School Nurses Case to Supreme Court

The California Supreme Court today will hear oral arguments about the safety and well-being of schoolchildren with diabetes. The case centers on school nurses, but nursing leaders say it could set precedent for the practice of nursing in California.

Cash-strapped school districts across the state have laid off school nurses, creating a dilemma for diabetic children who need insulin shots during school hours.

The state has argued that non-medical personnel can administer the shots. State officials say requiring nurses to do the job endangers children’s ready access to insulin injections and puts their health at risk.

But medical personnel argue that children will be put at risk if an untrained office worker or school secretary administers an improper dosage of insulin.

“Too much insulin can cause death, and we think children should not have a lesser quality of care than adults do,” said Linda Davis-Aldritt, president of the National Association of School Nurses. “A school district would not lay off a math teacher and say oh, the teacher’s aide can teach calculus now. You wouldn’t lay off a surgeon and pass on the surgery to a tech. School secretaries and clerks have other jobs to do, and they don’t have the training for this. This is all about child safety.”

According to John Griffin, chair of the board at the American Diabetes Association, child safety is the reason office staff members should be able to administer shots.

“Every child with diabetes has a right to be medically safe at school and to have the same educational opportunities as other children,” Griffin said. “We urge the California Supreme Court to recognize these rights and protect these children, and we will continue to fight for fairness and safety for children with diabetes and all those affected by the disease.”

The Supreme Court is scheduled to hear the case this morning in San Francisco.

There is a bigger issue at stake here, according to Tricia Hunter, executive director of the American Nurses Association of California. “It’s not just an issue of nursing or insulin,” Hunter said, “it’s the school district overruling the Nurse Practice Act.”

California’s rules about what nurses are allowed to do also includes the medical responsibilities of nurses, Davis-Aldritt said.

“The question is, does another entity other than the state Legislature determine what nurses do? When you’re challenging the Nursing Act, you’re talking about something of national importance,” Davis-Aldritt said. “Can an employer dictate nursing practice? That … takes away consumer protection of what a license requires.”

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