 When your child goes to school with the sniffles, you worry a little. But if your child has a chronic disease such as diabetes, the worry persists, all day, every day.
With help, however, children manage their diabetes in school very well.
“School is the very best place for children newly diagnosed with diabetes to be, because the structure is the same every day,” says Phyllis Magnuson, manager of FirstHealth’s School Health Program. “They eat at about the same time. They go to PE at the same time.” FirstHealth of the Carolinas manages Moore County’s school health program. The partnership gives school nurses access to FirstHealth’s continuing education resources and allows them to become part of a child’s care as soon as the child is diagnosed.
 Immediately after a child’s diagnosis, which usually occurs in the hospital, a school nurse will consult with the parents to plan for blood sugar monitoring, daily meals and snacks, and other care. With the permission of the parents, the nurse will talk to the child’s class about diabetes and explain why their friend may have to watch what he or she eats or get insulin shots.
During the 2005-2006 school year alone, the six nurses in Moore County’s school health program wrote individual care plans for more than 900 children with chronic conditions, including diabetes.
A plan takes work
Persuading a child to stick with a diet plan takes work, says Tammi Brown, R.N., a case manager with Kids ACT. The FirstHealth program, which is funded by The Duke Endowment, supports and coordinates care for Richmond County children who have chronic diseases or who are otherwise considered at risk.
“It’s hard for children with diabetes to understand that they can’t eat like the other kids are eating,” Brown says.
In junior high, packing a lunch isn’t cool. But if a child with diabetes decides to grab a candy bar on the run, the extra sugar can disrupt glucose levels. To help, a nutritionist employed by Kids ACT will make home visits to teach the family about controlling diabetes with diet.
Union Pines High School student Katie Martin has diabetes, but with the help of Sharon Nichols, R.N., of FirstHealth’s School Nurse Program, she is able to monitor her condition even when she is at school.
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Also, either Brown or another case manager, Bobbi Smith, R.N., will stay in close touch with school nurses.
According to Magnuson, the initial period after diagnosis, before glucose and insulin levels are stabilized, is crucial. In Moore County, a school nurse will closely monitor the child during this period.
With six nurses to care for 12,000 children in 22 schools, however, there isn’t a nurse on each campus every day. As a result, each child with diabetes is assigned to a teacher or other caregiver who will monitor the child, test blood sugar and administer insulin.
The school nurse delegates those tasks to the caregiver—but not until that person is fully trained—and will routinely continue to monitor the child’s care. |
“The bases are being covered as much as possible with the resources we have,” Magnuson says. “One of the biggest challenges is letting parents know that there is help here.” 
Helping children choose health
Lately, Amy Hamilton’s 5-year-old has been debating her 10-year-old about the best snacks.
“My 10-year-old is into honey buns and brownies,” Hamilton says.
The 5-year-old argues for—surprise—something with less sugar and fat, like an apple.
It’s in part because of Operation Healthy Kids, which strives to make healthier choices second nature to elementary-school children in Moore, Richmond, Montgomery and Hoke counties.
“My 5-year-old doesn’t even realize that my hospital has anything to do with the programming he’s learning,” says Hamilton, outreach manager for FirstHealth Community Health Services. “We hope that kids everywhere are having those kinds of conversations.”
The program provides resources from FirstHealth that help teachers weave nutrition and health information into the curriculum. Kids’ favorites include fitness dice, which children roll to choose activities, such as sit-ups or arm circles, to do between classes or on rainy days. Children also love two dolls named Little Organ Annie and Andy, whose organs can be removed for discussions about how nutrition might affect their functioning.
“It’s also teaching them some science and anatomy that they might not get until later,” Hamilton says.
One class made trail mix, which taught not only nutrition but also fractions and math since the students measured ingredients. “Every school has embraced (the program) in its own way,” Hamilton says. “We’re hoping that making smarter nutrition choices and getting kids moving might be a chance for a child who would be at risk for diabetes or hypertension or high cholesterol to avoid that.”
Operation Healthy Kids is part of the Fit Together initiative sponsored by the NC Health and Wellness Trust Fund. |
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