In the last few months, the American Federation of Teachers (AFT) met and issued guidelines on caring for a child with diabetes at school. After their annual meeting in July, the AFT released a brochure outlining their position on diabetes care.
The brochure states that children with diabetes should have the services of a full-time school nurse, and it advises teachers not to be involved in diabetes care. Furthermore, the brochure urges teachers and non-medical school personnel not to provide care if asked, even if a diabetes expert has trained them.
Decision Presents Problems for Diabetes Community
The AFT decision, in my opinion, is alarming.
The idea of having a full-time school nurse in every school is a good one. I would go as far as to say that it is necessary.
However, this request or demand from the AFT is simply implausible.
Our schools are in crisis. Funding challenges and staffing issues abound. Most school districts cannot afford nursing personnel. When nurses are available, most of them must service multiple schools.
The problem with the AFT’s decision is the “over servicing” of the nurses. We all know that diabetes emergencies are not scheduled or predictable. A child with diabetes requires protection and counseling at all times, not just a few hours a day or a few days of the week.
Diabetes-related organizations have been advocating for trained diabetes care providers in schools—nurses, teachers, administrators or volunteers. These individuals would be available to assist children with diabetes as needed or in the case of an emergency.
The AFT states that using “trained diabetes personnel” rather than increasing the numbers of school nurses is setting the stage for potentially dangerous situations. They say that the training would be inadequate and minimal.
The American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation (JDRF) and other diabetes organizations disagree and argue that the training would be complete and would nearly match the knowledge of other laypeople caring for children or adults with diabetes. Testing glucose with a fingerstick is not rocket science, and if a glucagon injection is needed, there is really no way a person can err. The point is to provide immediate assistance.
Only One Example to Support Its Position
The AFT uses one example in their brochure to support their concerns; however, the example is unsubstantiated.
They state that in a school in Texas, a school employee mistakenly gave a student 200 units of insulin rather than the prescribed two units.
I made a request for information to corroborate their account, but a response has not been received. In addition, Internet searches produced no results that matched their described situation.
From my personal research and experience, syringes used for insulin hold only 100, 50 or 30 units. To give 200 units would be impossible without giving multiple injections. Even insulin pens cannot dose 200 units of insulin at one time. The maximum pen dose is between 65 and 70 units in a single injection.
The AFT is well-meaning in their decision; however, it seems that the fight for more funding and staffing is being waged at the risk of young lives. The fight for school nurses must continue, but not at the cost of children with diabetes. To suggest that teachers and school personnel should ignore the needs of a child with diabetes is unacceptable. Furthermore, to refuse help from trained personnel is, in my opinion, unwise.