I am a school nurse practicing in a large public high school. Can I administer glucagon to an unconscious and known diabetic faculty or staff person without a doctors order? The school physicians write standing orders every school year, and the standing orders include glucagon administration to an unconscious student with known diabetes. Is it necessary to expand this order to include faculty and staff?
Dear Nancy replies:
Your job description is a good place to start in order to determine exactly what your responsibilities are as a school nurse when there is an emergency that involves faculty or staff. Responding to an emergency within the school setting, whether it involves a student, staff or faculty, is probably spelled out in that description, or it should be. Additionally, it is hoped that you, your school nurse supervisor, your principal and your school physicians have developed and established a policy and a procedure for such emergencies (e.g., who responds, who calls 911, and that someone stays with the student or staff member). First aid and CPR training, as examples, should be offered to all those who may need to respond to an emergency situation in the school setting, including the school nurse.
To obtain specific advice about the particular situation that is included in your question, it is best to consult with a nurse attorney or attorney in your state who can advise you in view of the state nurse practice act, the state good Samaritan act (if one exists), school district policy or policies that govern your school, and any tort immunity act or acts that might impact upon your role and your potential liability in this situation.
A good reference text that may help shed more light on your question as well is Schwab and Gelfman’s Legal Issues in School Health Services: A Resource for School Administrators, School Attorneys, School Nurses (Authors Choice Press, 2005).