The School Nurse: An Important Relationship for Families of Children with Type 1 Diabetes Mellitus

By Sarah Ogilvie

We conducted family interviews with families of children with type 1 diabetes mellitus, in order to better understand the stress that these families experience and the role that school nurses play in supporting these families. We had some interesting findings!

One of the findings that surprised me was how much stress surrounds the transitions to middle school and high school for these children and their families. The elementary school nurse is often a highly trusted individual who has formed a close relationship with the family, and moving on to middle school brings a lot of fear for both the parents and the child who has diabetes. At those transition points, the students need to be more independent in their diabetes care, and also get to know a new school nurse. If these families can receive some support with transition planning, this can lessen the stress of the transition. The school nurse can serve as a coach as the child learns to be more independent in their own cares, in preparation for such as a transition. Kids learn better troubleshooting situations in real life, rather than in a training session with a diabetes educator. If they can think through what to do when they are having blood sugar highs and lows with the school nurse as a coach, then they can learn to be more independent.

It is also important to recognize that siblings of children with diabetes are impacted by this disease as well. They may receive less attention in the family than their sibling who has diabetes, and they may worry about or feel a sense of vigilance over their sibling. This stress can feel like a big burden for these kids. They can benefit from support from school nursing as well.

Another key consideration is the feeling of having no breaks. These parents feel that diabetes is a relentless disease. Many families who have a child with diabetes may have limited resources anyway, and they have fewer opportunities for breaks. Typical childcare options such as a neighborhood babysitter may not work for them. These parents may be up in the night every night dealing with blood sugar highs and lows. When there is a single parent, the stress is magnified. Many times the school nurse is someone these families lean on when dealing with the challenges of the disease. The families who cope most effectively with diabetes are the ones who take a teamwork approach, where more than one family member learns diabetes cares and they can give each other breaks. This is something that the school nurse can encourage. The school nurse often may need to coordinate with the parents and the child’s provider in order to facilitate communication about the child’s care.

Connecting such families with other families who are going through the same thing can be really helpful. They may not know any other families who have children with diabetes, and it can be really powerful for these families to learn from each other. For parents to receive peer support, children with diabetes to find peers who also have diabetes, and siblings of children with diabetes to find peers in the same situation can be encouraging. Families who are functioning well with diabetes can help other families by sharing best practices. This can be accomplished in person or in online groups.

Article details

Family Interviews Inform School-based Nursing for Children with Type 1 Diabetes and their Families
Sarah J. Ogilvie, Patricia Beierwaltes, Gwen Verchota, Seonhwa Lee & Sandra Eggenberger
First Published: April 25, 2023
DOI: 10.1177/10598405231170686
The Journal of School Nursing

About the Author

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Sarah Ogilvie, DNP FNP-C APRN PHN CPHQ, is a former licensed school nurse who is passionate about working with patients and families to prevent and treat chronic conditions, especially diabetes. She is an Assistant Professor at Minnesota State University, Mankato, and also works as a Family Nurse Practitioner at Burnett Medical Center, a health center in rural Wisconsin. She volunteers at Health Commons at Pond, a free clinic for children in the Bloomington School District in Minnesota. Dr Ogilvie has a degree in chemical engineering from Brigham Young University, and then she later earned a baccalaureate nursing degree from the University of Pennsylvania and her DNP degree at Minnesota State University Mankato. Her other research interests include health care quality improvement and ethics in biotechnology.