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?

Genuine question- what happens in a medical /first aid situation? Are there people trained to attend to this on site? I know people think bumps, cuts and bruises are minor but it's big to children and still needs to be attended to.

A bit off topic - but healthcare staff are advised to have hepatitis B vaccination because of the risk of acquiring blood borne infections.

Whilst the risk when working with young children is very low, staff who are regularly doing pin prick testing and administering injections might wish to consider discussing with their GP.

I think it's reasonable that this is expected of you in your role.
The training will be provided.

Honestly it's really not that big a deal . I got trained up in fifteen minutes by by Sil when my husbands niece got diagnosed.

Are you a teacher or a TA and needed "official" workplace, insured and regulated training

I think I would have reservations as I think assisting a child with SEN and Medical Needs is challenging and perhaps would suit someone who has some sort of medical aptitude.

It would be a challenge to a lot of assistants confidence to have to balance both. Could the responsibly be shared ?

Of course the child should be at school of course they should have their needs met. But comparing a parents role and responsibilities with a TA is not fair.

I had this, and a specialist diabetes nurse came in and showed us how to do everything properly. But if you are doing Level 3 TA work, just make sure you are paid accordingly.

A First Aid trained member of staff will assess them, if they need medical attention the parent will be called to collect them and take them to the GP/minor injuries/A&E depending on the nature of the problem. If it's just a superficial cut, bump or bruise a First Aider will deal with it.

It's under the equalities act. You can't refuse to look after a diabetic child in school. That's discrimination. It's not rocket science. They'll train you, you'll learn.

An individual staff member can say they don’t want to do it. The school needs to put provision in place but they can’t force any staff member to do it.

Unless specifically employed for the role TA contract won’t have about providing medical care.

I can absolutely understand where you are coming from OP. I too would be apprehensive and fearful. The 'what ifs' would make me incredibly anxious.

We have a few children with diabetes in school (but not with additional SEN) and the staff that work with them have regular training and contact with parents. About 4 months after I started work there as a TA, I was asked to keep an eye on a diabetic child whilst his 1:1 ate her lunch. No training, no discussion. Just get on with it.

If I were you, I would accept the training but voice your concerns and worries. Meet with the parent and build a relationship. This is pretty serious and YOU need to know you have support from SLT.

Generally the trained first aider, technically there for the staff, also deals with the children. Many do paediatric first aid courses as well.

Could you do the training first and see how it goes before you decide?

It seems as if they just need you to do the stuff the child or mum would do, rather than anything on a par with nursing.

It might not be as scary as you think. I’m also wondering if the ‘telling’ has got your back up and you wouldn’t want to do whatever it was they told you to do, whether it was this or making the tea.

I feel the same in those circumstances. It is only polite to discuss any changes to your remit with you, even if it’s already been decided!

@FionMcCool You absolutely cannot be told to do this. It's against the law to instruct someone not medically trained to carry out any invasive procedure, in a school or any other setting. Or at least it was when my DCs were at primary school. And yes, sadly, the reality is that unless someone at the school volunteers for this duty, then a parent, guardian, grandparent etc will have to go into school at lunchtime to administer insulin.

Can I just tell you though how extraordinarily grateful we were that one of the TAs at our primary school offered to be trained and then inject if necessary. In our case it wasn't because my DCs wanted to take control of their condition themselves at a young age, but obviously it's different in this case because of the SEN.

Perhaps you could find it within yourself to do the training and then see how you feel? If you still feel really uncomfortable about it, I wouldn't blame you at all for declining but I can promise you it makes a massive difference to the family knowing that someone has offered to help out in this way.

Yanbu as it sounds like you’ve not been given the training to do this and I wouldn’t be able to do this without the training. But you don’t need to be a nurse or from medical background to do this.

My son was diagnosed with diabetes a year ago he has a set amount of insulin to take with each meal ,obviously he does take extra if his blood sugars are to high ,but in a school if g that happened I would assume there would be a plan of care in place and people to contact if there were any concerns

The question is, OP, If something goes wrong and the child becomes ill, or worse, who will get the blame?

It’s part of the job course you can be told to do it. But if I was the child’s parent, I’d request someone else who is a bit more compassionate.

This is another very good point to raise with SLT. If it were me, I would request yearly refreshers with the diabetes nurse and ask what happens in your absence.

Schools are a nightmare for these sudden 'dropping TAs in it'. You are a human being, not a commodity.

I really don’t think it would be a TA though I agree it’s definitely worth asking. Even if a nurse makes a mistake in a hospital and there’s a very bad consequence it’s the hospital which gets sued, not the individual nurse. A nurse might get struck off the nursing register but that’s not applicable to a TA.

The cases where an individual HCP has been in trouble afaik relates to very bad negligence, ie the nurses in Wales who didn’t do two hourly checks like they were supposed to because they were too busy gossiping at the nurses station (proven) and they forged blood sugar readings rather than actually doing them (proven) and the patient died. So as long as you were doing what was meant to be done to the best of your ability then I don’t think a TA would be in trouble for anything?

Diabetes UK state that staff on school need to be trained by the child's specialist nurse and signed off plus a minimum of 2 staff have to be named and trained for care of the child. This shouldn't fall to one TA

Our whole nursery team then quite a few people in school too did the training with the child's diabetes nurse and could call on her, we had great meetings with the family too. Mum was always open to giving us the right support. It's been helpful with more children being diagnosed with diabetes in the school.

But if you aren't comfortable then you do need to speak to the management team.

it's really not rocket science and it's just a pen injection. i did my dads for years. schools have to administer insulin - staff should have training and then it's just part of the job.

I have many, many years of direct family involvement with T1 diabetes and I agree that it isn't difficult, DD2 was testing and injecting herself at the age of 6.

But that's not really the point – @FionMcCool doesn't feel comfortable doing it (that may change after training, it may not) – it absolutely is NOT 'just part of the job'. It's only part of the job if OP wants it to be, she can't be told it is.

Funnily enough I know someone who had this same attitude towards his T1 diabetes and for years juggled eating the wrong foods with fiddling about with his insulin requirements. He thought he was smarter than the illness, now in his late twenties he has a number of the common diabetes complications , neuropathy, gastric problems, eye issues……..

And he was making his own choices, he wasn’t a child with special needs having their medication needs second guessed by an underpaid, untrained TA.