The debate in the California Supreme Court this week about whether schools must provide a licensed school nurse to administer insulin to diabetic schoolchildren comes as the school nursing profession is reeling from job cuts as well as position replacements by part-time licensed vocational nurses and health aides.

“Before Proposition 13, it used to be that just about every school in California had a full-time school nurse,” said Linda Davis-Alldritt, president of the National Association of School Nurses who served as the state school nurse consultant for the California Department of Education from 1996-2012. “Now there are very few.” It is common practice now for a nurse to serve four or five different schools in a district, she said.

“The jobs are there, but the hiring that’s going on is for licensed vocational nurses, health aides, and sometimes credentialed school nurses,” said Katy Waugh, president of the California School Nurses Organization. Vocational nurses must work under the supervision of a doctor or nurse, while health aides have a high school education and pass a test to work in school district, Waugh said. “Some districts have decided they can do without the school nurse,” she said.

The California Nurses Association has argued that state law requires licensed nurses to provide insulin injections and other medicines to students, and two lower courts have agreed, the Los Angeles Times reported. The American Diabetes Association appealed, arguing that state law should be interpreted to permit a trained, unlicensed and designated school employee to administer insulin shots with parental consent. During a hearing on Wednesday, some justices on the state high court appeared skeptical of the nurses’ arguments, the Times reported.

In California, nine counties had either no school nurse or one school nurse in 2011-12: Alpine, Amador, Del Norte, Inyo, Kings, Modoc, Sierra, Tuolumne and Yuba, according to the California Department of Education. California schools employed 2,361 full-time-equivalent school nurse positions in 2011-12, the latest data available. The most recent high employment mark for school nurses in California was 2,901 full-time-equivalent school nurse positions in 2008-09.

Davis-Alldritt noted that when she began working as a school nurse in the Elk Grove Unified School District in 1978, students with diabetes received insulin shots from their parents at home in the morning and afternoon. “Now we have kids getting diagnosed with diabetes over the weekend and coming to school on Monday with the expectation that the school is going to give blood glucose checks, as well as insulin shots, all throughout the school day,” she said. “That points to the need for a school nurse.”

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  1. Jud 5 years ago5 years ago

    What my concern is what sort of "training" will these school employees have in order to inject insulin to students? Will this be uniform training throughout California and who does the training? Next, who will be responsible should there be a medicatior dosage error. In many California hospitals, two nurses check the dosage of insulin before administered to patients as insulin comes in various dosages and concentrations. If there is … Read More

    What my concern is what sort of “training” will these school employees have in order to inject insulin to students? Will this be uniform training throughout California and who does the training? Next, who will be responsible should there be a medicatior dosage error. In many California hospitals, two nurses check the dosage of insulin before administered to patients as insulin comes in various dosages and concentrations. If there is an error, can the family sue the person that gives the insulin as well as the school district and the California Supereme Court for deciding who can administer medications. There is a reason that nurses are given this task and not lay people. Don’t have a comeback that the nurses do not go to the student’s home to give insulin shots. The family is trained to do this task with their own family members and not to others outside the unit. So why except for convience for the family members give this task to someone they do not know nor what their medical background is and who is there to make sure there is not an error in the dosage. Is your child’s life worth your convience parents? Having said this now and having a court that has taken away the safety net from you child by letting and essentially untrained person responsible for the well being of your child and someone you have no idea as to how they are trained or even how to dose you child should the bloodsugar levels be too high or too low. Would this person be prepared to take care of your child if a wrong dose was given either too high or too low. I think this issue needs to be taken out of the hands of people that do court rulings and let the medical profession take care of medical issues. The California supreme court has no business making judgements on medical care and allowing non professionals inject students with insulin.