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#1 of 106 Old 05-13-2008, 10:49 PM - Thread Starter
 
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Rumor has it that a new family is moving to my school. Apparently one of the kids is diabetic and needs shots every day, requiring a nurse to be on duty. My school has only 65 kids K-8 and our nurse is only there one day a week. The family apparently left another school because they couldn't provide a full-time nurse. I can't imagine how our school is going to be able to either.

I'm just curious: what are other people's thoughts on this situation? Should a school have to hire more of a nurse (that would be an enormous expense for this school)? Has anyone here ever had to request way more services (not considering special ed or IEPs--that's a whole other situation, I think) from a school than they originally provided? How did that go?
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#2 of 106 Old 05-13-2008, 10:53 PM
 
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Rumor has it that a new family is moving to my school. Apparently one of the kids is diabetic and needs shots every day, requiring a nurse to be on duty. My school has only 65 kids K-8 and our nurse is only there one day a week. The family apparently left another school because they couldn't provide a full-time nurse. I can't imagine how our school is going to be able to either.

I'm just curious: what are other people's thoughts on this situation? Should a school have to hire more of a nurse (that would be an enormous expense for this school)? Has anyone here ever had to request way more services (not considering special ed or IEPs--that's a whole other situation, I think) from a school than they originally provided? How did that go?
How old is the child?

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#3 of 106 Old 05-13-2008, 10:55 PM
 
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If the school is a public school then they are probably required to meet this child's medical needs.

Cost or no.

If she doesn't have an IEP or 504 she needs to get one, then they will have to accommodate her needs.

free and appropriate public education for all.

-Angela
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#4 of 106 Old 05-13-2008, 11:09 PM
 
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Sure, as long as the child has a 504 or IEP stating it's required.
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#5 of 106 Old 05-13-2008, 11:45 PM
 
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Sure, as long as the child has a 504 or IEP stating it's required.
Yup.

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#6 of 106 Old 05-14-2008, 12:16 AM
 
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Boy, I hope they're suing the last school since a school is legally required to provide accommodations under Section 504.

The school doesn't have to provide a nurse full time, but does have to provide a person--lvn, health aide, etc., to help the child monitor blood sugar and give the shot if necessary. And yes, I think schools "should" do it, even though they already do "have" to do it. That child has the right to attend school to, and maybe that child doesn't have a family member readily available to provide the shot.
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#7 of 106 Old 05-14-2008, 12:21 AM
 
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I think each state has different laws governing what can be in the IEP or 504 but I do think diabetic children are entitled to have a nurse on staff for all hours that student is in school. In NY, those students are also supposed to have nurses (RNs) go on field trips as well.

We had a hard time getting that met (and the nurse we did have was incompetant). It's one of the myriad reasons we now homeschool.

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#8 of 106 Old 05-14-2008, 12:38 AM
 
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AT a big middle school we have many diabetic students and I believe they have 504 plans. We don't have a full time nurse, but one nurse here 1-2 days a week and several low-paid "health assistants" who are trained in basics. The health assistant came on our last field trip because I had two diabetics.

Yes, I think the school should provide just as they provide special services for other medical conditions. It is expensive, but without that cost, how could all children access public schools? I guess the alternative is to have kids with special needs all together at a special school and I hear that is done in other countries, but I hope we are past that here.
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#9 of 106 Old 05-14-2008, 10:15 AM
 
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At my dd's school there is a health aide that is there every day.
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#10 of 106 Old 05-14-2008, 11:15 AM
 
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This is one of those subjects on which I have mixed feelings. I do believe that every child should have an appropriate education. But at times I do struggle with the amount of resources that are made available to children with special needs. It's not that I think kids with special needs shouldn't have those needs met, but when such a large percentage of resources is spent on such a small percentage of the population, it seems unfair. Especially in the case of a small school, where the addition of one extra staff person who is hired to care for only one child takes away from the resources available for the other 65 children who may not benefit from that extra staff person. In a small school, hiring a nurse or an extra paraprofessional may mean that there isn't money for an art class or for field trips.

I don't think this really has anything to do with whether or not there is adequate funding for schools, but rather how we as a society have chosen to prioritize school spending. As a society, we have decided that all kids should have their special needs accomidated, even if it means that the majority of students lose resources because of this. Again, I'm not against special education or against making accomidations for kids with special needs. But the reality is that special services do take funding away from mainstream funding, and this is especially true in small schools.

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#11 of 106 Old 05-14-2008, 11:37 AM
 
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This is one of those subjects on which I have mixed feelings. I do believe that every child should have an appropriate education. But at times I do struggle with the amount of resources that are made available to children with special needs. It's not that I think kids with special needs shouldn't have those needs met, but when such a large percentage of resources is spent on such a small percentage of the population, it seems unfair. Especially in the case of a small school, where the addition of one extra staff person who is hired to care for only one child takes away from the resources available for the other 65 children who may not benefit from that extra staff person. In a small school, hiring a nurse or an extra paraprofessional may mean that there isn't money for an art class or for field trips.

I don't think this really has anything to do with whether or not there is adequate funding for schools, but rather how we as a society have chosen to prioritize school spending. As a society, we have decided that all kids should have their special needs accomidated, even if it means that the majority of students lose resources because of this. Again, I'm not against special education or against making accomidations for kids with special needs. But the reality is that special services do take funding away from mainstream funding, and this is especially true in small schools.
What would you suggest instead?

-Angela
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#12 of 106 Old 05-14-2008, 11:53 AM
 
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Well, I can't speak to special needs staffing on an educational level but as the mother of a type 1 diabetic, reliable healthcare for the admistering of insulin is a life and death situation. The incompetant nurse I spoke of earier nearly gave my child an extremely dangerous dose of medication because her math skills were faulty.

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#13 of 106 Old 05-14-2008, 12:02 PM
 
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We have had a very similar situation at our school. We have 70 kids in preK-12 and last year one of the 1st graders was diagnosed as a type 1 diabetic. We also only had a nurse 1 day/week. What our school did was hire a LPN that works there 3/4 time (also helps out as an aide in a couple of classes as needed), and her mom is the preschool teacher (which is a part of the school), and she is there 3 mornings a week, and keeps a very close tab on things and fills in the other 1/4 time.

I am very happy with how they handled this, as they had never had a situation like this occur before and within a few weeks had this all in place. We are VERY rural and just happened to have someone that was qualified to fill this position.

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#14 of 106 Old 05-14-2008, 12:05 PM
 
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This is one of those subjects on which I have mixed feelings. I do believe that every child should have an appropriate education. But at times I do struggle with the amount of resources that are made available to children with special needs. It's not that I think kids with special needs shouldn't have those needs met, but when such a large percentage of resources is spent on such a small percentage of the population, it seems unfair. Especially in the case of a small school, where the addition of one extra staff person who is hired to care for only one child takes away from the resources available for the other 65 children who may not benefit from that extra staff person. In a small school, hiring a nurse or an extra paraprofessional may mean that there isn't money for an art class or for field trips.

I don't think this really has anything to do with whether or not there is adequate funding for schools, but rather how we as a society have chosen to prioritize school spending. As a society, we have decided that all kids should have their special needs accomidated, even if it means that the majority of students lose resources because of this. Again, I'm not against special education or against making accomidations for kids with special needs. But the reality is that special services do take funding away from mainstream funding, and this is especially true in small schools.
The money issue was a great concern for our district (we are very close to having to consolidate with another district - mostly we have not because there is not one close and our state test scores are very high). Our district was able to get a grant to pay for part of the LPN's salary and she is able to help be an aide in any of the elementary classrooms, which also helps the district.

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#15 of 106 Old 05-14-2008, 12:06 PM
 
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How often would a diabetic child who needs shots every day need to have the shots given in a day? I imagine it may vary, but I don't really know.

Our school does NOT have a nurse on staff ever. No medications are given by the staff unless it is an epi pen in an emergency situation. There is 1 kid I know of who needs medication at noon every day, his parents bring it to him & they give it to him.

It is school policy that they will not give medications to children. It is a public school with 250ish kids from K-8.

I can understand from the school's point on not giving it, I can understand on the parents point on wanting someone there to do it.
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#16 of 106 Old 05-14-2008, 12:10 PM
 
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How often would a diabetic child who needs shots every day need to have the shots given in a day? I imagine it may vary, but I don't really know.

Our school does NOT have a nurse on staff ever. No medications are given by the staff unless it is an epi pen in an emergency situation. There is 1 kid I know of who needs medication at noon every day, his parents bring it to him & they give it to him.

It is school policy that they will not give medications to children. It is a public school with 250ish kids from K-8.

I can understand from the school's point on not giving it, I can understand on the parents point on wanting someone there to do it.
In the US there are laws to ensure that every child has access to a free and appropriate public education. That includes medications like insulin.

-Angela
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#17 of 106 Old 05-14-2008, 12:27 PM
 
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How often would a diabetic child who needs shots every day need to have the shots given in a day? I imagine it may vary, but I don't really know.

Our school does NOT have a nurse on staff ever. No medications are given by the staff unless it is an epi pen in an emergency situation. There is 1 kid I know of who needs medication at noon every day, his parents bring it to him & they give it to him.

It is school policy that they will not give medications to children. It is a public school with 250ish kids from K-8.

I can understand from the school's point on not giving it, I can understand on the parents point on wanting someone there to do it.
A diabetic child on insulin shots woud need at least one shot every single time he or she ingests food. Average kid, average school day, that is at LEAST twice (snack and lunch). My son, who was newly diagnosed when we were still at the public school, needed several extra checks a day while we got a hold on the way the illness was affecting him so there was often a 3rd and 4th shot in there. The amount of insulin is calculated to compensate for current blood sugar levels and the amount of carbohydrates eaten. It's complicated and very very important.

Diabetics are not the only children who may need medical care during a 6+ hour school day. I am surprised to hear of a school of that size that does not have a medical professional on hand to deliver medication.

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#18 of 106 Old 05-14-2008, 02:19 PM
 
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None of the schools here have medical staff on hand. I don't know what they'd do in the case of a diabetic who needs insulin. I know there is 1 child who is diabetic(she doesn't participate in the breakfast program becuase of it), but AFAIK she isn't on insulin.

the 1 child who does take meds every day that his parents bring for him to take is on some sort of a ADHD medication. I can see if this child is new to this, it isn't simply a case where someone could come in to do it.

My dd is hypoglycemic & has allowances to eat at the last recess, but we don't have a specific plan set up for it.

I'm a noon supervisor at the school & from what I"ve seen there aren't any other kids besides that 1 who gets meds daily. There are some kids who have inhalers for asthma, but they keep those in their lockers. Some who don't need them all the time, just have them on hand JIC have them locked in the office. The epi pens are locked in the kids classrooms(there are 2 who have them at school)
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#19 of 106 Old 05-14-2008, 02:51 PM
 
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What would you suggest instead?

-Angela
I'm not suggesting anything else. I am saying that because we expect our schools to meet the special needs of students during school hours, it does take money and resources away from the kids who don't need special services.

I can see both sides of the argument.

ETA: Because of hearing about my mom's experiences as a special education teacher, I do have some ideas about reducing special education costs. But my thoughts probably wouldn't be well received, so I won't post them here

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#20 of 106 Old 05-14-2008, 02:56 PM
 
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None of the schools here have medical staff on hand. I don't know what they'd do in the case of a diabetic who needs insulin. I know there is 1 child who is diabetic(she doesn't participate in the breakfast program becuase of it), but AFAIK she isn't on insulin.
If she's not on insulin, then she's type 2, not type 1- a whole different ball game.

-Angela
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#21 of 106 Old 05-14-2008, 03:20 PM
 
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I am a school nurse in a public school system. We have over 100 schools in our district and over 100 school nurses. Cases like these are why we as school nurses here,are advocating for more hiring of nurses so that schools can be staffed with RN's at all times. It is a shame that due to finances we are spread so thin! Most schools do not have fulltime nurses. With job cuts(we are basically "teachers" per se, when it comes to pay, contracts,layoffs,etc.)we are always trying to advocate our importance.We have to delegate our nursing responsibilities to other staff and train them. This is a shame. There have been so many times that a school nurse has saved a life. We need more of us!!! Ok, a little off topic but just wanted to throw my 2 cents in! Oh, our district employes only RN's with BSN's. We also have our school nurse licensures. Each district is different though.

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#22 of 106 Old 05-14-2008, 03:40 PM - Thread Starter
 
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Boy, I hope they're suing the last school since a school is legally required to provide accommodations under Section 504.
Obviously you are not familiar with small communities and rural schools. We just don't handle things like that here.

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This is one of those subjects on which I have mixed feelings. I do believe that every child should have an appropriate education. But at times I do struggle with the amount of resources that are made available to children with special needs. It's not that I think kids with special needs shouldn't have those needs met, but when such a large percentage of resources is spent on such a small percentage of the population, it seems unfair. Especially in the case of a small school, where the addition of one extra staff person who is hired to care for only one child takes away from the resources available for the other 65 children who may not benefit from that extra staff person. In a small school, hiring a nurse or an extra paraprofessional may mean that there isn't money for an art class or for field trips.

I don't think this really has anything to do with whether or not there is adequate funding for schools, but rather how we as a society have chosen to prioritize school spending. As a society, we have decided that all kids should have their special needs accomidated, even if it means that the majority of students lose resources because of this. Again, I'm not against special education or against making accomidations for kids with special needs. But the reality is that special services do take funding away from mainstream funding, and this is especially true in small schools.
I feel the same way, which is I guess why I started this thread. I just don't know how to respond. I can't imagine how hiring another 80% of a staff member is even feasible with such a tight, small budget. I also know the town will have a VERY hard time approving a change to the budget, which they try to streamline too much already, after next year's budget has been approved. It's not that I don't think there should be a full time nurse, I just know the politics of this little town.

This is an interesting discussion. I'm so glad to hear from a school nurse and someone else from a tiny rural school!
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#23 of 106 Old 05-14-2008, 03:44 PM
 
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I'm not suggesting anything else. I am saying that because we expect our schools to meet the special needs of students during school hours, it does take money and resources away from the kids who don't need special services.

I can see both sides of the argument.

ETA: Because of hearing about my mom's experiences as a special education teacher, I do have some ideas about reducing special education costs. But my thoughts probably wouldn't be well received, so I won't post them here
eh, that's life. And sick people and old people use more health-care resources. Part of being part of a community.

some kids are more expensive to educate. No way around it. As long as we have a system of FREE and appropriate education for all, that's just the way the cookie crumbles.

It's expensive to build wheelchair ramps too...

-Angela
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#24 of 106 Old 05-14-2008, 03:53 PM
 
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Obviously you are not familiar with small communities and rural schools. We just don't handle things like that here.
It may not be how things have been handled, but legally it's how things MUST be handled.

There are a few other options that rural and small school districts have tried- things like paying for the child to go to another school district or private school, but they must provide transportation and such. But LEGALLY the child has a protected right to a free and appropriate public education. That includes medications (or modifications or technology) needed to function.

-Angela
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#25 of 106 Old 05-14-2008, 04:36 PM
 
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I thought in cases such as this a parent is responsible for going by the school to help the child out during the day if needed. I couldn't imagine them putting a nurse on staff just for one child but if they *are* doing it then good for them! That's wonderful.

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Diabetics are not the only children who may need medical care during a 6+ hour school day. I am surprised to hear of a school of that size that does not have a medical professional on hand to deliver medication.
this makes sense. Even if a nurse isn't needed each and every day, it should be law to have one there on site every single day for at least a few hours. If children get hurt who helps them? They could hire a nurse that could do office work as well or something so they aren't just sitting around doing nothing all day.

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#26 of 106 Old 05-14-2008, 05:30 PM
 
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If she's not on insulin, then she's type 2, not type 1- a whole different ball game.

-Angela
Yes I am aware of that.

I wonder if there is a parent who currently stays at home but is a RN or similar profession would who have the capability of doing the job but not necessarily be a full time nurse at the school.

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If children get hurt who helps them?
Teachers, TA's, Librarian, Janitor.

Today at noon I had 4 hurt kids. There are 250ish kids at the school. normally there are no hurt kids.

1(grade 4) was playing soccer & she tripped, when she landed another kid landed on her head. I had her lay down in the infirmiry(which is basically a closet). When the bell rang she did get up & go to class, though I told her teachers what had happened & they were going to let her lay down again or lay her head on her desk if she didn't want to lay down.

I had another one(grade 6) come in becuase she somehow landed with her face on the sand. I have no clue what she did. I got an ice pack for her & she sat in the office.

Then when the bell rang 2 more came in. 1(grade 3) was limping & she had hurt her ankle a bit, got her an ice pack. The other one(grade 1) got hit in the mouth/throat with a soccer ball. I didn't have any more icepacks becuase they seem to grow legs. She didn't look real hurt as if she needed an ice pack so I just sent her off to her class & told her to let her teacher know.

Most of the time if there is an injury all that is required is a bandaid. Before I started supervision, I heard through the grapevine that there were 2 instances where they had to call the ambulance in. However my kids don't know anything about these so either it is true & they were put into lockdown or it wasn't true.

The last school may have had a nurse on staff but wasn't full time, it doesn't mean the school wasn't meeting the accomodations but perhaps the parents wanted one there for the full day.
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#27 of 106 Old 05-14-2008, 06:54 PM
 
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Speaking as someone who has a diabetic in the family, it isn't something to take lightly so I am glad to see they have someone who is fully trained there w/ the child.

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#28 of 106 Old 05-14-2008, 07:13 PM
 
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My children, so far, don't have any ongoing medical issues that would require a school nurse to be present. But honestly, I'd have some deep misgivings about sending them to a school where there wasn't ANYONE who was a trained medical staff person available during the school day. Yeah, I know that teachers and aides and janitors can clean wounds and put on band-aids, but what if something more serious happened? What if a judgement call needed to be made?

Plus, what if one of the kids gets sick and someone needs to be with them away from the class until a parent can be found? Who handles that -- a teacher? an administrator?

At the moment, I work for a company with ~300 onsite employees. We're all adults, but we're required to have one trained EMT in the building and two people trained as first responders. I can't imagine that my kid's school would have lesser requirements than my workplace.

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#29 of 106 Old 05-14-2008, 09:14 PM
 
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my dd in first grade was dx'd with type 1 diabetes in march of this year. we have a *very* small school (37kids k-6) in a rural community. our school shares a nurse with 3 other schools in our district and she is only in our school one day a week.

when dd first went back to school after the diagnosis we had a meeting with all the school people who would interact with her in her day. this included her teacher, the lead teacher (principal so to speak), the cook and the school nurse.

everyone was taught (by me!) exactly how to care for her. this included the nurse who had never had a diabetic child in all her years of school nursing. she offered to come every day at luchtime and give dd her shot but tracey, the COOK stepped up and said that since she is aware of what every single kid eats on a daily basis, she would be willing to give the shot at lunch.

she has risen to the occasion and i feel very confident when i drive away from that school every day because i know she understands exactly what dd needs. we have had a couple "incidents" but nothing that has made me question tracey (things that happened when tracey was not in charge ie: after school). we feel very lucky that she is the one in charge of dd. in fact when the kids had a field trip today, she came to me in the morning and filled me in on exactly how the day would go and the school nurse gave her a shot for the very first time today since she was on the field trip and tracey wasn't.

our school is a bit smaller than yours (not by much, tho!) and we are pretty laid back people. also my dh is T1 as well so we are well aware that you can live a "normal" life with this disease. you just have to be surrounded by people who understand diabetes and are capable of helping you when you need help. IMO THAT is the schools responsibilty, not neccesarily providing an RN at all times. a diabetic child does not need an RN, they need an adult with a good grasp on the disease who can see if they are in distress and also help with keeping up with testing and giving the accurate amount of insulin.

but thats just my opinion and my kid has only had this since march..............so............take what you will!!
i hope it works out for your school, i know how it is with small schools........sometimes it seems like you're just one more budget expense away from being shut down.
trina
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#30 of 106 Old 05-14-2008, 10:20 PM
 
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Yeah, I know that teachers and aides and janitors can clean wounds and put on band-aids, but what if something more serious happened? What if a judgement call needed to be made?
Something more serious like what? a broken bone? we call 911 or a staff member would drive them to the hospital. Everything in this city is 10 minutes away. It would take just as long(or longer) for an ambulance to drive here than for us to drive a child to the ER. If it is something that 911 needed to be called on most people would have the capability to make that judgement call without having medical training.

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Plus, what if one of the kids gets sick and someone needs to be with them away from the class until a parent can be found? Who handles that -- a teacher? an administrator?
Most likely the receptionist, she's the one who truely runs the school. she is right across from the infirmiry closet. If she couldn't there are a number of TA's or staff who are doing prep work at any time of the day who would be able to leave what they are doing in order to take care of the child. There are roughly 27 staff members in the building at most times, only 10 classrooms which would leave 17 people not teaching at any time. There'd be even more people if there were parent volunteers in the school(and there often are)

obviously it hasn't been an issue if none of the schools in this district have nurses on staff.
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