Appendix A: California Department of Education (CDE) K.C. Settlement Agreement and Legal Advisory
For all of these reasons, we conclude the medical-orders exception does permit a
layperson to carry out a physician’s medical orders for a patient, even orders that would
otherwise fall within the definition of nursing practice, without thereby violating the rule against
unauthor ized practice. To fall outside the exception by “assum[ing] to practice as a . . . nurse”
(Bus. & Prof. Code, § 2727, subd. (e)), one must go further by holding oneself out, explicitly or
implicitly, to be a nurse in fact. This conclusion disposes of the issue, because unlicensed school
personnel do not hold themselves out to be nurses simply by volunteering to act on behalf of
particular students in accordance with the Education Code and its implementing regulations.
We thus proceed to consider the Nurses ’ remaining objections to the conclusion that such
personnel may administer medications.
3. Medication-specific Statutes.
In statutes enacted between 2001 and 2011, the Legislature imposed additional training
and administrative requirements before unlicensed school personnel may administer three
specific emergency medications: epinephrine auto-injectors to treat anaphylaxis (§ 49414, added
by Stats. 2001, ch. 458, § 2, p. 4023), glucagon for severe hypoglycemia (§ 49414.5, added by
Stats. 2003, ch. 684, § 1, as subsequently amended), and antiseizure medication for epilepsy (§
49414.7, added by Stats. 2011, ch. 560, § 2). Each of these statutes, while expressing the
Legislature ’ s preference that registered nurses administer the subject medications whenever
possible, expressly permits trained, unlicensed school personnel to do so when no nurse is
available. (See §§ 49414, subd. (f)(1), 49414.5, subd. (a), 49414.7, subds. (a), (b).)
The Nurses contend these statutes would not have been necessary if the NPA‟s medi cal-
orders exception already, by its own force, permitted unlicensed school personnel to administer
BP 2006 – Provision of Healthcare Services
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Desert Mountain Special Education Local Plan Area (DMSELPA) (rev. 11/16)
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