The Robert Wood Johnson Foundation has published a brief addressing
the importance of school nurses. The brief details the important role
that registered nurses (RNs) play in school, as well as the shortage of
school nurses that America is facing. The Foundation hopes that proposed
legislation will amend this problem. Student access to school nurses
"has become an increasingly critical, if often overlooked, component in
the nation?s health care system," according to the document.
The brief, entitled "Unlocking the Potential of School Nursing: Keeping
Children Health, in School, and Ready to Learn," stresses that
policy-makers should use their positions to fight for children's access
to school nurses. A great variety of health ailments commonly beset
children, including chronic conditions, allergy and asthma attacks,
physical injuries, and school-wide outbreaks of illness. Additionally,
nurses are needed for first aid services, hearing and vision tests,
immunization compliance, reproductive health services, and dealing with
children's mental and behavioral problems. Despite these regular and
ongoing services being of great importance both to children and the
communities they live in, half of America's schools do not have a
full-time nurse on staff.
The confusion of funding means that some schools are left out in the
cold, their students suffering because their jurisdiction doesn't have a
full-time RN. These pupils can only be provided first aid care and only
by employees who are not registered nurses. Some schools are able to
have supervision by off-site RNs, but this, says the Foundation, is not
enough. The brief points to the safety and the cost-effectiveness of
having a strong system of school nurses throughout the country:
"The varying approaches are often driven by funding, rather than by
concerns about students? needs or quality of care. But the data on
effectiveness are mounting. Research shows that the daily presence of
school nurses advances the twin goals of improving health and
educational outcomes, particularly where nurse-to-student ratios are at
workable levels. Milwaukee Public Schools recently added additional
registered nurses, with the goal of a 1-to-750 nurse-to-student ratio,
and made impressive gains in immunization rates, identification of
asthma and life-threatening conditions. The changes also allowed
teachers who had previously handled health matters to return their focus
to the classroom. School staff had reported spending an average of 13
hours a day per school on health matters, at an estimated annual cost of
$133,000 in salary and benefits?almost twice the cost of hiring a
nurse."
The brief pinpoints several potential policy approaches that could be
successful at the federal level. There is legislation to provide
competitive grants to stated with nurse-to-student ratios better than
one nurse to 1,000 students. The brief supports a comprehensive national
data collection to better understand the severity of the problem and its
impact on student health. Another approach the document supports is the
creation of an office in the U.S. Department of Education to provide
school nurses, school social workers, school psychologists, and others
with a centralized network dedicated to identifying best practices,
providing technical assistance, and offering professional development
opportunities.
The brief concluded with praise for a few officials for their support of
the problem:
"The value of school nursing is clear to at least some federal
policy-makers. U.S. Representative Lois Capps, D-Calif., a former school
nurse, says, ?When children receive the support they need to remain
healthy and focused on learning, the entire classroom benefits.
Increasing the presence of nurses in our schools can be a critical
element in achieving this goal.?
"U.S. Senator Olympia Snowe, R-Maine, agrees, ?A school nurse is the
only consistent contact that millions of children have with a health
care professional, yet half of the nation?s schools lack a full-time
registered nurse. We need to make sure that all children have access to
a nurse in their schools.?
"Secretary of Education Arne Duncan concurs. ?We know that students need
to be healthy to learn,? the brief quotes him saying. ?School nurses
play a vital role in making sure children are healthy and ready to
learn.? "