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School Nurses Fight to Block Unlicensed Injections

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

The ADA position says that "because there's not a nurse in every school, effectively the licensing laws should be ignored," Cones says. "What's next? If a nurse doesn't have to provide medication in accordance of state law are gym teachers going to be providing physical therapy?"

That "what's next?" statement gets to the heart of the real issue that should be worrying to nurses everywhere: Ruling that anyone can administer insulin cheapens and devalues not only the practice of nursing, but also the clout of its own licensing authorities.  

"The hallmark of any true profession is the ability to regulate itself. If the ADA prevails, the board of nursing will no longer be able to decide who is qualified to administer any medication," Cones says. "It erodes the profession of nursing."  

Nurses are naturally protective of their turf and are trying to preserve school nursing jobs. Some people might see irony here because this fight is being waged at the same time that nursing unions and advocates are lobbying to extend scope-of-practice laws in many states. Nurses with advance practice licenses rail against physician groups who want to keep them from practicing without physician supervision.

However, in my opinion, this isn't it's an accurate parallel. Secretaries and teachers and janitors aren't healthcare professionals like doctors and nurses so it's like comparing apples and oranges. I know how to do my daughter's PT stretches and I'm sure lots of people could be taught how, too, but I still expect a licensed physical therapist to provide her PT her in school. She's entitled to that under law.

Read the ANA's position [PDF] and ADA's position [PDF], and tell us what you think in the comments below.


Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.

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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!