By Jessie Marchesseau

In any given hour at Sierra House Elementary School in South Lake Tahoe, half a dozen kids are in and out of the nurse’s office. Illnesses, injuries, bloody noses and burns are among the ailments.

A young girl wearing purple jeans and a bright orange bow in her hair wanders into the office looking right at home. She pulls out a lunch menu and starts perusing the choices for the day. This is Maritza Torres. She is 10 years old and she has diabetes.

Torres, happily sucking on a candy cane, explains how she thinks having diabetes is easy, but she still does not like it.

“I have to get a shot all the time and if I want to play soccer or something, I have to check my blood sugar all the time,” she says.

Everyday Torres and the school nurse decide what she is going to eat for lunch, calculate the carbohydrates, test her blood sugar and administer the proper amount of insulin.

Kelsey Buckley, 8, Makenzie McMillen, 10, and McKenna Brewer, 10, are used to having medical kits with them at all times. Photos/Jessie Marchesseau

This might not seem to take up a great deal of time in the school nurse’s day, but Torres is not alone in this battle. Nine other students in the four other schools within Lake Tahoe Unified School District also suffer from diabetes, and all vie for the nurses’ time.

Having 10 diabetic students in LTUSD is a significant increase from a decade ago when Rand Norberg was the only one.

His mother, Loreen, a second-grade teacher for LTUSD, remembers being “scared to death” when she found out her son had Type I diabetes. He was in third grade.

“At that time, I had so much faith in our school nurses, and just kept saying, ‘they know more than I do,’” she said.

Loreen Norberg refers to the nurses as “a god-send” and credits Margaret McKean, a school nurse for LTUSD, with teaching her some of the most important aspects of helping her son deal with diabetes.

Without the school nurses and staff available to help Rand manage his blood sugar and administer insulin daily, Norberg said she would likely have had to quit her job in order to monitor her son. This is a consequence not uncommon among families with a diabetic child.

Rand, like Maritza Torres, received an insulin injection everyday at lunch and any other time he ate.

“A lot of times it fell in the hands of the school secretary,” Norberg said. “I was fine with that. As long as he got his shot, I didn’t care who did it.”

However, administering insulin shots is now restricted to the school nurse, the child or a relative. This means LTUSD nurses need to be available to assist all 10 diabetic students every day.

McKean says there are too many students with diabetes in different places, and she cannot be in two places at once. The additional care needed for these students prompted the district to hire two additional part-time nurses this fall, bringing the total to two full-time and three part-time nurses.

“I think the school district is really going above and beyond in the budget crunch,” McKean said.

The number of students needing and using school medical services may make it somewhat hard to believe that having a school nurse in California is not all that common. The state does not provide funding for nurses, so it is up to individual districts to decide to have a nurse on staff.

“We’ve made it our priority in our district: our kids with diabetes and our kids with food allergies,” McKean said. “It’s a life or death situation.”

McKean has been a school nurse for 28 years and has seen the number of diabetic students increase greatly in recent years. More and more children are being diagnosed with Type I diabetes, and the medical community has not yet figured out why.

She explained how what is usually in the news is Type II diabetes. It is often caused by being overweight and can be reversed over time. Type I, however, is not a result of weight issues. Type I is what most of the LTUSD students suffer from. It can never be eliminated. They will live with it for the rest of their lives, and it can be deadly if not properly managed.

Susie Brumbach, school nurse for the Douglas County schools at the lake, said she has not seen the same increase LTUSD has. Brumbach said she is aware of one student with Type I diabetes at her schools and has not had a diabetic student at the elementary level in more than 10 years.

LTUSD, however, has not been so fortunate. Seven of the 10 diabetic students are at the elementary or middle school level. Many of them are relatively independent and either wear insulin pumps or administer their own injections, but they still require a nurse’s supervision.

Each of these students has their own manual of sorts in the nurse’s office with all relevant information regarding their condition. There are also diabetes protocols and insulin calculation formulas posted on the walls.

Even though 10-year-old Maritza Torres says having diabetes is easy, Loreen Norberg has a different opinion. She knows the seriousness of the disease and says she wishes the school district would have shown greater concern and hired more nurses before the school year started. She felt so strongly about it that she appeared before the school board at the beginning of the school year to tell them why.

“When somebody has a disability, it needs to be taken care of from day one,” she said. “They hired extra nurses, but not soon enough.”

Her son Rand is 20 now. He graduated from the LTUSD system and went away to college. Norberg said she still worries about him being on his own and dealing with diabetes. But tears come to her eyes when she says how proud she is of him mentoring children who are newly diagnosed with diabetes.

This mix of emotions about being the parent of a diabetic child does not appear to be unique to Loreen Norberg.

When asked how her mom feels about her having diabetes, Maritza responded: “She’s happy that I’m OK, and sad that I have it.”

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