When I wrote the school chapter of the book Kids First, Diabetes Second, I think Q was in second or third grade. She has definitely become more independent in her care since then, but I still do the same training and make sure that her 504 plan is followed. In the book I have a list of supplies to stock at school, information about 504 plans, as well as quite a few tips you might find useful to navigate diabetes at school. The section “Training School Staff” is part of the chapter called “School Days.”
Training School Staff
When Q started kindergarten, we contacted the assistant principal during the summer to set up teacher training, and we have continued to do so every new school year. I like to call a meeting every year in the day or two before school starts to train all of the teachers who oversee her throughout the school day. This includes the classroom, art, music, and PE teachers, as well as the librarian, the assistant principal, and the nurse. For some of these staff members, it is a refresher course; but for the classroom teacher, it is always brand new.
During the training session we go over key aspects of her 504 plan, especially the items that pertain to her daily school life, like access to water and the bathroom, checking blood sugar as needed, snacking at scheduled times, and checking blood sugar before important tests. I stress that her supply kit is listed as a separate child on the class roster, so that it is taken (and brought back) on field trips, and any time she leaves the immediate school grounds, such as during a fire drill.
I go over an instruction sheet I create for teachers line-by-line. It includes: the symptoms of low blood sugar; Q’s usual symptoms and the language she uses to describe them; the rule of 15s; low blood sugar treatments; when to use glucagon and to call 911 if it’s needed; and the symptoms of high blood sugar, along with protocol for checking and treating. I point out the three phone numbers they can call to reach my husband or myself, and encourage them to call with any questions. This sheet also includes a photo of Q so she can be easily identified, and it is placed in the lesson plan any time there is a substitute teacher. I put the instruction sheets in plastic page protectors and give one to each teacher, the nurse, and assistant principal.
I then show them the classroom kit, and we decide where each of the kits will be kept. We keep one in the classroom, usually on a shelf near the door, and one in the music room in the supply cabinet because that’s where she would likely take shelter during severe weather or a lock down situation. I go through the entire contents of the classroom kit because teachers might not be familiar with each of the items.
Although Q tests her own blood sugar, I show staff how to load a lancet, lance a finger, and apply blood to the test strip in the meter. If she were unable to think clearly or were shaky, someone might have to test her blood sugar for her. When I demonstrate, I’m always surprised at how much it hurts!
The training session culminates in a demonstration of the glucagon kit. I explain that, while the need for glucagon is not common, it is very important that if she is unconscious or having a seizure, the glucagon must be given immediately and 911 called. Not doing so can result in brain damage or death. This always scares teachers. I assure them it’s like an insurance plan: you need to be prepared just in case, though you may never need it.
I think glucagon makes people nervous for three reasons. First, they are nervous because it’s used in an emergency situation for the child, and they are afraid they won’t remember what to do under pressure. Second, they are afraid that if they do it wrong they will do more harm than good. And third, that needle is really huge!
When training school staff, I try to be as calm and reassuring as possible. I show them what the plastic case looks like and where they can find one in an emergency (in Q’s d-supply bag, in the classroom kits, in the main office). I show them exactly how to use the kit and remind them to have someone call 911. After horrifying the teachers with the glucagon instruction, I assure them, once again, that they will get the hang of things even if they are feeling overwhelmed with the depth of information, and I tell them not to hesitate to reach out to the nurse, or assistant principal, or me with any questions.
After the regular staff leave, I stay a bit longer for more in-depth training with diabetes personnel listed on Q’s 504 plan, which include the school nurse and assistant principal. With these staff I go into more detail about checking ketones and blood sugar, making sure she gets insulin for the food she actually eats at lunchtime, and how to use her insulin pump.
If you’d like to learn more about the book, you can read more on the Kids First, Diabetes Second book page. It’s available widely in print and as an eBook from book sellers such as Barnes & Noble, Amazon.com, and IndieBound. And if you do read it and find it to be a valuable resource, I would greatly appreciate if you could write a review on any of the online retail sites. Thanks!
Disclosure: This post contains affiliate links to booksellers.
More posts about glucagon
Back to School with Diabetes: Lots of information and links!
I have an entire chapter about school in my book Kids First, Diabetes Second.
Read more posts about Diabetes at School.
Please remember that I never give medical advice. Ask your endocrinologist or pediatrician for advice about your own child. Make your own informed decisions for your own child.