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The following is a speech Cynthia Heintz made to her local school board regarding the impact of eliminating her children’s full-time school nurse. She starts with a possible scenario of a student with diabetes not getting the attention she needs in the classroom because the nurse is no longer there and the teacher has her hands full. Chilling, isn’t it?
Minute 1: Child doesn't feel well
Minutes 2-3: Child decides to tell teacher, but teacher says "just a minute"
Minute 4: Child returns to seat feeling confused
Minutes 5-6: Child begins to feel worse and cannot express thoughts clearly
Minutes 7-8: Another student notices child with head on desk, tells teacher
Minutes 9-10: Teacher asks child if she is OK
Minute 11: Child cannot communicate
Minutes 12-13: Child passes out, may begin to have seizures
Minute 14-15: Teacher calls the office to call "911"
Minutes 16-17: Teacher tries to move all other students out of classroom
Minutes 18-20: Child's brain function decreases as the sirens are heard in the distance
This is a worst case scenario.
This is the untrained trying to do the unknown.
This is 20 minutes of hell.
[Editor's note: I have left some explanations in this article that are usually assumed known to our readers. This is in case you wish to adapt this speech for use in front of your own school board.]
I am here tonight to voice my concern about the elimination of the full-time nurse position in our schools. Not only is the nurse invaluable for routine support at our campus, but she also trains the staff in the use of glucagon.
Glucagon is an injection given intramuscularly to a diabetic in the event of stupor or unconsciousness. It takes three to five minutes for an ambulance to arrive at a school, locate a hypoglycemic child, and begin life-saving procedures. Using glucagon buys valuable time between the observation of severe hypoglycemia and the treatment necessary to reverse that process.
Our nurse has done an amazing job of training the school staff to use glucagon. Imagine how many people come into contact with one of my three children with diabetes in the course of a school day. Now try to imagine training all of those people in the vital use of glucagon. That is not something that can be accomplished on a one-day-a-week basis.
The job of school nurse has been proven time and time again to be vital in maintaining the safety of our children.
Our nurse has been a lifeline for us. I know that I can trust her observations of my children. Because she is a full-time nurse, she knows what looks "normal," and she is able to detect the signs of a dangerous situation and the subtle nuances that precede a severe hypoglycemic state. Familiarity combined with acquired individual knowledge cannot be dismissed as having little or no impact.
In addition, there are state-mandated responsibilities of a school nurse. These cannot possibly be complied with on a one-day-a-week basis.
Federal laws protecting children with diabetes include Section 504 of the Rehabilitation Act of 1973, the Individuals with Disabilities Education Act of 1991, and the Americans with Disabilities Act. Under these laws, diabetes is considered a disability. It is illegal for schools and/or day care centers to discriminate against children with disabilities. In addition, any school that receives federal funding or any facility considered open to the public must reasonably accommodate the special needs of children with diabetes.
To facilitate the appropriate care of the student with diabetes, school and day care personnel must have an understanding of diabetes and must be trained in its management and in the treatment of diabetes emergencies. Knowledgeable trained personnel are essential if the student is to avoid the immediate health risks of low blood glucose and to achieve the metabolic control required to decrease the risk of diabetes complications.
Studies have shown that most school personnel have an inadequate understanding of diabetes. Much of what is known by our staff about diabetes has been taught by our nurse. Nurse Kate Cowsky is an invaluable resource when it comes to educating the teachers. Her style of teaching is one that invites questions and clarifications regarding the daily management of the child with diabetes and includes physical demonstrations, including positioning an unconscious child to avoid aspiration and the practice of giving an injection (to an orange!).
Knowledge is power. Knowing what to do when a child with diabetes is having a medical situation makes all the difference in the world, not just for the child (although obviously that is the most important), but also for the teacher, who feels empowered and not helpless. The parents, too, can breathe a little easier and go about their jobs. The teacher knows what steps to take, the other children in the classroom know exactly what to do (and there have been drills to make certain of this), and the parents know that while they are racing to the school, every step has been taken to ensure the safety of their child. This is the kind of training you receive from a full-time school nurse.
We will settle for nothing less.
Sep 4, 2008
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.