From Horseheads, New York, USA:
I am employed as an LPN in a local school district. As an LPN, am I able to treat a student that has an insulin pump or does that have to be an RN?
Thank you for your question and concern about the very important topic of the care of children with diabetes in the school system. I am not sure what you mean by treatment, so I will answer generically.
It is essential that you research your own professional status through the NY State Board of Education and make sure you are staying within the scope of practice of an LPN. In addition, you would need to follow the guidelines and procedures where you work.
That said, children in the school system with diabetes, who may or may not use an insulin pump, require an appropriate level of supervision and support. Excellent communication with parents/guardians and the child's health care provider are key and lead to a plan to care for the child effectively. Depending on the age of the child, the amount of school personnel involvement would be different. Clear instructions on glucose and ketone monitoring, recognizing and treating hypoglycemia would be part of all of the school personnel's involvement, as would knowing when hyperglycemia and ketones require contact with parent or clinician. Usually, children have very specific instructions from their healthcare provider on the above, as well as insulin dosing for carbohydrate intake and high glucoses. Most children will do their own insulin bolus, but may need supervision to do so. In a younger child that requires adult care for this, you would need to follow your state practice act and school policies.
If you need more information you can contact the American Diabetes Association, State and National Associations of School Nurses, the NY State Board of Education, and, of course, please view the information at this web site on Diabetes at School.
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