From Virginia, USA:
My 8 year old daughter was diagnosed as diabetes just over 7 years ago. My family has relocated to different states quite a bit due to my husband's job demands.
Interesting enough, we have encountered different policies and protocols with each new school district. In our current school in Virginia, the school board strictly prohibits the administration of glucagon by anyone other than an RN or MD. Since most of the schools do not have RN's, the protocol is to call 911. Our endocrinologist has opined that glucagon should be administered immediately if unconsciousness or seizure occurs due to low blood sugar and that every second counts. It seems to me that our school district is violating Civil Rights/Disability laws by refusing to provide the care that my daughter needs in the event of severe hypoglycemia and also this anti-glucagon policy clearly ignores our doctor's order. A group of concerned parents in the community are working with the ADA as the ADA feels this is clearly a discriminatory practice and the health and well-being of children with diabetes is being jeopardized.
Do you have any advice that would help persuade our school board to amend its policy using negotiation rather than litigation?
You are correct that glucagon needs to be given immediately. I agree with your choice to go for policy amendment over litigation if possible. To begin, it is important that you know what the Virginia Nurse Practice Act says and what the Administrative Rules of the Virginia State Board of Nursing are regarding this situation.
In Idaho, there is an exclusion clause regarding emergency medications (which includes glucagon) in the Rules for Licensed Nurses that allows an unlicensed assistive personnel (UAP) to give glucagon. The person must have documented education/training about glucagon and its administration. Let me clarify that a UAP can be anyone who is unlicensed, anyone from a secretary to a principal would qualify. Therefore in my district, the school nurses identify the person willing to be the back up emergency person in that building and that person is trained to give glucagon in an emergency.
I would ask a diabetes educator in your area to work with your school board and your school nurses to provide this much needed emergency measure. Perhaps the diabetes educator can alleviate fears the board may have regarding the safety of this injection (it may be fear that is driving their decision). Good luck and thanks to you for taking on an important issue for our children!
Original posting 30 Jan 1999
Posted to Social Issues: School and Daycare
Last Updated: Tuesday April 06, 2010 15:09:01
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