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?

Yoy have no idea how terrifying it is sending your child back to school after a life changing medical diagnosis.

Luckily his teachers are brilliant and phone me with any concern. Not all parents are this lucky, other parents have teachers who refuse to let their children use their medical devices or won’t leave the class to get their hypo treatment.

The risk is huge. The alternative is he doesn’t go to school. Which isn’t ok either.

@allypally33So what happens if any of them make a mistake, leading to your child being hospitalised

Well it is what it is I guess, but it’s honestly really easy, quite mistake proof. As long as trained the average person can’t really make mistakes as such. In this situation would a TA not be umbrella’d under the schools indemnity insurance?

It's very easy understandable to be nervous and anxious about this. I'd have a serious talk with SLT to outline your concerns. Maybe agree to the training as you may be surprised at how much it changes your opinion when you are properly informed. If you feel afterwards that the training hasn't reassured you and given you the confidence to handle the condition competently, then have another discussion. Nobody should be forced to do this.

Look, I agree that it’s really fucking shit that TA’s would be expected to do this on the shit money they earn, and I agree that there is risk involved. I agree that the onus is on the school to ultimately provide staffing to meet the needs of this child. If OP just wants to say “No” and not give any reason they can do, but we don’t generally get away with conducting ourselves like that in employment. The school also needs to provide information and reassurance to involved staff about the extent of their personal liability, vicarious liability, insurance issues, etc.

I also think it’s fucking shit that any children develop diabetes, and that living with a chronic condition has long lasting health, educational and psychosocial implications for them. The child deserves an education and as normal a childhood as possible because they’re already on the back foot there with diabetes and SEN.

It’s also shit that this child’s parents have already probably fought tooth and nail to get her into an appropriate setting whilst maintaining employment, family finances, their own mental health, the wellbeing of any other children in the family, etc etc.

Appropriate training from professionals would help massively in mitigating risk, and also in building staff confidence and competence to minimise the risk in the first place. Other measures can also be put in place to mitigate risk, as mentioned above two person checks before administration of insulin, a clear and specific protocol of what to do in every eventuality - including if a mistake is made with too much insulin being given. The child should also have prescribed Glucagon injection kept on site which can be administered in a hypo where they’re unconscious or unable to swallow food. If a mistake was made with insulin administration then appropriate action would be to call 999 immediately, who would provide further guidance until a crew arrived on scene to give further glucagon or IV Glucose and blue light them in to ED. If you gave too much, they don’t drop dead right in front of your eyes, there’s time to get help.

But careful and diligent administration of insulin, checked by two members of staff against a defined plan written by a paediatric endocrinology consultant is unlikely to ever get as far as needing 999/glucagon because of accidental drug error.

YANBU you should not be forced to do something that you are uncomfortable with. I work in a school, we do epipen training. I have known some members of staff to say that they are uncomfortable administrating an epipen even after training. School have always said that is fine and have taken them off the list of people who will administer. We are all different, my DC would never be able to do this as they are extremely needle phobic.
Try and speak to the school again and explain that you are not comfortable and won’t be doing it.
To posters saying go and look for another job. TA’s do an amazing job for very little money. It always surprises me how many talented people are willing to do it. You can earn more money taking temp TA work and there seems to be a real demand atm. One of my colleagues has just left to do that.

So even you're saying the risk is huge. But @HoppingPavlova You and PP claim it's easy and mistake proof, if so there'd be very little risk, wouldn't there?

I think the issue here is OP isn't being supported. She's just been 'told' to do it. Presumably if she made a mistake, she'd also be thrown under the bus. @FlyingPizzaMonkey Can you honestly say that you wouldn't want action taken against the person who made the mistake?

If it really IS easy, and hence low-risk all of this should be explained to the OP and she needs to be reassured that she won't be left alone to deal with any fallout if the worst happens.

I don't know much about T1 diabetes, but neither does the OP, so I'm coming at this from the layperson just being 'told what to do' perspective.

Also @FlyingPizzaMonkey the alternative isn't that your child doesn't go to school it's that the council pays for someone properly trained to do all this. Or at least, pay the OP! They often don't WANT to , and it's a huge battle but one that many SEN parents have to go through.

I would do the training and see how i felt then but doing it as a TA is VERY different to doing it as a parent. We have a T1child. Who is responsible if the child will not cooperate or if you get the amount of insulin wrong? Are you fully protected? Dosages will always be different depending on diet, activity levels or if the child is unwell even minorly. I would want to be part of a team of 2 if I were responsible for someone else's child. Presumably as this is an added major responsibility for which you were not contracted or offered the choice you will be given a pay rise?

I think the end of the first paragraph is really important here.,
OP wasn't even engaged with. She was just told to do so. Her opinion wasn't even asked! She's not just said 'no', she's already stated that she was uncomfortable with it, but hasn't been listened to.
It doesn't seem to me an environment that would be supportive. More like people are happy to throw her under the bus in case of any issues.

Now if she had said, 'they have X Y Z plan, lots of training, blah blah' and they had approached it with the aim of partnering with OP and bringing her on board, she might be U.

@allypally33 So even you're saying the risk is huge. But @HoppingPavlova You and PP claim it's easy and mistake proof, if so there'd be very little risk, wouldn't there?

Well, yes, if trained appropriately, there would be very little risk as it’s not hard. But again, would any indemnity, if it ever came to that, not be covered via employment covered by the school?

Can you honestly say that you wouldn't want action taken against the person who made the mistake?

I can.

A Ta made a mistake with my child’s medication - not her insulin - and it could have had serious consequences. As it was a night in hospital for observation and she was on her way.

Basically complacency had set in and the two working together didn’t actually check each others work properly. Just trusted each other.

When I went in they apologised and told me what they’d put in place to make sure it didn’t ever happen again. The fact they took it seriously and put things in place was enough for me.

Even the most fool proof things can go wrong on rare occasions. I trust when my DD goes to school that the staff do what I do - they look after her to the best of their abilities. That’s all I can ask.

The big issue with this is the way the SLT have approached the OP.

they shouldn’t be demanding it.

Even if it is, surely it's not just about the payment, but the court process, that the OP might be dragged though.

@ARichtGoodDram exactly!

Again, I am not saying that parents should have to do it, or anything else but the responsibility shouldn't be pushed onto OP with no discussion. Because someone else doesn't want to pay or whatever.

I feel sorry that she's received so much hate from people. saying that she shouldn't be working with children, is irresponsible blah2.

If the worst possible thing happened, it would be the school summoned to Coroners court, and the school would request statements from involved parties. The Coroner might call these individuals to an inquest to discuss their statements. Issues of training, assessment of competence, staffing, etc would all fall at the school/head teachers and local health authorities door - not at the foot of any individual staff member provided that they had acted within their training and guidelines.

The Coroner would go over with a fine tooth comb the training given to everyone involved, how the mistake came to happen and if there was any case for anyone to answer. Only in the event of true negligence would blame fall at the OP’s door, and I hope in those circumstances that’s what we’d all consider appropriate.

I’m with @ARichtGoodDram in that I honestly wouldn’t take action either. I was in the position of having one of my kids require medical care at school. I was in the position I could provide the training (A&E consultant), but honestly beyond that you only expect that people can do the best they can do. If an honest mistake is made, that’s what it is. I’d also expect there was indemnity via employment under the school, but I’d never consider the individual themselves to blame as such.

None of us were privy to the conversation and OP is retelling the events from an (understandable) place of fear and resistance.

For all we know, if the OP spoke up and said “I don’t think I feel comfortable doing this” the school might have said “okay, we will assign another member of staff to 1:1 this child”.

@allypally33 no I wouldn’t take action or have them thrown under bus because I am also a nurse and errors happen and I understand why. I can’t imagine how devastated one of our TAs would be if they were to make a mistake. It would never be purposeful and maybe would highlight that more training was needed.

As it is I trust them, they are fantastic and we’re very lucky.

There is no funding for health anymore for schools, it was removed, by the government I expect.

There are also some equality and discrimination laws that come into play here too. But it’s something I need to learn more about. The Facebook groups for diabetic parents are very informative.

I wouldn't do it until received training in diabetes care, how to take the pinprick and what is normal or abnormal, how to draw up, give and dispise of insulin and syringes, how to store insulin, how to treat hypo, keep a food diary, it would probably only be the midday dose that needs giving but if thechild hadn't eaten that would be serious. Do they have a suitable fridge. Sharps boxes etc.

Look at the levels of aggro here, the accusations of not caring the ‘You will deprive a child of the right to an education’ and vague promises of ‘Oh, it’ll be fine’ That’s the reality of stepping up to take extra responsibility for a child.
The danger is present and real and constant.
Why would a TA volunteer to be part of that for no extra money and with no written guarantees of support? Why take the risk if you don’t have to? For minimum wage?
Some posters are being as abusive and manipulative as SLT and parents can be. Then when things go wrong, they step back and point fingers and lay the blame on the TA.
SLT members, and teachers should step up as the responsible ones. The final checks. And that should be written in a protocol, so that if there is a problem, SLT carry the can.

Completely agree!
But there have also been good perspectives shared by parents grateful that people are willing to take responsibility.

This is a team effort that requires engagement and planning. Not guilt-tripping or emotional manipulation.

@CaraMiaMonCher well if the OP says no and they accept it then the problem's solved, no need for any of us to comment. It's only if she's forced, that this entire thread becomes relevant.

For every MNetter saying ‘Oh, I wouldn’t blame anyone for an incident’ there are more parents ready to throw down and attack. You can only speak for yourself, but over the last 40 years, parents have become more volatile and hostile to staff in schools. The well-intentioned waffling on here doesn’t refute the evidence in the schools and in the news of staff being accused and threatened for a wide range of perceived offences.
If the OP doesn’t want the responsibility, she should have the right to say no. Without being bullied for it.
No is a complete sentence, as the cliche on here goes.

Just to say there are no syringes. The child will have an insulin pen containing the insulin cartridge (which gets changed when it’s empty) which you dial up to the required amount of units. The needles have safety lids. Nothing goes in the fridge.

How many schools do you think have a school nurse these days???

How has this all been risked assessed? Surely the only feasible way to mitigate any risks would be a competent, knowledgeable staff member (you will admit yourself that you don't fit this profile.) One training session (if that's what they are suggesting) is not enough to successfully support her to manage this condition.

@FlyingPizzaMonkey children with medical needs should be supported by a school nurse who has spent minimum of 3 years studying. Not a simple training session as a tick box exercise.

Are you in a union Op? I’d check your employment contract and speak to union for advice.
It sounds like it’s being foisted on you and Op is concerned there may not be proper training or procedures in place.
It’s also a massive change to her role from being a class TA to just being a carer for 1 child.
Posters are assuming child is compliant and biddable, Op knows nothing about her or nature if SEN. Prompting and assisting a compliant child is a very different kettle of fish to a child who doesn’t understand need and is wriggling around or screaming get off me.