By Drew Fitzgerald
The Pittsburgh Tribune
SCRANTON, Penn. — After his daughter’s blood sugar dipped dangerously low at school last year, Scranton-area resident Rob O’Donnell was so determined to prevent a repeat that he convinced her principal and superintendent to receive diabetes treatment training.
Now, Principal Alan King says he can personally administer potentially life-saving glucagon to any diabetic student in an emergency if a nurse is unavailable.
“We’re a rural school district,” King said. “We’re not very close to first-responders. So we would call the paramedics, call the parents, but obviously someone has to administer the glucagon in the meantime.”
After “emotional” testimony in Harrisburg last week, Rep. Matt Smith, D-Mt. Lebanon, and Sen. Jane Orie, R-McCandless, are asking the same of school officials statewide. Both sponsored bills that would train at least three staff members in all schools to recognize and treat symptoms diabetics suffer. They proposed separate bills that would allow students with severe allergies to carry ephedrine injectors with doctors’ and parents’ permission.
Both proposals aim to make students healthier so they can succeed academically, Smith said.
“We need to look to the educational system as a whole now, and you can’t separate student health and student nutrition from scholastic performance,” he said.
The state Department of Health reported 6,908 students diagnosed with diabetes during the 2006-07 academic year, the earliest year for which data are available, a 21 percent increase over five years ago. Diabetes affects the body’s ability to produce or use insulin, a hormone that regulates blood sugar. Diabetics constantly monitor their blood sugar to make sure it does not reach unsafe levels.
The allergy medication proposal passed the Senate last week, but the diabetes bills remain in the House and Senate education committees. Orie said similar legislation died at committee level for three years, but lawmakers looked at the issue with urgency when testimony from O’Donnell and others “put it into perspective.”
“It’s a life-or-death situation in some cases,” Orie said. “When you hear of these incidences, they really cause emotion on this because you see something happening to a student that could be easily prevented.”
Not everyone embraces the idea. Cheryl Mattern, president of Pennsylvania Association of School Nurses and Practitioners, worries that school faculty would not be capable of giving diabetic students the same kind of personalized care as nurses.
Diabetics react uniquely when their blood sugar content approaches unsafe levels, and non-nurses might not devote as much attention to each student’s personalized needs, Mattern said.
“If safety is the ultimate concern, I’m just not sure this is a good fix for it,” she said. “They’re trying to make it a general rule, but these kids are very different, and they all have different needs.”
Non-nurses could expose themselves to litigation if last-resort treatments such as glucagon or insulin pumps fail to work on unconscious students, Mattern said, pointing to the state Nurse Practice Act, which prohibits nurses from delegating their responsibilities to others.
Smith said he is working with House Education Committee members to ensure the law does not delegate nurses’ duties to non-nurse school staff. Linda Siminerio, co-chair of the American Diabetes Association’s working group on school safety, said nurses should treat students before other staffers or faculty, but argued that in an emergency non-nurses should be able to render aid.
“We want the school nurses to be involved — that’s our key message — but they aren’t always available,” Siminerio said. “If we could have a school nurse in every school, I’d love to have that, but that’s just not a reality in our current health care environment.”
Siminerio said the legal liability of helping a sick student in good faith always exists.
“On the flip side, there’s always some exposure for challenge legally when people don’t act immediately,” Siminerio said. “I think there’s just as much risk not knowing what to do.”
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