The California Supreme Court has unanimously ruled that trained school employees, as well as licensed nurses, can administer insulin injections to students in the state’s public schools.
The decision settles a lawsuit brought against the state in 2005, which among other things contended that the shortage of licensed nurses often led to crucial delays in administering insulin, disrupting family life when parents had to leave their jobs to personally administer injections.
The California Nurses Association had opposed the move to allow unlicensed school personnel to give insulin injections on the grounds that California state law bans the unauthorized practice of nursing.
But writing for the court, Justice Kathryn Mickle Werdegar cited another law, stating that “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.”
The American Nurses Association. called the ruling “a disturbing precedent for California and the nation. This decision lowers level of care for children who are entitled to receive healthcare services at school and puts them at risk for medication errors that could have severe health consequences.”
An estimated 14,000 public school children in California have diabetes and need insulin injections at regularly scheduled times as well as when blood glucose levels rise unpredictably. The state’s public schools have one nurse for every 2,200 students. Five percent of schools have full-time nurses, 69 percent have part-time nurses and 26 percent no nurses at all. The disparity is what led some schools to allow non-licensed personnel employees to administer insulin.
Several groups supported to ruling, including the Child Care Law Center, the American Academy of Pediatrics Section on Endocrinology, the American Association of Diabetes Educators, the California district of the American Academy of Pediatrics, the Endocrine Society, and the Pediatric Endocrine Society.