A law signed by New Jersey Governor Jon Corzine that allows teachers to give emergency glucagon shots to students with diabetes has parents elated but has drawn strong opposition from teachers and nurses. The law also allows students with diabetes to test their own blood glucose levels and use insulin pumps while they are in the classroom, two activities that were not previously allowed.
Under the new law, teachers can volunteer to learn how to administer glucagon to treat students who are suffering from severe hypoglycemia. (Glucagon is a pancreatic hormone that has the opposite effect of insulin, increasing blood sugar levels in the event of hypoglycemia.) Previously, only trained nurses were allowed to inject the drug.
Parents and students had bridled at the restrictions, noting that students with diabetes are experienced and at ease with routine self-administered blood sugar measurements and injections. They also cited the inconvenience of the legal requirement that nurses be present at extracurricular activities when students with diabetes are participants. The lack of available nurses often meant that children with diabetes had to forgo such activities.
Nurses’ opposition to the bill stems from their belief that it is illegal for them to delegate procedures to non-medical personnel. The president of the New Jersey State School Nurses Association told The Times of Trenton newspaper that school nurses will be unable to abide by the bill, due to the legal conflict it creates for them.
The state teachers union also opposed the bill, but did not state specifically why. Typically, in other states that have passed similar laws, teachers’ opposition was based on fears of increased exposure to liability, as well as the introduction of potential classroom disruptions by students testing or injecting themselves.
Despite the fact that the new law contains a liability waiver designed to protect trained non-medical personnel against lawsuits arising from emergency injections, the newspaper reported that the principal at one school who expressed interest in learning how to give glucagon injections was advised not to by school attorneys because of liability concerns. So it’s possible that the law will face a court test at some date to determine just how strong the waiver is.
Another element in the bill is a requirement that school nurses develop detailed individualized healthcare plans for students with diabetes. The plans must include complete profiles of students’ blood testing routines, prescribed drug dosages, patterns of hypoglycemia, dietary requirements and other information. They must also include written instructions from doctors and parents authorizing such plans on an annual basis.
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