Medical needs with no nursing medical background

[FionMcCool]

I am currently a teaching assistant at a local primary school, have worked in my current role since 2017. Job role is literally a general teaching assistant, nothing extra. A new child has started at the school and has diabetes. She needs to pin prick her finger daily and has injections. She is also SEN so cannot do so independently, an adult has to administer the needles, take the blood etc. I have been 'told' - not asked, I am to be her 1:1 and tend to her medical needs. I have had no nursing experience, and am extremely uncomfortable with this. Firstly, I wasn't actually asked if I am confident and at ease with this, was just told blasé I would get training and get on with it. Simple fact is, no, I'm not going to do it. I'll take it all the way with meetings etc I don't care, I am uneasy, anxious and upset and will not be forced in to doing so. AIBU?

Yes but as a parent, it's 'their' child.

The op is posting as an employee in a school....the difference, and responsibility for someone else's child is huge.

I'd ask to meet with the parents. Surely there is a middle ground. Like helping child monitor bloods but parents coming in to school to administer insulin.

I would not be happy giving insulin to a child.

If the parent has to come administer insulin every day, the impact on their job and ability to support the child is impacted.

Having done it, It's not a complex procedure that requires a nurse.

Also, if a TA can't manage this procedure with training, which of the other foreseeable health issues among children will they want to opt out of?

If an allergic child gets stung, will they refuse to administer an epi pen? What if a child is injured, will they opt out of administering first aid?

There are plenty of things we might not want to do in a job, or not feel comfortable doing them. But they still need to be done.

Maybe you could do it rather than the TA being paid minimum wage. What an awful attitude you have.

What if a child is injured, will they opt out of administering first aid?
Im not allowed to do first aid in schools, because I’m not a designated first aider. Not everyone in school is, or has to be.
TAs shouldn’t be guilted and manipulated into things because no one else is available. That’s a management failure.

I see where you’re coming from, but can you dig very deeply into why you might feel so uncomfortable with it, assuming that all training will be given and the child is happy for you to do it? Is it a fear of blood/needles? Making a mistake? Not being paid enough for this to be added to your role? Don’t want to be assigned as an 1:1 and would prefer to retain some flexibility in your role? Etc.

Checking a blood sugar and giving insulin isn’t a “nursing” task, the parents and family members of newly diagnosed diabetic children have to hit the ground running with this stuff all the time when they’re diagnosed.

It’s a shame that this child isn’t on a CGM method, as that would almost completely negate the need for finger pricks unless there was a sensor problem and no replacement available.

You’re going to sound far more credible and reasonable to your employer if you can properly describe your concerns and suggest a plan that would allow you to confidently provide the care that this child needs. Perhaps the paediatric diabetes nurse can come into school and train a few of you, rather than training coming via the parents, then you’ll know that you’ve had all the correct information direct from the horses mouth, then a second session perhaps with the parents for any little hints and tricks that they find useful.

The diabetes nurse should also be able to help you/your employer to write a specific formal plan for how her diabetes should be managed in school - very prescriptive and simple; if this happens, then do this, or if this happens make contact with this person, if blood sugar below this amount then give X amount of this food and repeat finger prick after 15 minutes, this sugar above this level then administer X amount of Actrapid, etc.

Hopefully at some point in the future this child will be able to go onto a CGM method and perhaps an insulin pump which should reduce stress and intervention for everyone in her life.

I would add that it’s reasonable to insist that it’s a “two person check” when insulin is administered - so you can check the blood sugar, leave the reading on the screen - show it to the other member of staff, confirm on the child’s diabetes plan that the dose of insulin should be X, draw that up on the insulin pen - corroborate that it’s the correct dose as per plan and then administer to the child.

Nurses do two nurse checks on lots of drugs for safety and reassurance.

Maybe I'm just cynical but I don't see the need for OP to 'dig deeply'. It's obvious, isn't it?

A mistake could result in child being hospitalised or worse, a fatality.
The emotional impacts aside do you think the parents will happily keep quiet instead of suing or pushing for OP to be punished? Sad and angry people lash out, we live in a society that's lawyer happy. She could lose her job, her reputation destroyed. No matter what 'two person check' is used, or training provided. A risk that isn't present at all for family members.

Of course I know such a thing doesn't exist and is probably illegal. But since people are banging on about family members. If I was the OP, the only way I'd do this is if I was treated the exact same way as a parent. A guarantee of no suing or complaints! Bearing in mind that OP is being treated a similar way in terms of being provided the same 'training'. She is not a medical professional that has signed up to do this and so should not be held to higher standards and 'know better'.

YANBU OP. It's really on the school to find a solution. Not you.

Two people check my child’s insulin and administer it.

I leave a note telling them how much to give.

So all parents of children with medical needs should give up their jobs?

Best get yourself down the Job Centre. You're refusing a reasonable instruction for something that is an entirely normal part of a Support Staff role.

You don't need a nursing degree to look after a diabetic child ffs.

You'll be trained, so I think YABU.

The guidance for schools make it very clear a staff member is under no obligation to provide medical care.

schools need to ensure the child’s needs are met but they can’t force any staff member to do it.

Schools no longer get any funding for it either. It’s terrible really.

I'm a teacher and I would object to this.

Having seemingly sole responsibility for something that could kill a child? For what, a salary of like £15k?

I'd want masses of training, led by actual medical professionals, and not some online video which is what you often get given for things like this, plus another member of staff to share responsibility, to even start to consider it.

Besides that it's discrimination, you'll administer first aid, youll do a epi pen, you'll help a child with another disability yet a diabetic child... nope?

It literally takes ten seconds to give insulin. You're saving that child's life. Without insulin they'll die.
Maybe your in the wrong profession if you don't care about the children you're working with. And it's not the parents job to come in every few hours to do insulin either whilst they are in the care of the school.

But that’s exactly what should happen. My child’s diabetic team provided a lot of training, meetings prior to school residential etc.

The most important thing is that he leads a normal life and feels the same as his friends, that he doesn’t feel any stigma. I am hugely thankful that he has a great team.

Honestly I think you should at least do the training and see how you feel after that. I'm a TA working in mainstream with no nursing experience and I have a student who needs suctioning and tube feeding. Nurses trained us. I'm firmly of the belief that my student should have the ability to have an education just like anyone else so there was no way I was going to deny that.

I understand your concerns. You’re told you’re going to be ‘medically responsible’ for this child, without knowing anything about diabetes, what triggers to look out for etc. It’s a scary prospect and one you didn’t sign up for.

So what happens if any of them make a mistake, leading to your child being hospitalised?

If she is a child she qualifies for a CGM under NICE guidelines in England

"If your child is under 18 and you’re in England or Wales, they should be offered a continuous glucose monitor (CGM) say NICE guidelines.
If your child is under 18 and you live in Scotland, national guidelines say they should be offered a flash glucose monitor (Freestyle Libre). National guidelines do not recommend CGM, but it may still be worth asking your child’s healthcare team if you think it could benefit them, as it is sometimes prescribed on the NHS."

I think you need to granulate what the issue is. Is it that you are not trained? Can this be solved with training? Is it that you (rightly) feel that the responsibility is not aligned with the pay you receive? Is it something else?

None of what is being asked for is actually hard, provided you have appropriate training and support but you appear to have no training and I’d argue you probably need more $ for it.

If they make a mistake it's easily fixed by giving them more or less carbs to balance insulin.