School Nurses Fight to Block Unlicensed Injections

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

Maureen Cones, associate general counsel for the ANA, tells me that the implications of this case could extend way beyond what happens in California schools.  

"With budgets being what they are, schools and school districts are quick to eliminate nursing positions," she says. For that reason, this case is being watched by many states experiencing the same issues. "If the ADA prevails and the decision is overturned, it will give license to any state to allow unlicensed personnel to administer insulin."  

Moreover, the ANA believes that overturning the previous rulings would set a dangerous precedent: Cones says it will be the first time anywhere that a healthcare licensing law would be preempted in favor of a federal disability law.  

"That would have very far reaching implications nationally," Cones says.  

The ANA says its position doesn't mean that federal disability laws don't apply; they're simply saying that the two laws need to work together. In fact, the ANA says that the courts' rulings "do not prevent students with diabetes in California's public schools from receiving the health services to which they are entitled. California law permits several categories of individuals to administer insulin in the school setting, including parental designees." Moreover, nursing positions in schools shouldn't be on the chopping block because of budget constraints.

The ADA says this on its website:  

[F]amilies of children with diabetes and diabetes health care experts not only disagree with the idea that you need a health care license to administer insulin, but know that this position puts students with diabetes at risk. There is only one school nurse for every 2,200 students in California and a budget crisis with school personnel being laid off across the state. And even if there was a full-time school nurse in every school, the nurse wouldn't be available for all extra-curricular activities and field trips.
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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!




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