School Insulin Shots, Not Just by Nurses

It looks unlikely that the California nurses union will prevail in their fight to keep non-nurses from giving diabetic children insulin shots in schools.  A majority of the California Supreme Court’s seven justices appeared ready Wednesday to restore the ability of schools to train non-nurses to give the shots to children, with parental consent.  Such a decision would overturn a lower court ruling that prevented non-nurses from giving the shots.

The justices hit the American Nurses Association lawyer with tough questions about the practical implications of requiring schools to use nurses to give insulin shots, when children can learn to do it themselves.

Roughly 14,000 students in the state’s public schools have diabetes and most require multiple insulin doses daily, according to papers filed in the case.  At least 26 percent of the state’s public schools have no nurse in even a parttime capacity.

In a highly unusual move, the Obama Administration piped up with its own submission to the court, urging the justices to allow other school employees to give shots if nurses are not around.

Nursing groups, led by the ANA, sued the state Department of Education arguing that state law bars anyone but a licensed health care professional to give insulin shots to children. The American Diabetes Association took the opposite side, arguing to expand the access to insulin in schools, asking the state Supreme Court to review the Court of Appeal decision in 2010 that state law prohibits school employees, who are not nurses, from giving shots.

The state had allowed trained, but unlicensed non-medical workers to give shots in schools.

Justice Ming Chin pointed out that U.S. Supreme Court Justice Sonia Sotomayor had diabetes at a young age and was taught to give herself shots.  “Would this be outlawed,” he asked.

The law does allow children, old enough to be trained, to give themselves shots, or their parents to provide them.

Justice Joyce Kennard, acting as Chief Justice asked, “If a kid can self-administer and a parent can administer insulin, what amount of scientific knowledge is necessary.”

Justice Carol Corrigan wanted to know the practical implications if 26 percent of schools have no nurses.  “If my child needs insulin do I have to leave my job and show up to administer it?”

Justice Goodwin Liu asked repeatedly about the language of the statute, which talks about “any person” in the providing of insulin.  Justice Marvin Baxter focused on the financial burden to schools in an era of limited resources.

The high court is expected to issue a decision within 90 days.  Chief Justice Tani Cantil-Sakauye did not participate in the case.

Case: American Nurses Association v. O’Connell, S184583

Photo: Diabetes Partnership of Cleveland