The ruling is significant in underscoring the state board of nursing’s authority in regulating nursing practice and protecting against other agencies issuing regulations that affect nursing practice without the profession’s input.
“The nursing profession is committed to vigorous self-regulation to ensure provision of safe and high-quality care,” said Karen A. Daley, PhD, RN, FAAN, who was the American Nurses Association (ANA) president at the time of the ruling. “It’s a dangerous practice to allow other professions to make unilateral decisions about how to provide safe health care services that fall under nursing’s responsibilities. The court made a wise ruling in the best interests of nurses, students and patients.”
A California appellate court agreed with ANA that the California Department of Education violated state law when it promulgated a new regulation in 2007 allowing unlicensed school personnel to administer insulin to students with diabetes. The education department issued the regulation without giving nurses and other stakeholders notice and a chance to comment, a violation of California’s Administrative Procedures Act, which says no regulation can be enacted without such notice and a comment period.
The education department’s 2007 regulation ran counter to long-standing positions published by both the department and the California Board of Registered Nursing that said unlicensed school employees could not administer insulin. California’s Nursing Practice Act provides that administering medication is a nursing function, and the Nursing Practice Act prohibits unlicensed individuals from engaging in the practice of nursing.
In a related decision, the California Supreme Court ruled in favor of the American Diabetes Association in 2013 to allow unlicensed personnel to administer insulin to students, overriding two lower courts that ruled that the practice was an unlawful violation of the Nursing Practice Act’s prohibition against the unlicensed practice of nursing.
The current ruling by the California appellate court on requirements to provide notice and opportunity for comment does not affect or overturn the California Supreme Court’s decision allowing unlicensed personnel to administer insulin to students.