"Safe at School" Bills and Diabetes Care in Children
Children and adolescents spend much of their waking time in the school setting for both academic and extracurricular activities. As such, it is essential that they be safe at school and allow parents and caregivers to proceed with their usual day-to-day activities.
Nurses, of course, are essential in the care of children in schools. However, it is absolutely erroneous to assume that they are the only individuals who can safely check blood sugars, administer insulin via injection or pump, or treat with rapid-acting carbohydrate. Clearly, millions of non-medical professionals, such as patient family members, childcare providers, and friends provide care to children with diabetes on a daily basis. Indeed, many of our children with diabetes can perform these complex tasks by themselves.
The United States Department of Education and Justice, Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH), along with the American Diabetes Association (ADA) are all in agreement that that trained non-medical personnel are the most appropriate individuals to keep children safe in the school setting when no nurse is available.
As such, the ADA has filed "Safe at School" bills in the Maryland General Assembly, and it is expected that the first hearing will be in the Senate on March 4th, 2015. This will be the very first time that the ADA "Safe at School" legislation will be introduced in Maryland. Two bills will be introduced in both the House of Representatives and Senate to allow trained school employees to provide diabetes care. In addition, according to Crystal Jackson, Director, Safe at School Government Affairs and Legal Advocacy, the bill will permit students capable of performing self-care skills to self- manage their diabetes anywhere, anytime
Several years ago, the District of Columbia Department of Health asked our diabetes team to educate the District’s non-medical school professionals in regard to diabetes care in the school setting. The ADA advocated for this education in order to enable care to students with diabetes by trained personnel other than nurses since nurses are not always available in the school setting.
Why is this so important?
We are now in the position to enable independent students in Maryland the opportunity to self-manage within the school setting as well as provide care for those who need assistance if a school nurse is not on campus. This has long been an issue for students who are required to leave the classroom to check blood sugars or administer insulin, thus missing valuable class time. In addition, students who were experiencing low blood sugars and capable of self-administering rapid acting carbohydrate were still required to be escorted to the school nurse, often by another student. Assuming this bill will be passed, these concerns will no longer be an issue. Parents also will be relieved that they will no longer need to leave work to go to the school and administer insulin or check blood sugars. The exception, of course, is the presence of ketones or very high blood sugars. In this case, parents will most likely need to attend to their child and seek medical assistance from the diabetes healthcare team.
The diabetes team at Children’s National Health System has been a long-standing advocate of the above legislation and has provided supportive documentation to the ADA in an effort to advocate for our students in the Maryland school system.
They deserve nothing less!
Fran Cogen, M.D., C.D.E., is the director of the Childhood and Adolescent Diabetes Program at Children’s National Health System. She wrote about diabetes for HealthCentral.