Diastat Bill Needs a Gubernatorial Veto


Posted on 07 September 2011

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By Joshua Pechthalt and Pat Christie, RN

What do you do with legislation that proposes to meet a real need, but diverts attention from the real solution, and stampedes legislators to vote for it in a cloud of emotional manipulation of the issue?

You ask the governor to veto it.

This is what should happen with Senate Bill 161, which allows administration of a prescription dose of valium by a non-medical K-12 school employee volunteer to students with seizure disorders. The drug, Diastat, must be injected rectally in a child experiencing a seizure lasting longer than their usual seizure activity. This assumes the volunteer knows the student’s typical seizure pattern, and can determine this is different.

Diastat’s manufacturer recommends the student be observed for 4 hours post- administration (respiratory arrest is one of the potential side effects of this medication).

This bill manipulates parents of medically fragile children into believing their children will have safe conditions for learning, when they do not, and into resenting school employees who refuse, for good reasons, to take on what should be a medical professional's task. It deftly follows the Republican “look over there!” strategy of talking about anything in the world other than the need for revenues to fund our schools properly.

The author of the bill, Bob Huff, is a Republican who has voted against funding public education every chance he has had.  He is a signatory to Grover Norquist’s “no new taxes” pledge, meaning he supports an all-cuts approach to solving the state’s budget deficit.  One consequence of this approach is that the once ubiquitous school nurse is an endangered species.

The proponents of the bill dwell in an alternative universe in which declining funding for education is a given, and an opportunity for schools to become “more efficient.” They claim that there will be medical emergency training for volunteers, yet the bill provides not one dime of funding for training.

SB161 advocates would have us believe this is a simple medical task, and that anyone who refuses to learn how to do it is putting children at risk. Some parents and Republican legislators have emotionally accused school employees arguing for licensed medical personnel on school sites, instead of volunteers, of being selfish.

The hypocrisy is breathtaking.

One of the co-authors of this opinion editorial is a school nurse. The other is a former high school teacher. One of us is qualified to perform this procedure. She is a licensed medical professional, and knows what to do in a medical emergency. But because the Republicans refuse to restore more than $18 billion in cuts to public education over the past three years by never considering any tax, any time, there are fewer and fewer of her profession in the schools. This puts all our students, not just students with seizure disorders, at potential medical risk.

The other one of us has received no medical training, and if back in the classroom, would not receive such training under the financial terms of this bill. He would be scared to death to attempt to intervene in such a moment. But according to Bob Huff, this would be the appropriate choice to make.

It’s time to call out the Republicans who are steadily defunding our schools. It’s time to help the public understand why the Legislature is at a standstill, and why there is no prospect of things getting any better so long as just over one third of the Legislature is Republican. SB 161 would make a great teaching moment for Governor Jerry Brown. If he vetoes SB 161 with a clear message explaining we need licensed medical personnel, not volunteers, to handle medical emergencies in our schools, we would be a step closer to keeping all our children safer.

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Joshua Pechthalt is president of the California Federation of Teachers. Pat Christie is a school nurse in Menlo Park.

My brother uses Diastat a few times a year, and it has saved his life many times over. I liken it to CPR or the Heimlich, both of which have risks attached to them, and can be 'embarrassing' (touching one's chest or doing mouth-to-mouth)... But when it comes to essential medical intervention; you make due with what you have.

Otherwise, why nurses in schools? Why not physicians? (Better medical care)

Why EMTs as first responders? Ideally we would want full fledged surgeons and ER docs riding around in ambulances...

The key here is speedy intervention to save lives. Not hypothetical ones either.

As a licensed EMT, I have been trained to perform medical procedures (under the license and approval of a physician) as a First Responder. As an EMT or AEMT (Advanced EMT) I could not administer Diastat rectally. Only a Paramedic has scope of practice to administer this medication. Paramedics go through several levels or training and must work as an EMT before earning the Paramedic certification. In addition, they are required to complete ongoing training and recertification throughout their career. To ask a teaching professional, an individual with little or no medical training, to administer a drug rectally to a child during a ongoing seizure is unfair to the student AND the teacher. To ask them to do so without any funding for training is appalling. Our children deserve better, our teachers deserve better.

Why are the people who teach our children and the people who come when our lives are at risk some of the most poorly compensated professionals in the state? It is an atrocity for both professions that their contributions and importance to the community are so undervalued. Until you've dialed 911 with a truly life-threatening emergency, most people never understand the real value of EMS professionals. We don't have enough doctors to staff our hospitals adequately, much less ambulances as well. In addition, there are only so many things you can do in the field. The surgeon needs a sterile environment to work in, not the back of a bouncing vehicle.

I don't think anyone will argue that teachers are already over-worked and under-paid. Now you want teachers and volunteers to take on additional responsibility in regards to emergency healthcare for their students? The potential liability is astounding. The bottom line is schools need better funding. Schools need nurses who are trained and licensed to administer drugs like Diastat in the corrent manner at the appropriate time. This is only one of many health issues that students in public schools face today. They need medical professionals to care for them. Our politicians need to figure out how to make that happen and quit asking teachers and students to take unrealistic risks with their health.

The only groups opposing this bill are unions. Doctors, parents, schools and epilepsy rights groups all support it - I'm going to trust the doctors on this one.

Also, what do you mean "call out Republicans"??? This bill was supported and co-authored by Democrats. Democrats are the majority! You can't get a bill to the governor's desk without their votes! If you think Republicans are hypocritical for supporting this bill then you have to think Democrats are too.

Dear capitolreader,
Rather than trusting the doctors who have no clue how schools operate, why don't you trust those who actually work there and know what is really going on? It never ceases to amaze me how the expertise of teachers and school nurses is so minimized by those who are so ignorant of the real situation in CA schools. When is the last time you spent any time in a classroom or school office setting? If you would do so, you would see how the budget cuts to schools have caused the layoffs of thousands of support personnel. Yes, there are not nearly enough school nurses. But there is often just one person working in the school office. And class sizes have risen way too high for teachers to manage effectively. How are teachers supposed to stop their primary job of teaching to take care of a seizing child in front of many other kids? Those who oppose the bill are the ones who know the realities and how this situation will make kids less safe!

I am a union leader AND and public school employee of 20 years. In my wildest dreams I would never volunteer to administer any type of medication to anyone of that magnitude. I agree that there needs to be some mechanisms in place to help the students, but you seriously believe it to be okay for a janitor, campus security officer, clerk, secretary, cook, cafeteria worker, librarian, attendance clerk, data entry operator, warehouse worker, transportation scheduler, school bus driver, or other school employee to administer a drug that on one hand would help a student that is suffering but on the other hand possibly harm the student even further if not properly done? It is sad that unions are perceived to be an enemy as opposed to a fighter of workplace rights. We negotiate and bargain for certain conditions of employment which create an environment that is fair and reasonable for employees. We recognize and understand the importance of students receiving timely care which is all the more reason I will fight for a trained medical professional to administer drugs. I haven't come across anything that addresses the liability of volunteers that provide this "service" to students. I am a First Aid/CPR trained public school employee and during our training we are advised that we can be sued for injuries to citizens that we "help" in their time of need. We are told to be very careful in performing first aid/cpr. With that in mind, what liabilities would these "volunteers" be subjected to if helping a student goes dangerously wrong? As a union leader I will push for the 632 members that I represent to be informed and hopefully led away from this type of volunteerism. However, if they are informed and choose to participate, that, too is their individual choice. I choose not to participate, but I will make sure the child doesn't further harm his/herself while seizing, I will make the phone calls and wait for medical attention to arrive. I leave you with this: If it's truly about the students, if students are REALLY that important, especially those in relation to this topic, why not have a trained medical professional at the school? What's the issue? It would even stand to benefit all other students at the school as well, someone would be there for their injuries as well; no matter how small! There should always be a trained medical professional on a campus where there are students. In Unity!

Bravo to Joshua and Pat for their sensible exposé of the dangers and obfuscations of the Diastat legislation. Very few schools even have school health personnel any more. Would you want to put a child in seizure on the floor, pull down his/her pants and rectally insert Diastat?

Neither would I.

This is a very tough one. Every teacher I know would do what it takes to save the life of a student. Diastat really does help prevent massive brain injury in children with seizures. That being said, the reason we are in this situation is that school nurses have been cut from virtually every school in our state. It is not just "union thugs" who are fighting this. Teachers are saying,"Enough is enough! You cut school nurses and now you expect us to do a nurse's job. We need to take a stand and say 'No!'"

I have read the legislation. I have to say that the injection of a drug that would bring a child or adult out of a seizure believe it or not is EXCEPTIONAL.
First and formost, regardless if you are a bus driver,a teacher,a janitor, a principal, or a parent at the end of each day it should be in our hearts to love, teach and inspire each child in this world.
Some children aren't as blessed as others and for some unknown reason have seizures.

If you have ever seen a child that has had a seizure the bill should not just state that if someone knows a normal seizure v.s. a longer seizure then a trained person should administer the injection.
What is this????? This is a step into some kind of good for parents that send there children to school and know there children have seizures. It is not acceptable.. Who decides what is to long? If you have ever had a seizure and or seen one then we know that there is no magic amount of minutes for a good seizure or a bad seizure.
I do believe if I saw my next door neighbors child having a seizure medically trained or not that I would do whatever it took to help this child! I ask that you think about if this was you or what you would do if it was you or your child ... Close your eyes imagine your bodies muscles spasming 150 times a minute and then tell me the agoning pain and what you would do if that way you or your child..
I would hope that in my life people that work with our children would be compassionate, caring and somehow teach our children it is ok to help someone in need of care. I also would hope that in this world we would all learn it is ok to help someone in need of care and not just get sued..
Although I know it is easy to say that I don't want to learn how to give this injection, It is my hope in the life that my daughter Naomi lived that you would think about the life she never had due to no one administered this shot. Please close your eyes and imagine one minute your beautiful daughter is playing and walking and laughing and the next she is in a seizure and it was that very moment that changed everything in our lives. It was the choice of a complete community, school, and the ignorance to not care enough or be EDUCATED enough to just help Naomi with an injection to save her life.. I AM A MOTHER THAT IS EDUCATED AND WOULD ASK YOU ALL TO READ THIS AND COPY AND PAST IT AND SEND IT ON.. MAKE THIS INJECTION A MANDATORY EVENT IN THE LIFE OF A CHILD WITH A SEIZURE .. IF YOU HAVE ANY QUESTIONS EMAIL ME AT sp1968@cox.net lets talk..
For Naomi's Legacy lets do this..

I thought nurses were called to their profession to save and serve. Well apparently not. Apparently all nurses care about is their job security. This article is authored by hypocrites and are obstructing the health of vulnerable kids.

I am a mother of a child who has febrile seizures - not epilepsy. She has had one complex seizure that after it was over required the prescription of Diastat in case another complex seizure were to occur. Luckily for me, she has never had to make use of it but having it handy in case she has another complex seizure, is very comforting. The IDEA that the nurses are blocking this SB 161 with NO SUPPORT from the teachers is telling. The Nurses Union is only interested in using this to leverage their calls for job security.

I am a life long Democrat. But this kind of pandering and special interest jockeying is making me consider my political affiliation. I support unions. But I DO NOT support unions who use my KIDS health as a pawn in their game for job jockeying. My daughter should have the benefit of a volunteer who might want to help her in a time of need. God forbid a teacher or a volunteer might want to ease her discomfort?! I know I would help out any sick kid I saw with CPR or life saving measures. So I call you out ALL Nurses who are opposed to this legislation as hypocrites. This bill passed BOTH houses unanimously because the ridiculous claims of litigation is finally been done away with. Volunteer teachers can give EpiPen injections and Insulin but not Diastat that could prevent BRAIN DAMAGE?? This is a sad day for you "hero" nurses who always want so much credit. You are exposed for who you are... slaves to your contracts and to high demands that are bankrupting this state.

Governor Brown MUST sign this bill. Stand up for Kids Governor and Stand Against Bullying (Nurses) Unions who care nothing about our Community!

I work in a large high school. There is no way this could be done by me in my overcrowded classroom. There would be an emergency call to the office to send the nurse. We have one due to parent fund raising.
They thought it was an important person to have on campus during school hours so they raised the money to pay for the position.
I think when the word gets around among my colleagues about this bill, there will be a groundswell of outrage.
There should always be a qualified medical professional on duty at every school.