So we had an IHP meeting yesterday at the school and since I took the time to vent in my previous school post, it seemed only fair to post an update. I think it would be fair to say it was a positive meeting. Most importantly, I think we cleared up 2 key points - a lot of missed class time and punishments for diabetes care.
Alex will now test in the classroom except at lunch and the end of the day. This is a big deal because I don't get the impression the other 4 kids with diabetes do much testing outside the health room or care to (and as an aside they all have classrooms close to the healthroom. Alex's classroom is about as far as one could get from the healthroom).
The nurse seemed completely on board with making this happen. That was probably my saving grace. The teacher didn't seem opposed - just scared. She has never seen a blood glucose test. So I happened to have a meter and pulled it out to show her what it involved. Though I think they were both taken aback at me testing right there and then I thought it was the most effective way to demonstrate that testing wasn't about big giant needles and gobs of blood. In fact no one would ever really see any needles in the classroom. Alex will dispose of used strips/lancets in the healthroom at lunch and the end of the day (and transport them in a pouch in her meter case). I really think it helped to show the teacher that what sounds complex and scary isn't all that much so.
So the plan is that Alex will test and bolus and correct in the classroom for snacks, before/after PE and recess and whenever necessary. She will have to call the nurse the first week to report her numbers. She will have to write her numbers in a paper log in her meter case and carry that to the healthroom. After a week the nurse will not make her call each time she tests - and just use the log and report her numbers at lunch and end of day. I'm good with this plan. Alex will be allowed to test and bolus as long as her numbers fall between 81-280. If it's below or above that, she will visit the health room. I'm good with that too. My hope is this will prevent a lot of 10-15 minute walks to the health room each day. For some time, Alex has been visiting the healthroom 4-5 times per day at an average of 10-15 minutes out of the classroom. That's A LOT of time! That should also help with missed classwork.
As far as standing at the wall for recess due to missing agendas (because she was in the health-room)....the teacher says she had no idea Alex was losing recess. Honestly, this doesn't make a ton of sense. How could you not know? She has over 30 kids. I get that. But...if it's a punishment, don't you know about it? She says she has said if kids aren't responsible, they lose recess. Another child marks them as missing their agenda. She says many kids don't even follow the rule when they go on the playground. But Alex has followed it. I asked why it wasn't marked on a school behavior card and the teacher said because the card didn't have to do with agendas. I reviewed that behavior card today. It sure looks like it would be the place to record any type of disciplinary action. So if you're telling me that Alex shouldn't have stood against the wall and yet Alex says her name was on the board as one who should stand at recess....something isn't adding up. So...I told Alex from now she isn't to stand against the wall unless the behavior card is marked AND the teacher specifically tells HER to do it. If another child tells her to do it...she doesn't do it. Period. And if she stands against the wall again and there is no mark on her behavior card or message to me...I'm going to the administration. 30 kids or 10 kids you should know who is losing recess and be able to mark it somewhere as a disciplinary action. And if it is just a "threatened" punishment where some adhere and some do not, that's pretty confusing. You're teaching kids to get away with breaking rules. Something didn't sit well with me there.
At any rate, the teacher agreed 100% that Alex shouldn't have been marked for missing her agenda or receiving bad grades for work missed due to diabetes care. From now on, Alex will write "at nurse" if she doesn't finish something or doesn't write her agenda. The point was made that Alex hasn't communicated to the teacher any of these concerns about not finishing work and she has 30 kids and doesn't catch when something isn't done because of a valid reason. If she writes she was at the nurse, the teacher will not give her a 0 but allow make up time. The teacher also suggested Alex will write her agenda in the beginning of the day instead of end of day but the rest of the class would stick to end of day. Alex won't have to do morning drill work so she can do her agenda. I'm again not sure this was my favorite outcome but better than no agenda coming home to me at all I suppose if the teacher was not willing to just have the whole class do agenda another time of day besides 2:45 PM.
One of the last big concerns we discussed was the buddy system. If Alex is low, she is walked to the health room by another 9 or 10 year old. All the doors are locked in the school now due to security. I asked how would a 9 or 10 year old know what to do if Alex went down in the hallway. Has anyone really discussed it? They suggested the buddy would run to the office...and leave Alex down in the hallway. But I still don't think anyone has specifically talked to these buddies about why they are Alex's buddy and the specific procedure for a bad incident. So this morning, the nurse is visiting the classroom and going over that as well as Alex testing in the classroom. Additionally, if Alex is below 55, the nurse will come to her instead of walking to the health room. And above 55, she will take her tablets and walk to the health room with her buddy. I hope this will help.
So there are the outcomes and a new IHP is being completed. I think we got what was needed. I think the teacher and the nurse were receptive to making things better for Alex. I really do think we have a great school nurse who has always been easy to talk to and has a lot of background with type 1 diabetes. I think the teacher honestly means well and cares about Alex. I think she has a large class and has absolutely zero background with a child with T1. I think it's a matter of talking to her repeatedly as needed. And I guess a matter of me keeping an even closer eye on Alex's school work before it gets out of hand again.