BVSD Health Services Coordinator leads project for Colorado's National Association of School Nurses

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Carrie Lee RN, ND, NCSN, and BVSD's Health Services Coordinator and Diabetes Resource Nurse, is leading a project developing a nationally utilized pediatric diabetes curriculum, for the National Association of School Nurses (NASN). Lee also serves as the president of the Diabetes Resource Nurses Colorado organization (DRNCO).

As an expert in pediatric Type 1 Diabetes (T1D) care, Lee believes the Boulder Valley School District offers expert diabetes care for students. 

“Our school nurses are so great, we offer a lot of support for our students with diabetes in school and beyond as well as the families who are caring for our students and working to give them as typical of a childhood and school experience as possible,” says Lee.

However, many places across the nation and even other districts within Colorado do not have a dedicated Diabetes Resource Nurse to support schools and students, especially in rural areas.

Lee aims to change that as she is working on a three year project for NASN to implement her knowledge and experience from BVSD and the DRNCO into a nationally-available online curriculum resource for school nurses who care for T1D students.

Childhood T1D prevalence
Childhood diabetes is more prevalent than people may think. BVSD has close to 100 kids at any time living with T1D in the district with the number of new cases in children increasing nationally.

“It’s really hard for our families, they are very nervous and fearful of what could go wrong,” said Lee. “They often come to us with a lot of anxiety and some of the newer technology can be overwhelming to manage at first.”

Lee also shared that some students when first diagnosed can be resistant to self treatment and have to fight through an acceptance of a lifelong condition they now have to manage.

“We are recognizing for our school staff that this can feel like an overwhelming thing to care for a student with diabetes. But through resources, access to education and information, our schools can still give our students the typical success in their academic setting, which as we know includes so much more than sitting at a desk learning.”

Not all nurses are equipped with youth diabetes education
Lee shares that school nurses come from a variety of different backgrounds and many come from clinical settings like hospitals, in which providing care for an individual with diabetes is very different than in a school.

"The level of care that goes into it is so large and encompassing, it’s not just understanding how to check a finger stick, it’s how to work the new technologies like the pumps and monitors, how to respond to emergencies, manage testing, lunch time, sports, camps, etc,” says Lee. “A lot of accommodations and planning are required.”

Understandably so, there can be a lot of fear around the administration of insulin for students.

“Insulin needs to be stored appropriately, and if not administered correctly, it can be dangerous,” said Lee. “Diabetes care varies in the setting that you learn it and provide the care, most nurses as they come into the school setting need that education and support around diabetes care in the community setting because it is always changing and shifting. This allows them to be the best resources for our staff and students.”

Lee’s path to becoming BVSD’s Diabetes Resource Nurse
Lee became an expert in the field of children’s T1D as a nurse at Children’s Hospital Colorado, then as a district nurse in Jeffco Public Schools where she became involved in the care of kids with T1D and worked to provide opportunities for education, support and advocacy.

An opening for a Diabetes Nurse Position in Boulder Valley came in 2018 and Lee joined the district health services team.

“When I was working as a school nurse I had 3 or 4 kids with diabetes I worked closely with, and their home care wasn’t up to par as we would like it to be,” said Lee. “I gained a lot of experience helping their families learn how to provide care, how to empower students to care for themselves, ranging from kindergartners to adolescents.”

Developing a national curriculum in Colorado
Colorado is unique when it comes to care of kids with diabetes in the school system as it is one of the only states that has a model of a state Diabetes Resource Nurses (DRNCO) organization that serves as a resource for school district nurses. DRNCO are experts in children’s diabetes care, and when the National Association of School Nurses reached out asking the organization for support and resources, Lee took the lead as the medical expert in developing the curriculum.

“Everyone has been trying to match the model we use,” said Carrie. “There is a shortage of resources and knowledge on this topic nation-wide, and a lot of kids and families who need care and support.”

Lee and the DRNCO agreed to write a curriculum and convert it to e-learning modules that will be available nationally to any school nurse through the association.

An excerpt from the NASN project reads:

Managing T1D in children requires around-the-clock care, and in schools, this means seamless coordination among the school health team, the student’s family, and their healthcare providers. Despite being one of the most common chronic conditions in school-aged children, diabetes management varies widely across states and schools. Factors like state regulations, school nurse confidence, and skill gaps significantly impact the quality of care.

To address these challenges, the National Association of School Nurses (NASN) with DRNCO as clinical expertise is launching a comprehensive national curriculum for school nurses, grounded in evidence-based practices and delivered through online training. This initiative includes a technical assistance center and a pilot data collection program in select states to track the impact of effective diabetes management on student health and academic outcomes. Our goal is to empower school nurses with the knowledge and skills necessary to ensure that students with T1D can thrive both academically and health-wise.

Lee and her colleagues at the DRN have spent the last year writing the curriculum, then taught it to four states in a live zoom meeting over three days as a first step. They then provide monthly webinars to give updates, discuss educational topics, answer questions, and hear challenges other school nurses are facing. 

When asked about the project's impact Lee shares, “this is absolutely the biggest project I’ve been a part of in my career; this is my passion so to get it out to all school nurses is an incredible opportunity. We have so many school nurses who don’t have this support or resource for individual support, so this will be an outstanding resource for school nurses nationwide.” 

An exciting accolade, Lee will be listed as an author on the final publication of the materials.

The next phase of the curriculum development is to add a few more states to the e-learning platform for further testing, with a goal that the online curriculum be available to all in 2027.

Find more information on Diabetes resources and care, as well as Lee’s contact info on the BVSD health conditions webpage.