CPS manager advised nurses to cut back on services for diabetic kids

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Ashya O’Connell, 11, who has Type 1 diabetes, sits at her kitchen table on September 21, 2018, in Hegewisch. I Maria de la Guardia/Sun-Times

Background checks that sidelined a number of nurses caring for Chicago Public Schools students at the start of the year have made an already tenuous nursing situation worse, a number of parents say.

And recent instructions given to some CPS nurses encouraging them to cut back on care for some kids with diabetes “due to the significant number of newly diagnosed students who require daily nursing services” adds new worry to families of schoolchildren with chronic conditions.

CPS officials will be meeting Monday with the parent group Raise Your Hand. The group’s founder, Wendy Katten, called that a “positive” development.

Parents say problems keeping nurses who are trained in students’ specific needs date back to when CPS shifted many nursing needs to private agencies. That led to a revolving door of agency nurses in many schools, turnover which has posed dangers to kids, they say.

“There were days I pulled them out of school because there was no nurse, or the nurse who showed up knew so little about Type 1 diabetes, I thought there could be danger,” said Catherine Diedrich, whose two daughters have the disease that can be fatal without careful and regular blood sugar monitoring.

Her younger daughter was once severely overdosed by an agency nurse, who overrode the child’s pump and gave her several times more insulin than her body could stand, said Diedrich, who had to rush to the rescue.

The nurse’s action disregarded instructions in the girl’s 504 plan, a written document that spells out supports that children with disabilities are federally entitled to at school, Diedrich said. A civil rights complaint filed with the U.S. Department of Education in 2017 led to CPS assigning the school a permanent nurse, Diedrich said — one of about 200 nurses CPS employs for its 500-plus schools.

The CPS nurses, who are also members of the Chicago Teachers Union, typically split time among schools, five schools each on average, according to spring 2018 data analyzed by the CTU. That leaves many daily nursing needs to private agency nurses.

Kids have seen multiple nurses in the school year, threatening continuity of care. One second-grader at Disney II Magnet Elementary School had as many as 20 in kindergarten for her Type 1 diabetes, said her mother, Nicole Seidlitz, who downgraded her full-time job to part-time to monitor her daughter.

Parents also leave jobs to fill in when no nurse is available. After the preschool nurse caring for her 6-year-old son — who has spinal bifida and needs a catheter — Jenifer Korotko took two weeks off work until a replacement appeared.

Merrick O’Connell said she transferred her daughter, now 11, to Gallistel Elementary Language Academy, which has a steady nurse, from a gifted school where Ashya’s insulin doses were sometimes skipped, other times doubled up.

“Why can’t they have consistent people to be working with our children so they have trust and confidence?” O’Connell asked.

Several parents, O’Connell included, say they had to train new nurses on how to use insulin pumps, a task that grew cumbersome when nurses frequently changed.

And, parents say, even conscientious principals have been powerless over nurses who report to a private employer.

Recently, nurses were advised to cut back on services for diabetic kids capable of their own monitoring under adult supervision and to update those students’ 504 plans “as soon as possible.” One email said that such such students “should not receive daily nursing minutes on the next 504 plan,” and should receive nursing coverage “via video or phone conference.”

Federal law requires parents and providers to agree on modifications. A new email went out after the Chicago Sun-Times asked about the proposed cutbacks, to “retract” earlier directives and to insist on “full parental participation” for any changes.

Still, Amy Zimmerman of the Legal Council for Health Justice, said, “Now that CPS has shown their cards, parents and health care providers will need to vigilantly guard against these efforts.”

CPS spokesman Michael Passman said late Sunday that one nurse manager wrote emails sent to “four nurses regarding potential service modifications for four students.” The office overseeing nurses didn’t approve the messages and ordered their retraction. “No student service plans were formally or informally changed as a result,” he wrote.

As of Friday, 21 nurses awaited clearance for work after a new round of districtwide background checks, down from 37 as of the end of the first week of school.

“CPS is fully committed” to meeting students’ needs, so staffing adjustments “have been adjusted to help ensure all students receive necessary services” with CPS nurses “redeployed” to fill holes left by RCM Health Care Services — 17 of its 180 daily assignments as of last week, Passman said.

RCM, whom CPS has paid $13.6 million since 2015, couldn’t be reached for comment.

“Don’t think the solution is to get a better temp agency,” said Katten, who counted at least 23 nurses one year for her son. “Temps are temps. They’re temporary, and they don’t know the children.”

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