As tough budget cuts work their way through Congress, school nurses brace for
the impact. Only 45 percent of American schools have a full-time nurse, while 30
percent have a part-time nurse, and 25 percent of public schools have no school
nurse at all, which raises the question: will the lack of adequate health
services at schools make American children unsafe?
While parents troubled, schools say the funding just isn?t there. There?s no
shortage of people willing and qualified to serve as school nurses, according to
Sandi Delack, president of the National Association of School Nurses, simply not
enough money.
While the pressure to produce good academic test scores remains high, schools
have suffered tough budget cuts that threaten their ability to pursue education
and academic standards, and school nurses have fallen below the cut mark in many
places.
When cuts are forced, the first programs to be eliminated are those that the law
does not require, and only a few states have mandated that a nurse be in every
school. It is generally left to individual school districts to decide whether or
not to have a school nurse on staff.
While educating is clearly the top priority of education, some experts have
claimed that more low-income children would perform better in school if they
could receive physical, dental, and mental health care there.
Registered nurses (RNs) working in schools have been pawns in the cost cutting
game. School districts are quick to lay off nurses, reduce their hours, or
replace RNs with untrained employees.
In Cincinnati, the majority of the district?s nurses are soon to be out of work.
Across the country, school nurses may soon find themselves replaced by
less-qualified workers. In Pennsylvania, the state Senate is considering a bill
that would allow public schools to replace nurses with less expensive employees
who lack the same level of medical expertise; and in Wichita, Kan., schools may
replace RNs with less trained licensed practical nurses (LPNs).
Millions of American children have asthma, ADHD, food allergies, and other
common health conditions that are treated by school nurses every day. "I know
we're not generating any measurable test scores, but there's so much going on
with the children of our district, you wouldn't believe it,? RN Mandy Pilla, who
worked in Wichita schools until last year, reported to The Wichita Eagle.
?Nurses are a crucial part of schools."
"We have to think about what we're giving up when we give up this service that's
been in the community for 25 years," said Marilyn Crumpton, medical director for
the Division of School and Adolescent Health at the Cincinnati Health
Department. "We're seeing really great health outcomes from what we're doing.
The biggest thing I'm concerned about is how much of those outcomes are we going
to give up."
The National Association of School Nurses (NASN) recommends nurse-to-student
ratios based on the health of the student. A ratio of one nurse to 750 students
is recommended for the general population. One to 225 students is recommended in
populations requiring daily professional school nursing services or
interventions. One to 125 students is recommended for populations with complex
health care needs. One nurse to one student, the NASN says, may be necessary for
individual students who require daily and continuous professional nursing
services.
The NASN also recommends that staffing ratios for school nurses take into
account factors such as how many students are on free or reduced lunch, number
of students with a medical home, and average number of emergency services
annually.