Tips for School Nurses provide ideas to help the school nurse coordinate diabetes care in the school setting. Tips include planning for the care newly diagnosed or returning student, where to seek training resources, preparation for field trips, what information to provide to transportation, and other information.
- Meet with parent/guardian before the school year begins or after diagnosis to review the student's Diabetes Medical Management Plan/physician's orders (DMMP) and secure needed diabetes supplies, equipment, medication, and snacks.
- Determine if parents/guardian is authorized to make adjustments to insulin as indicated in the student's DMMP.
- Make sure the parent/guardian provides notification of any changes to the student's diabetes regimen and obtains an updated DMMP to document changes.
- Seek out training as needed to update your skills and gain knowledge about new technologies such as the insulin pump or continuous glucose monitor.
- Put an Emergency Action Plan in place for prompt recognition and treatment of hypoglycemia (low blood glucose) and make sure the student has immediate access to a quick-acting form of glucose (regular soda, fruit juice, glucose tabs).
- Put an Emergency Action Plan in place for prompt recognition and treatment of hyperglycemia (high blood glucose) and make sure the student has immediate access to a water and insulin as prescribed in the DMMP.
- Inform school employees that a student with diabetes should never be sent anywhere alone if feeling hypoglycemic or hyperglycemic.
- Inform parent/guardian that their child has rights under relevant federal laws such as Section 504 and be a member of the team that determines eligibility for services under federal law and develops the 504 plan or other written accommodations plan.
- Identify and recruit school employees who are willing to be trained and coordinate a training designed to meet the individual needs of the student as prescribed by the DMMP and plan for ongoing supervision and training. Provide appropriate delegation of care per state regulations or as necessary to ensure proper diabetes care is available for the student at all times. For more information about relevant state laws, go here.
- Understand that the school is responsible for providing appropriate training to school staff. Many times a school nurse may collaborate with a diabetes educator to develop and facilitate training for school staff. Parents can provide information about their individual child's needs. If a school nurse asks for assistance from a diabetes educator or another diabetes health care professional, many times the student's own diabetes provider can provide help and resources. Additional assistance might be available at local pediatric diabetes centers and health departments, or at a local affiliate of the American Association of Diabetes Educators. In addition, training resources for the school nurse or diabetes health care professional may be accessed at here.
- Provide basic diabetes and diabetes emergency response information to the student's teachers, substitute teachers, and other school employees who have custodial responsibility for the student.
- Communicate on an ongoing basis with the parent/guardian, teachers, and other school employees to ensure the student's needs are met and to problem-solve.
- Inform those responsible for transportation that a student on their route has diabetes and provide basic diabetes training to bus drivers and make sure they know how to respond and who to contact in the event of a diabetes emergency.
- Work with the student's teacher(s) to provide notice to the parent/guardian of classroom parties and special events.
- Develop a plan for the school day, field trips, extracurricular and before- and after-school programs to ensure a school nurse or trained school employee is available to provide needed care and needed diabetes supplies, equipment, and medication and accompany the student.
- Understand that becoming independent and capable of self-management is a process and each student is different in achieving various levels of independence.
- Recognize that students who self-manage will need help in the event of a diabetes emergency and a school nurse or school employees should be trained to administer glucagon.