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How can a school nurse take care of 4 diabetic students in 3 schools?

Dear Nancy,

How does a school nurse care for four diabetic students, who need insulin administered with adult supervision, in three different schools? I cannot be present on each campus at one time, and the district will not hire a substitute nurse.


Dear Pat,

A complete response to your question is beyond the scope of this column. However, generally, there may be many solutions to the problem you raise as the only school nurse covering three schools when you have four diabetic students who need insulin administered with adult supervision. One simple solution is that one of the parents, or another adult family member (such as a grandmother), come to the school and administer the insulin. This solution has worked in some school districts without difficulty.

A second solution is if the student is old enough, and is doing so at home, the student can self-administer insulin with the supervision of an adult (for example, a teacher) who is willing to perform this task and is trained by you in insulin administration. Also important to include here would be the importance of training the adult who is performing this task to be skilled in understanding the importance and results of blood glucose testing prior to the student’s self-administration of insulin.

Some states allow the delegation of insulin administration to unlicensed persons who are adequately trained and supervised by the school nurse.

One way in which you can become more versed in options available in a situation like yours is to visit the National Association of School Nurses website. It provides a wealth of information on school nursing, including downloadable resources, conferences and position statements on school nursing practice. Three that might be helpful to you initially are: Diabetes Management in the School Setting (2012), Nursing Delegation to Unlicensed Assistive Personnel in the School Setting (2014) and Medication Administration in the School Setting (2012), all available under the Policy and Advocacy tab.

In addition to the published resources available on the NASN website, the following text would be helpful to you: Schwab and Gelfman (editors), “Legal Issues in School Health Services: A Guide for School Administrators, School Attorneys, School Nurses.” (2005). The text provides needed information on the topic of your concern, including forms, policies developed by schools for working with diabetic students, and policies for the delegation of medication administration to others in the school setting.

You should consider becoming a member of the NASN if you are not already. Membership benefits include educational programs, resources and research, advocacy and outreach, and partnerships with other professional organizations.

Regards, Nancy

By | 2021-05-07T09:28:07-04:00 June 26th, 2015|Categories: Nursing Careers and Jobs|0 Comments

About the Author:

Nancy J. Brent, MS, JD, RN
Our legal information columnist Nancy J. Brent, MS, JD, RN, received her Juris Doctor from Loyola University Chicago School of Law and concentrates her solo law practice in health law and legal representation, consultation and education for healthcare professionals, school of nursing faculty and healthcare delivery facilities. Brent has conducted many seminars on legal issues in nursing and healthcare delivery across the country and has published extensively in the area of law and nursing practice. She brings more than 30 years of experience to her role of legal information columnist. Her posts are designed for educational purposes only and are not to be taken as specific legal or other advice. Individuals who need advice on a specific incident or work situation should contact a nurse attorney or attorney in their state. Visit The American Association of Nurse Attorneys website to search its attorney referral database by state.

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