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School Nurses Fight to Block Unlicensed Injections

Alexandra Wilson Pecci, for HealthLeaders Media, June 11, 2013

A California ruling that would allow non-licensed adults to administer insulin in schools cheapens and devalues not only the practice of nursing, but also the clout of its own licensing authorities.

My daughter has a spinal cord defect and because of that, the law says the school district must provide her with physical therapy. But what if she got to school at the beginning of September and I found out that rather than getting PT from a licensed physical therapist, she'd receive it from the school secretary instead?

It's a ridiculous scenario, and one that wouldn't ever happen, right? But in California, there's something similar afoot, something that threatens to devalue nursing and that the American Nursing Association is fighting hard to prevent.

Here's the issue: The California Department of Education wants to allow unlicensed personnel to give insulin [PDF] to children in schools. Two lower courts have already ruled that this violates the state's Nursing Practice Act, which says that administering medication is a nursing function that cannot be performed by unlicensed individuals.  

The American Diabetes Association, however, and others have appealed to the California Supreme Court, arguing that the law puts students' safety at risk because not all schools have nurses. Oral arguments began on May 29.  

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29 comments on "School Nurses Fight to Block Unlicensed Injections"


Suzette Scheuermann PHD RN (5/17/2014 at 9:52 PM)
Now that our KY board of nursing has permitted delegation of insulin to unlicensed school staff, they are now considering the undersight of mental health aides and medication administration. This will impact our home health and public health nurses. Nurses get ready to be replaced, Kentucky no longer has a nursing shortage!

Suzette Scheuermann PHD RN (8/23/2013 at 2:59 PM)
I think it is short and sweet to say, ...the school system can delegate any task they wish to do so on their unsuspecting school staff and personnel. Please don't make the nurse liable for this delegation. Make the delegation result from the parent or the prescriber of the insulin. This will have the same impact that medication aides have had in long term care with no licenses, one RN maybe and a bunch of administrators. The real impact will be that no nurses will choose this environment for practice so all care for these children will be at the discretion of the school anyway.

Pat Dunn, PhD, RN (6/18/2013 at 2:45 PM)
Administering insulin is not simply a matter of performing an injection. What must be considered is the importance of giving the right dose and type of insulin to the right child as well as monitoring for potential side effects at specific times. UAPs cannot be educated to safely administer insulin as they have no background in anatomy, physiology, pharmacology, or health assessment. In today's litigious environment if a bad outcome is associated with a medication error or failure to identify an associated problem, many deem this negligence. This results in lawsuits, loss of money, and bad will between workers. Can a School District afford millions of dollars to settle a case because hypoglycemia caused brain damage or loss of life? Nurses are educated not just in the procedure of giving insulin correctly but in managing complications that may develop. UAPs are incompetent to give insulin!