TO SUBSCRIBERS OF ALABAMA BOARD OF NURSING LIST SERVS
Attached is SB 57 introduced in the legislature by Senators Jabo Waggoner and Paul Bussman. The bill provides for unlicensed school personnel to administer glucagon and INSULIN. There have been discussions about the issues the last couple of years. The Board of Nursing identified prevention of the need for glucagon as part of the issue that needs to be addressed in the schools and those rules were approved by the Board yesterday, January 16, 2014. Many of the items in the proposed legislation are duplicative of what is being done already (care plan, documentation, education, etc).
Please read Section 6 because it states that the "activities" in Section 5(a) are "not the practice of nursing." Nurses should pay attention to that language because we have an advocacy group trying to define what is and is not the practice of nursing. As many of us identified a long time ago, it is not the "activities" that separate nurses from non-nurses. It is the knowledge and judgment of nurses that provide patients (and in this case students) with ongoing education and oversight. The Board's legal mandate is protection of the public health, safety, and welfare and the Board's position is that the proposed legislation actually LOWERS THE STANDARD OF CARE FOR STUDENTS IN THE SCHOOLS WHO HAVE DIABETES.
This is a "one size fits all" proposed bill as well. As you know, diabetes is not a "one size fits all" chronic illness---particularly when dealing with children with diabetes. The advances in diabetes management require the additional knowledge and judgment of nurses---I have a master's degree in nursing and I am still learning about carb counting and according to my endocrinologist, I am not always successful!
The attached bill has comments included. If you place your cursor over the comment box, you will see the comment. The Board directed me to provide you with the comments as well as the bill so that you can see the Board's concerns.
The latest statistics we have is that there are approximately 2,500 students with diabetes in the public schools. Many of those students are in middle school and high school and can self-administer their prescribed insulin or oral hypoglycemic. This bill treats them the same as children with new onset Type I diabetes who are in elementary school. So while we are unsure of the number or subset of those with diabetes who cannot self-manage, it is those young children who are newly diagnosed or who have a change in their insulin from injections to a pump or from a pen to a pump that require nursing oversight and supervision and education.
There is a corresponding bill in the House of Representatives, introduced by Representative Ron Johnson. Both bills are on the agenda for public hearings on Wednesday, January 22, 2014. The House Health Committee will hold a public hearing at 9:00 AM in the Joint Briefing Room of the State House on the 8th floor (you have to go to seven and then either take the one elevator to eight or walk the stairs). The Senate Health Committee will hold a public hearing at noon on Wednesday, January 22, 2014, in Room 304 of the State House. If you have opinions about the proposed legislation, you should advise your legislators. The State House is on the corner of Union Street and Washington Avenue and non-lobbyists enter through the Union Street (front) entrance.
Let me know if you have questions and I will try to answer. Thanks!
N. Genell Lee, MSN, RN, JD
Alabama Board of Nursing
P.O. Box 303900
Montgomery, AL 36130-3900