My daughter is going to high school next year (eek). So among many anxiety-inducing steps we met the new nurse. We also met the old nurse, who is retiring but orienting the new nurse.
It was a familiar routine. By my count, these were the 8th and 9th school nurses we've met in as many years. Not including, of course, countless substitutes. I'm incredibly grateful that while we've definitely clicked more with some nurses than others I've always left these meetings feeling comfortable that my daughter would be in good hands. These people have done everything we've needed them to do to support my daughter's care in the nurse's office. They have also been proactive in communicating and planning for my daughter's diabetes needs with staff throughout the school and at school-based activities. Taking a step backwards, I'm very grateful that we've always had a full-time school nurse at all, since so many schools do not.
The conversation about the school year gets shorter every time, as my daughter takes on more and more of her own care. We were reassured that teachers would be informed of my daughter's diabetes, alerted to symptoms of low blood sugar, and even given a roll of glucose tabs per classroom which, as far as I know, is a step beyond what took place in the middle school. She'll continue to go to the nurse when she is low, because it's important for her to be somewhere safe and because it's also important for her teachers to know she's not absorbing the material being presented or that she's unable to adequately complete the classwork, quiz or test of the day. She'll also visit if she's high enough that she feels unwell or needs to troubleshoot the cause of the high blood sugar. Which goes hand in hand with visits for pump alarms, and emergency site change needs. In August we'll deliver our bag of strips, glucose tabs, juice boxes, a back-up meter and more so that the nurse's office can also serve as a source of back-up supplies.
The biggest topic of conversation about the school day involved lunch. My daughter decided that she'd rather handle lunch on her own and only come to the nurse's at lunchtime if there's an issue (she's low, runs out of strips, can't figure out the carbs). She has handled lunch by herself at her summer music program for years, and does her own mealtime routine at home without help. The other motive for this request was a desire to maximize her time. Our high school's schedule is designed to accommodate club meetings and extra teacher help during lunch periods, to allow a little study or library time, or to provide a solid break in the day for kids who participate in both before and afterschool activities. With a hefty fall extracurricular schedule, every spare moment during the school day will be valuable. Taking care of lunch independently was, apparently, how other kids have handled diabetes at our high school in the past, so this plan was not only allowed but encouraged. The philosophy (which is refreshingly in tune with the day-to-day realities of living with T1D) is that gaining self-sufficiency is an overall high school goal and that diabetes self-sufficiency is at least as important as bringing the right materials to class. Support and help are available if she needs it but she does not have to come to the nurse daily.
Woven into these conversations were threads of humor, helpfulness, and welcome. My daughter was reassured that she is welcome in the health office at any time. It was clear that if she changes her mind on any of the plans we made that nothing is written in stone. While a nurse with enough knowledge to use glucagon if needed and to educate the staff about diabetes is important, what's more important to us is that the nurse is someone my daughter feels comfortable asking for help when she needs it and someone who is good company to sit with while she comes up from a low.
We're grateful to have one less thing to worry about in the fall.