The school nurse plays a crucial role in the provision of health services for children with special health needs, particularly those with chronic illnesses and disabilities of various degrees of severity. This case focuses on the role of the school nurse in caring for a child with type 1 diabetes. In this particular scenario, the nurse is responsible for the care of two students with type 1 diabetes, one of whom requires blood glucose monitoring and daily insulin injections, while the other uses a continuous insulin infusion pump.
Type 1 diabetes is a prevalent chronic illness in childhood, being the second most common after asthma. According to the American Diabetes Association (ADA, 2015), there are approximately 193,000 Americans under the age of 20 living with diabetes, with 17,900 new cases of type 1 diabetes being diagnosed each year, along with an additional 5,300 cases of type 2 diabetes. It is important to note that children with diabetes are considered disabled and are protected under federal laws that prohibit discrimination against children with disabilities.
Despite the prevalence of type 1 diabetes and the legal protections in place, studies have shown that many school personnel have an inadequate understanding of effective diabetes management. Therefore, it is essential for the school nurse to have a comprehensive understanding of diabetes and its management in order to provide appropriate care for students with type 1 diabetes.
One of the primary responsibilities of the school nurse is to ensure that the student’s blood glucose levels are monitored regularly and responded to promptly. This involves checking the student’s blood glucose levels using a glucometer and taking appropriate action based on the results. Monitoring blood glucose levels allows the nurse to assess the student’s overall glycemic control and make necessary adjustments to insulin doses or other aspects of the management plan.
The nurse must also be knowledgeable about the signs and symptoms of both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) and be prepared to respond quickly in case of an emergency. Hypoglycemia can result in symptoms such as shakiness, dizziness, sweating, and confusion, while hyperglycemia may cause symptoms such as increased thirst, frequent urination, and blurred vision. Prompt recognition and intervention are crucial to prevent complications and maintain the student’s health and well-being.
In addition to blood glucose monitoring and response, the school nurse should collaborate with the student, their family, and other healthcare providers to develop and implement an individualized diabetes management plan. This plan should consider factors such as the student’s insulin regimen, dietary needs, physical activity levels, and other medical conditions or medications that may impact their diabetes management. Regular communication with the student’s healthcare team is essential to ensure that all aspects of the plan are effectively coordinated and that any changes in the student’s condition or treatment are promptly addressed.
In conclusion, the school nurse plays a vital role in caring for students with type 1 diabetes. By ensuring regular blood glucose monitoring and prompt response to results, understanding the signs and symptoms of hypoglycemia and hyperglycemia, and collaborating with the student, their family, and other healthcare providers in developing and implementing an individualized diabetes management plan, the nurse can support the student’s health and well-being. However, it is important to address the inadequate understanding of diabetes management among school personnel to ensure optimal care for all students with type 1 diabetes.
