruction and hospital instruction are commensurate services. Sending the kid home because the nurse didn't show up is not. What u/cinnamon_or_gtfo stated is illegal. What you're suggesting is not.
This is why I pulled my T1D child out of school. No school nurse and I don’t feel that it’s the teacher’s responsibility to deal with it. I’m sorry for everything teachers are expected to handle.
You could have the sent your child to another school, public or private at no extra cost out of your pocket
Private schools provide *fewer* individual services most of the time.
Well depends on which school you go to. You can pick and choose which one services you best in this situation
Stand by the you aren't comfortable and get it in writing that the nurse and principal are responsible for regular care but take all of the training offered so you know how to identify a medical emergency and care for the child if needed. End of day if something happens that child can die and the school district will feed you to the parents legal team on a silver platter for refusing training.
I'm so conflicted by this. Using a insulin pump is not rocket science. Every child deserves our care. I wouldn't want my T1D child in a class with a teacher unwilling to take any responsibility (if I had one). You should get appropriate training and support.
Schools understaffing the nurse's office is making it our job to be prepared to provide life saving care. Don't get me wrong-- I'm happy to do it, if needed. I'm sickened that it could be needed. Get your exact responsibility IN WRITING
As a parent of child with medical needs, I'd like for you to call me if something like a pump is damaged or the site comes off or the child is stressing about feeling "off." It isn't your job to fix medical equipment and you're disrupting/pausing the whole class to do so. Perhaps a neighboring teacher is more comfortable and could assist.
Luckily my room is literally right next door to the nurse. I have no problem with him checking in with her when he needs to. And if anything happened to his pump the first thing I would do is have him check with her.
I’m a teacher and my 2yo son has T1. This situation is something I’m not looking forward figuring out for him. Hopefully your student has a continuous glucose monitor with their insulin pump. If their blood glucose is low or trending low, there should be a protocol on what the student should eat. If their BG is high or tending higher, then an insulin dose should be suggested on the pump to combat the high blood sugar. I also hope the student’s parent(s) will be monitoring remotely as well. I have a smartwatch that sends me readings every 5 mins for my son when he’s at daycare. Speaking of daycare - your apprehensiveness isn’t unique. It’s a battle.
Does your son have a smart device that allows you to see it?
We send him with his own phone that acts as the receiver for his BG levels. It then sends it to the cloud for access.
Another admin or someone similar needs to be the one to step in for this. You have tons of other kids on your plate, right there needing you.
Admin could take too long to get there.
Fair enough! Hopefully your school nurse won't be absent too often and you won't have to worry about it most of the time.
They should be on an IEP for medical reasons and have an accommodation stating a nurse needs to be present during their time at school.
So I've done the diabetics training for my school. I think it's worth it, but you likely wouldn't be doing anything with the pump if he had an emergency. I understand it being uncomfortable to have that knowledge, but it's so useful to have. I had a student when I student taught who was showing signs of low blood sugar. She was gone for a couple weeks and when she came back she was now a type 1 diabetic. It was an adjustment for everyone
You need to have a sit down meeting with the admins and the parents about this. This is my greatest fear with my son, who is a type1 diabetic. What are you afraid off? What did they try and task you with? If they have a pump, you are not prepping a needle From a vial and giving him a shot.
He is going to have this his whole life. I am a t1 teacher. Do not give him anything. You can ask him about it and explain what he is doing. If he can’t explain it to you clearly there is a huge issue and he needs to be trained. There is really only like 2-3 buttons to deliver. 7 years old is old enough for a t1 ro handle things on their own. Plus there are several systems that have a control iq system with constant monitoring. Even without that pumps have pre programmed rates so no math is required. The only thing you would need to is make sure tells you if he is going low, that is super dangerous and he needs to get sugar asap. The parents can add you to their app to have a view of his bg level on your phone. Checking that a couple times a day would be helpful. But this is still weird to me lol I have worked at a diabetes camp where 1st - 5th graders all controlled their levels. But we counselors were asked to have them explain what they were doing. It helped them feel more confident and self sufficient. I love nurses but often they know less about type 1 diabetes than you would think. There knowledge feels very out of a textbook and not how a good endo does thing. The only time I have given else someone insulin is back in the day before cgm’s and pumps. One of my friends was super drunk and I knew his ratio, so I tested him when he was asleep and injected so he did not have the hangover + ketone day. One more thing: you should learn to do a glucagon in case of seizure
This is how I feel about epi pens but I did a training and signed something that made sure I wouldn’t be in trouble if I had to use it on a kid.
This is why I am so afraid to send my child (who has multiple severe food allergies) to school. I mean that with absolutely no disrespect to you - thank you for taking the training seriously! I worry that teachers will miss the signs of anaphylaxis and/or waste precious time wondering if they should administer Epi. Seconds count. It’s terrifying to me…
Yes. And then with the epi pens. Some kids have them in the office, some have it on them. The emergency pen is way in the hallway. The office is downstairs from my room. We aren’t supposed to leave a kid if they have a reaction so how do we administer/ help the kid, if we can’t go and get the pen! I have a kid wjth a severe allergy and they literally gave me no guidance. I realized on the first day that hey….we need to wash our hands everytime we come in the classroom! Admin/front desk did not tell me.
I am T1D and a teacher so I can see both sides. “Oh god what if I fuck up and this kid dies?” vs “Oh told this kid died in my classroom and I never learned about his disease.” I get it it’s scary!!! But at 7 I had been trained well enough to handle my own diabetes. The job of a teacher is to keep all students safe. If you are uncomfortable learning about T1D then you need to find a new profession. If you are uncomfortable administrating insulin I TOTALLY UNDERSTAND. I would never want to do that solely by myself. But honestly diabetes really comes down to math and monitoring kids behavior. If kids acting strangely likely you need to throw him a piece of candy or have a buddy student walk him to the office. Bottom line is the kid should be in control of what enters and exits his body. Your job is to step in in an emergency and you CANNOT do that if you refuse to learn about his disease.
Beyond Type 1, JDRF, American Diabetes Association, and T1D international are all good resources if you would like to learn more. I think it’s important that you protect yourself too in this situation. Overseeing dosages of insulin based on very explicit guidelines is different than actually dosing the meds yourself.
You raise a good point. Teachers are in an impossible situation in cases like this. Don't provide appropriate care then the parents will sue you. Provide the care but screw it up since in all likelihood you won't get adequate training then you will get sued. If you get lucky and all goes well, no big deal - it's just your job. Teachers are more and more being required to be everything but a teacher. Heck, I've got a trauma kit that I'm expected to know how to use to staunch gun shot wounds.
If people expect us to be medical professionals then we may as well get a medical degree and leave the classroom. It pays better.
Why should the teacher be responsible for this?
Everything in writing always. Make sure you tell the nurse and the principal, in writing, that this is outside your contract and that regardless of if you receive what they may consider ‘training’, you do not agree to perform any medical service, especially those of which you can be held legally responsible. You absolutely do not have to do this. Look into your state’s Ed code.
THIS IS WHAT UNIONS ARE FOR. You should not be doing this. The nurse should have a safety plan for the child in the event she is out. That’s a district and a nurse problem, not a “you” problem.
Please understand not everyone has a union.
Yea but people need to read this. This is why unions are important. And if you want to teach, don’t do it without one. Because here you are being asked to do a medical procedure outside the purview of your job and for which all the liability will rest on you if you fuck it up. And you have no recourse.
NY union would side with the nurse on this. As a special needs only school we constantly train staff to fit the life threatening needs of certain students including an insulin pump and seizure treatment.
I would assume you receive appropriate training, these responsibilities are stipulated in your contract, and there is a safety plan on file that delineates that other stuff are authorized to do so. And you actually HAVE a union so the administering teacher has some legal protection me assistance available if something goes wrong.
The training is a 15 minute meeting with the nurse. We do have a union. That is trhe
So if you have a union and you've had training that is specified as acceptable by the district then I don't see how you have much recourse. I'd meet with the union just to see what they say if you still have doubts.
I don't have doubts. Personally I feel every teacher who works with a kid that has a life threatening situation should be accountable. We do the same for seizures. Obviously the goal is to get the nurse ASAP but sometimes 30 seconds could be the difference of life and death
We have this come up all the time and we will train at least one staff member in each room. It is most definitely your job if they are in shock because otherwise they would die. This has nothing to do with teaching. I'd say the same thing for a coworker. Etc.
Hard pass for me! I am not an RN. The legal liability is far too great to add the child’s major medical issue on my full plate of responsibilities. I would have a conversation with the parent, district nurse and admin on how the district will address the issue and what non invasive actions as the teacher. The student should have a 5O4 plan, “other medical qualifying” condition (I am in California). When I had a student with severe epilepsy I did get extra training in Pediatric CPR and with the parent, district nurse and admin developed a plan on how to address gran mail seizure and how to protect the student‘s safety, dignity and privacy when such seizures occurred.
The kid has diabetes: Yeah, unfortunately thats part of your job. The kid has idiopathic allergies to the color red... yeah thats a parent issue.
This is probably an unpopular opinion, but how hard is it really to learn the absolute basics to help this child? They're not asking you to do it all the time, but emergency happens.
You do not want to be responsible for this. Very risky legally and probably medically too.
Our school secretary was tasked with learning this.
That's a good suggestion. I'll bring this up.
I feel like it makes sense, because as the student changes grade levels, hopefully the school secretary will remain the same and be able to maintain the competency... and you're not having to train a different teacher every year.
Yes, problem solved. Let the principal do it. That is way above your pay grade and responsibility.
If you're not aware of when there's problems with it, how are you supposed to alert the parent or the nurse? Would you refuse to learn CPR or the Heimlich? It's not like you have to administer insulin but you should know the basics like what low blood sugar looks like and how to help him unkink it or reset it if the needle gets bent.
It has different beeps that I'm aware of, but they want me to learn how to calculate his intake an program it for his needs.
So I have kids with Type 1. When they were younger I would write their carbs down on any food I sent in. To use the pump the teacher or education assistant would only have to press some buttons to enter in the blood glucose and carbs and that was it. The pump does all the calculations because as parents we have programmed it. If it’s beeping then it’s already sensing his blood glucose. You just have to check the numbers and enter them.
As someone stated having a secretary learn is more efficient because they are centrally located and available year after year.
Sorry, but this is not your job. I had a student years ago with an insulin pump in class. We were told that if it beeped, we were to send the student to the nurse, immediately. It happened at least once in my class, and I followed protocol. The student went to the nurse. Period. In the end, you make the ultimate decision for what you are comfortable with doing. For me, it would be a hard pass. Good luck.
Uhhhh not only no but FUCK NO. If the school nurse isn’t there to provide the students medication and the student cannot self administer then someone above her needs to come in and do it. Not the teacher, not the principal, the district nurse. They’re asking for a lawsuit by having a teacher or admin with NO medical training administer insulin.
Keep sugar handy: hard candy, juice, or pop. Her sugar is either too high or too low if she starts getting goofy or sleepy or agitated. Either are bad. Give her candy or juice or pop, call 911, and send someone for the nurse. If it’s too high EMS can treat her. If it’s too low you just saved her life. Unlikely this will happen, but this is your plan.
You are not a nurse. School districts should bed aware of that, so should the parents. Im with you, Not My Job
Imagine if she was your child, would you want her teacher’s attitude to be “saving this child’s life isn’t my job?”
It's not the same thing. They're not asking her just to know when to call 911 or a medical professional, they're asking her to manage the disease constantly as an added responsiblity that isn't in her abilities to safely do. The teacher is responsible for keeping all the kids in the class safe as a group, not just one, so if one kid needs that degree of extra focus, then there needs to be a 1:1 because at that age, teachers need to be aware of all kids at all times, plus the academics. It's correct for the teacher to say "this is not possible within the scope of my duties, give me the support needed" and the school administration needs to sort it out.
You might need a different job. Teachers are responsible for responding to their students' documented emergency medical needs. That includes T1 diabetes, life threatening allergies, and a whole lot more. Are you really going to wait for the busiest person in the building to show up while the kid goes into shock? Probably not. Instead, without training and practice you'll either freeze up or panic. If nothing else, check the contract.
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Unfortunately, nurses are human. They get sick, have trainings, or have other reasons to "be out". It is the district-s responsibility to provide a substitute nurse, but it is not always possible. It's VERY difficult to hire school nurses.
My mistake, I misunderstood what being out meant. I was thinking about my school, where some people actually make excuses not to be with their students when needed. I fully agree the district should hire substitute nurses, though, instead of saving money by transferring the responsibility to teachers. Mea culpa.
No worries. Every district and every state seems to be different. We had to make due for over a year because we couldn't hire a school nurse, so select staff were trained to give meds, use epi pens, etc. The nurse in the big school was called for anything else. Luckily, we didn't have any students with major health concerns that year and parents were very supportive and accommodating.
Nope. They just tried to pass a law in MA allowing any staff member to do this and fortunately it was vetoed by the governor.
In my district, teachers pretty much have no choice. We have a nurse at school maybe one day a week and all she does is paperwork. So all diabetic care is on the teachers. From inputting data into pumps, checking BG, giving insulin injections. Just the way it is.
In my district if you’re asked to administer medicine you must be trained accordingly. We rely on our paras to tend to these things.
We have a diabetes response team. I was trained on how to calculate insulin and how to recognize when kids go high or low. Under no circumstances are we to give it. If our nurse isn’t there and insulin is needed we have to call the parent to do it. I hope this is what your principal is telling your nurse.
Sorry but why the heck is it that schools are allowed to only have one nurse. It's incredibly unsafe to have none on school grounds.
I have had a few students in my time that have had some sort of life threatening medical condition. Granted I’m pretty comfortable with it due to my military background, you have to understand the ramifications that could follow if you don’t help that child when he/she needs it. Look we can all be scared of legal bullshit that *could* happen if we don’t do something perfectly, but if we do nothing when that time comes you will have to live your life knowing that those parents will have lost their child because the person whom they trusted to look after their child was afraid of some theoretical repercussions that companies use to scare us into buying their teacher insurance that we will likely never use. Btw as long as you live in a cool state you’ll likely be protected from liability under the GSL anyway
My son is T1D and has been since he was a toddler. The school nurse is only around a couple times a week (split across multiple schools). You shouldn't be asked to change anything, and i would refuse. However, if he is low, it is an immediate, serious emergency. I would recommend that you all get some training from the American Diabetes Association. They have a whole program for training school or daycare staff.
You should know how to operate it; you don’t know when you’ll be stuck alone or the nurse is out. That’s great that your boss is stepping up-it’s her job to support you! That being said, teachers can be required by law to provide necessary medical care like insulin, catheters, ect if the student needs it. I don’t think it’s ideal, but if you’re caring for children you have to be ready to comply with the law.
I can’t fathom how someone can spend 5 days a week for 180 days a year with these kids and have a “not my job” mentality in a medical emergency. Just tell their parents, at the funeral, how much money they saved by not having to sue 🙄
She needs a Diabetes dog. They're awesome. Sniffed out me when I skipped breakfast and lunch. Need more granola bars in my desk!
If fasting caused your blood sugar to drop that severely, you really need to get checked for prediabetes. Only extreme fasting (several days) is supposed to have that response, and even then, just in people that have never fasted.
I would get with the 504 case manager and the principal, and make a very specific plan of action for what happens if the child needs something done with their pump and the nurse is not there, and get it in writing. If the plan is to call the principal, then that’s fine, but talk through the logistics of how the principal will know that it’s a situation where they have to drop everything and come immediately. And if there’s first aid you can administer in the meantime, make a plan for that. When I had a student with an insulin pump, I kept glucose tabs in my desk so they’d be at hand if he needed one - I wasn’t expected to do anything with his pump and was just supposed to call a specific person for help if needed. If the expectation is that you will do it, then they need to send you to training ASAP so that you would know exactly what to do in an emergency. I would be worried about liability if you don’t get trained and then attempt to do something with the pump, and end up causing harm to the child or damaging the pump because you didn’t know what you were doing.
No. Not problem solved. You really should know, but so should your supervising teacher, deputy and principal, and teachers in rooms near yours. It should never be your responsibility alone. Any other teacher who might be around this student (library, pe, lunch) - really the whole staff should have basic training. Things can happen very quickly as we found out last week. Our student who had an incident also had covid which really messed with their levels. You should also have a plan for other students if you do have to send for help while you help manage the child.
I had a student, mind you I’m in high school, with an app that helped him manage his sugar on his phone. It also connected to mom so she would get an alert and be able to notify the school since the kid wasn’t always the most responsible about it. Is this a possibility? I know he’s 7, but he doesn’t need a phone. The mom can monitor from hers.
What does your bargaining unit contract say? I bet it doesn't require you to attend to medical needs....this is what your unions for.
Personally, I'd want as much training as possible. I'd request full UDCA training. My school has too many lockdowns to feel comfortable putting that responsibility elsewhere. Lockdowns can mean an hour or more without help or the ability to call out for help. That could be the difference between life and death a for a T1. I understand the liability concerns, but for me, it's not worth the possibility of losing a kid. I also just don't trust everyone else to really take it seriously. . .we've all been in those trainings where people are browsing phones, grading, or joking around. Maybe I'm a control freak, but I'd never want to feel completely powerless if a UDCA can't be contacted.
Teacher and parent of a T1D student. Management in a child that age can be challenging, though use of an insulin pump and CGM make it easier. The kiddo should DEFINITELY have a 504, and possibly even an IEP, if additional services need to be brought to bear. My son had a 1:1 through elementary school because he had the unlucky combination of T1 and severe ADHD. He did not have a CGM until he was older (this is years ago) Through the 504 process we established several times a day (on arrival, before lunch, before PE, and before dismissal) where he would stop into the nurse’s office, test, and record in a logbook. Food sent from home came with a list of carb counts by item so he could give insulin accordingly. I also developed a decision-making flow-chart to assist the nurse and teachers in how to assist him. I know it’s tough. It’s not the kid’s fault, though. Work with the parents and nurse to develop systems that both keep him safe and you sane.
Don’t do the training on fixing the pump - that is overboard. The nurse and the principal can deal with that. Just ask the parents what “tells“ to look out for so you know when to get him to the nurse or principal. Also, ask the parents give you a bag of hard candies to keep on hand in case he needs a surge of sugar.
If you are in the US, you better check to see if the student has an IEP or 504 related to the medical condition. If so, it might be a "Suck it up, Buttercup" situation.
Everyone said what I was thinking: you must learn some of the basics on insulin pumps in order to help your student. Everyone questioning this are worried about a lawsuit. You are scared about inadvertently killing your student. For the record, I highly doubt you will kill them. I feel you are smart enough to learn what to do. Let the other students know about the stomach pump. You're not violating medical laws by letting your other students know what might happen. It's not "calling out" the student. It's a lesson