Lorraine Dolengo-Santiago teaches fellow school nurses, students, parents and educators in the Bronx how to manage diabetes in school.

What is the role of a school nurse?

First and foremost, school nurses are advocates for students with chronic medical conditions. We arrange for the accommodations they need, like access to water or the bathroom, and we administer medication to students. These things are needed to keep children in the classroom, which is why I say our most important job is to facilitate learning.

What do diabetes nurse educators do?

Diabetes nurse educators are nurses who focus just on diabetes care and management. We go to different schools in our assigned borough — mine is the Bronx — and teach other school nurses, teachers and paraprofessionals how to keep students with diabetes safe and participating in the classroom. That means keeping the child’s blood sugar within a target range as determined by their medical provider. My team members and I also do one-on-one counseling with parents and students on diabetes, how to use the technology to manage diabetes and relevant life skills like nutrition.

How do you explain diabetes to students?

No. 1: You did nothing wrong to get diabetes. Something — we don’t know what — triggered your immune system to start attacking the beta cells in your pancreas and now those cells can’t make insulin. We need insulin to turn the sugar in the food we eat — what we call carbohydrates — into energy.

It’s not easy to live with diabetes. I remind educators in my trainings to provide grace to the student and the family. Imagine being an 8-year-old child and every time you eat, you have to count your carbs and calculate your insulin dose. It’s a lot to ask of a child. And a lot to ask of parents. Many confirm that their child’s blood sugar level is good in the evening, say goodnight, and then don’t sleep because they’re afraid their child’s blood sugar will drop and their child won’t wake up in the morning. That’s why, with students and parents, when they get an “aha” moment about a way to manage diabetes, it really makes my day. It eases their anxiety.

Why do we need diabetes nurse educators?

The need is great. It started with a lawsuit. In 2018, parent groups and the American Diabetes Association told the DOE to improve the quality of care that students with diabetes were receiving at school. Parents were concerned that their children were spending too much time in the nurse’s office when some of this care could be provided in the classroom. Our team was created in early 2020 to solve this problem. I’m one of the original five team members — one for each borough.

During our orientation, COVID hit and we had a massive shutdown. With schools closed, we were able to create curricula for various groups of school staff. Our team has since grown from five nurses to nine.

What is your favorite part of your job?

I love to teach staff that as complicated as diabetes can be, it can also be very simple. We can keep students safe in the classroom. With the technology most students use, if they have low blood sugar, they don’t need to go to the nurse’s office. They can sit in class, drink some juice, keep learning, and 15 minutes later, their blood sugar is in a safe range.

— As told to Hannah Brown