Lessons From Loudoun
How nurses can train others to keep kids safe at school
On June 19, Devin Jackson was one of 306 students who graduated from Loudoun County High School in Leesburg, Va. It was an accomplishment beyond what she achieved in classes and cheerleading tournaments: Jackson, now 18, was diagnosed with type 1 diabetes when she was only 17 months old.
Throughout her years in the public school system, Jackson and her family relied on her own smarts and discipline to keep her safe and healthy—but also on nurses, teachers, and other school personnel, like Cathy Sturgeon, a nurse and the Supervisor of Health Services at Loudoun County Public Schools. "Providing care to a student with diabetes requires a team effort led by the school nurse," explains Sturgeon. "Everyone has a role: the school nurse, the principal, teachers, coaches, food service manager, school secretaries, parents, and, of course, the student."
Loudoun County has one of the fastest-growing districts in the nation, with about 53,000 students. Next year the district will increase from 72 schools to 75—putting a strain on already precious health resources. Still, Loudoun is also an exemplar system, in which school nurses train other staffers to provide basic care to students with diabetes when a nurse is not present. In a nation where there are unfortunately not enough nurses in schools, that sort of help is invaluable, which is why this training is one of the principles of school diabetes care supported by the American Diabetes Association.
Still, not every district supports nurses training other staffers, and the diabetes care provided in schools around the country ranges from model schools like those in Loudoun County to other schools that end up excluding students with diabetes altogether. To encourage schools to implement programs like Loudon's, ADA spreads the word through its Safe at School campaign. ADA is committed to ensuring that every student with diabetes stays healthy while getting the same access to educational opportunity as other students. The Association does this through providing education to parents and school personnel, and negotiating with schools and school districts. When that doesn't resolve the problem, ADA works to achieve safety in schools through litigation and legislation. While federal laws provide some protections, state laws and regulations can stand in the way of good care. ADA has lobbied successfully for legislation in over a dozen states and has worked with regulatory boards in three others.
Every Loudoun school that has a student with diabetes is required to have three employees who are trained to perform diabetes care tasks, like administering insulin. "I used to have a needle phobia," says Arlene Lewis, a teacher at Loudoun High School. "However, when it comes to my students with diabetes, there was no question that I wanted to be able to help." With training, Lewis says she gained confidence in her ability to administer glucagon. Kathy Glenn, RN, a Loudoun elementary school resource nurse, adds that it's not only a matter of being ready for emergencies; schools must also help kids manage their diabetes while still getting the best education possible. "It is important that older and more mature students be able to check their blood sugar in the classroom so they don't miss out on important classroom time," Glenn says.
Indeed, the scope of diabetes care provided depends on the age of the student, as well as the student's individual capabilities. "When I was younger, I needed someone at school who was able to give me insulin and help in an emergency," Jackson says. "Now that I'm older … I still need someone to help in an emergency, but otherwise I just need the freedom to self-manage my diabetes whenever and wherever."
As she prepares to go to college and plans for a career after that, Jackson says she wants to return the favor.
"Part of the reason I want to be a teacher," she says, "is because I want to provide the same kind of help and encouragement to my students as my teachers gave me when it came to understanding and taking care of my diabetes."
If you feel your child is not receiving adequate care for his or her diabetes at school, you can do something about it. Learn more about your child's rights, and how you can work with your school to establish a plan of care for your child. Visit www.diabetes.org/schooldiscrimination or call 1-800-DIABETES and ask for a packet of information and to talk to a legal advocate.
View ADA's "Becoming an Advocate in the Schools" brochure at www.diabetes.org/advocacy/school_brochure.pdf.