Tuesday, August 13, 2013
Non-Nurses May Inject Diabetic Students With Insulin, S.C. Says
From Staff and Wire Service Reports
Trained school employees who are not licensed healthcare professionals may administer insulin shots to diabetic students if a nurse is not available, the California Supreme Court unanimously ruled yesterday.
Overturning a Third District Court of Appeal decision, the court said the state Department of Education was correct when it advised school districts in 2007 that the administration of insulin by non-nurses did not constitute the unauthorized practice of nursing. That advice came following an agreement between the department and the American Diabetes Association, which argued that student health was being put at risk because there were an insufficient number of nurses to administer the shots.
Citing various provisions of the Education Code, department regulations, and the nursing statutes, Justice Kathryn M. Werdegar wrote:
Personnel to Administer Medications
“In fact, California law expressly permits trained, unlicensed school personnel to administer prescription medications such as insulin in accordance with the written statements of a student’s treating physician and parents…and expressly exempts persons who thus carry out physicians’ medical orders from laws prohibiting the unauthorized practice of nursing….Through these provisions, state law in effect leaves to each student’s physician, with parental consent, the question whether insulin may safely and appropriately be administered by unlicensed school personnel, and reflects the practical reality that most insulin administered outside of hospitals and other clinical settings is in fact administered by laypersons. “
The 2007 agreement settled a federal class action alleging the state’s schools had failed to ensure diabetic students receive legally required health care services.
The American Nurses Association sued to block the agreement, arguing that inappropriately administered shots could hurt students. Other nursing groups supported their position, as did the umbrella group for state nursing boards and unions representing teachers and other school employees.
But the diabetes association—which intervened in the action after the nurses group sued the state superintendent of public instruction and others—and its amici, who included parents groups, children’s rights activists, the California School Boards Association, a section of the American Academy of Pediatrics, and the Obama administration said many school districts across the state are experiencing a shortage of licensed nurses, which could leave the children who cannot self-administer their shots at risk.
There are an estimated 14,000 diabetic students in California public schools. The state has one nurse for every 2,200 students. Sixty-nine percent of California’s schools have only a part-time nurse, and 26 percent have no nurse at all.
Lawyers with the American Nurses Association did not return calls for comment. The American Diabetes Association distributed a statement by its board chair, Karen Talmadge, who said the ruling “affirms that every child with diabetes has the right to access the lifesaving insulin needed to stay healthy and safe at school.”
“School staff can volunteer to be trained to provide diabetes care when a school nurse is unavailable. This means parents of children with diabetes can feel confident of their children’s well-being when they send them to school every day.”
The association said it “recognizes the vital role school nurses play in maintaining the overall health of all students, including those with diabetes” and that the ruling “in no way lessens that role, as school nurses oversee diabetes care in schools, and coordinate and provide training to other school personnel so they can administer insulin when the school nurse is not available.”
The group said it was prepared to assist schools whose personnel need training in proper diabetes care.
The case is American Nurses Association v. Torlakson, 13 S.O.S. 4155.
Copyright 2013, Metropolitan News Company