I am so proud to be Regional District 13's first school nurse to get a "Good Apple Award". The award is given to an individual nominated by another staff member of parent. The award is given for efforts above and beyond the normal scope of your position. I was nominated by a classroom teacher due to the extended efforts to teach her, her class and the student newly diagnosed with Type I Diabetes. He received his pump the day before school started, so what the means is he came to me using insulin in that pump for the first time.
He was student #2 for me with a pump and they were as far from my office as could be. Both parents wanted less time out of classroom. This certainly had me doing lots of walking, teaching, teaching and teaching. As I too am an advocate for them to be in class as much as possible and being only 5 & 7 years old, they too developmentally needed extra care.
So, what did that mean. Well it meant that I went to them more than they came to me. The older of the two, I had here in my school since the age of 3y.o. and with a pump! So obviously it made sense to go to where ever he was for snack bolus and low's. I continued that tradition with the newly diagnosed 5 y.o. as well. Last year being 5 & 7 I split the treatment plan by going to them for snack, which was a great indicator for the teacher either it was time immediately or in 15 minutes depending on the plan per student.
They came to me in route to lunch and at bus time for their pm check/snack and bolus.
Not sure if any other nurses have come across a plan like this, but the elder student had a bit of a different plan. One due to different insulin type in the pump due to tolerance, but also due to a bit of a different philosophy. That philosophy is that we naturally start to put out a little extra insulin prior to actually eating, which prompts us to eat. So, this is how the different plan of action/idea came to be as well. That student actually was "pre-loaded" 15 minutes prior to his scheduled snack and lunch time with a set minimal amount to cover 15 carbs, so long as BG at acceptable level, AND then after he ate I would have to then "post-load" the rest of the carbs he actually ate. This started when he was 3 y.o. and originally I thought mostly as we never knew how much snack he would actually eat. Over the years the rationale of continuing this practice emerged.
Having stated that my newest student with Type I doesn't have that plan, but he does have the faster acting insulin in his pump. At any rate, though I was very busy at snack time, I found it so worth the effort. I would enter the room and not disturb one bit of the learning going on at the moment. The other students got use to me being there after the first week. The teacher then knew for sure it was time for snack. The student didn't miss a thing....I have even tested as reading kept right on going by these boys. So, really didn't miss a beat. The student got an appreciation as to what to look for to help them and a better understanding as to what they go though every day. I saw these boys go from the possibility of being seen different to being seen as brave having to poke themselves all the time.
This year I only have one of these boys left in my building and certainly the workload is lighter. The appreciation of the families, students and the teachers remain. They all have come to appreciate the difference a school nurse can really make in individuals and a classroom.
Cheers to my fellow Elementary School Nurses that may have to go up and beyond for our younger students!
Mary Ellen Johnson, RN