D. A skilled nursing service taught to the patient does not negate the skilled aspect of the service when performed by the nurse

It is customary to teach the patient and/or a family member the skills required to administer insulin injections safely and effectively. Once the patient or other nonmedical person has mastered these skills, they are to all intents and purposes functioning as a skilled person when administering or self-administering the injection. If a patient is unable to learn these skills or is physically or mentally incapable of performing the service for themselves, e.g., they are blind, senile, or spastic, and there is no one else willing and able to learn and perform the service for them, the administration of the injection by a nurse constitutes a skilled nursing service.