Injections in School

It’s an unusual debate, with natural allies — school nurses and mainstream medical organizations — facing off against each other. But so it seems to go whenever the topic is administering injections for diabetes in schools.

A few years ago here at Diabetes Flashpoints, we followed the path of a lawsuit filed by parents of children with diabetes in California public schools, challenging rules that allowed only school nurses to deliver insulin in schools. At first, the state Department of Education responded by issuing new rules that allowed trained staff members other than nurses to administer insulin. Then the California School Nurses Association sued the state, arguing that the new rules violated state law — and won the lawsuit. The case was eventually appealed to the California Supreme Court, which struck down the state law limiting insulin injections to nurses on the grounds that it violated students’ right to an education. Most California schools, as in other states, don’t have a full-time nurse on staff, so schools were scrambling to hire nurses, and parents were sometimes forced to come to school to give their children insulin.

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Now, on the opposite side of the country, a similar debate is taking place, but this time in it’s in a legislative chamber rather than a courtroom. Two bills in Massachusetts are being considered that would allow specially trained school staff to administer injections of diabetes drugs like insulin and glucagon. According to an article on a hearing by the Legislature’s Joint Education Committee published last week in The Boston Globe, parents of children with diabetes and the Massachusetts Medical Society are backing the bills in the face of opposition from the Massachusetts School Nurse Organization. School nurses argue that they are being rendered obsolete, and that eventually teachers may be expected to administer a wide range of drugs and treatments in schools — at the expense of students who are best served by a medical professional.

Children with diabetes and their parents, on the other hand, note that school nurses aren’t always available, especially during after-school extracurricular activities. The athletic nature of many activities, they argue, means that the risk of hypoglycemia (low blood glucose) is especially high — sometimes making an emergency glucagon injection necessary. The Massachusetts Medical Society argues that since hesitation in such a crisis can have severe consequences — including seizure and even death — it’s important that several people working both during and after school know how to deliver glucagon.

What’s your view on injections in schools — can anyone be trained to deliver them? Do liberal rules on injections simply let schools off the hook for not having a full-time nurse on duty? Even with a full-time nurse on staff, would it be a good idea to train other school personnel in giving emergency glucagon injections? Leave a comment below!