By Peggy McDaniel, BSN, RN
I was amazed by a MarketWatch article this week about the overall lack of school nurses. According to the article, the National Association of School Nurses recommends that one nurse be available for every 750 well children. Many states operate with ratios greatly exceeding that number. For example, in 2009 Michigan had one nurse for every 4,836 children. To give credit where it is due, that same year Vermont provided one nurse for every 311 students. As a nurse, and a parent, I find this data frightening. Not only are there fewer trained professional nurses available to our children every year, but approximately 30% of American children suffer from chronic conditions such as type 1 or type 2 diabetes, asthma, and high blood pressure.
Having more nurses available to patients in an inpatient setting has been proven to promote better patient outcomes. I’m going to go out on a limb and suggest that the same is probably true for school nurses.
Lousy timing. This acute shortage of school nurses could not come at a worse time. With more families than ever feeling the pinch of the recession, children are not immune to the oft-reported outcomes related to our current overall economic condition. Less money can translate into fewer visits to health care providers and dentists, greater family stress, and even hunger, among many other things. School nurses not only help kids with cuts and bruises but also make referrals to dentists and other needed services. The article I mentioned above didn’t discuss the number of children with mental health issues in our public school system, but this factor adds another level of complexity to the care of our nation’s children, one that nurses are prepared to assist with.
As a parent of healthy kids, I didn’t worry too much about the availability of a school nurse. My daughters actually regretted the fact that I was not only a pediatric nurse, but also owned a medical grade thermometer—needless to say, you didn’t stay home at our house unless you were truly sick! My good friend has a daughter who was diagnosed with type 1 diabetes just prior to entering first grade. My friend spent many an hour working with the school and the secretary responsible for watching the child check and report her blood sugar level.
My friend, at the time, was a stay-at-home mom and could more easily afford the extra time for such meetings and calls. But how do parents who both work full-time manage such a child in our current school system? I assume it “works,” but wouldn’t it be safer if every school had a nurse? Having a person who is not medically trained be responsible for a child with significant health issues should concern us all. I’m worried not only for the children and their families, but also the aides, teachers, secretaries, and others “drafted into” these responsible roles.
What’s your experience? I’m sure there are many more examples, and probably more severe than this, that could be shared. Are there any school nurses who would like to weigh in? How do such staffing levels work for you? Have you had any problems as a result? What should the answer be? I’ve never been a school nurse, so if the school nurses tell me this is no problem, then I’ll worry about something else!
(As a last comment: I heard about the pledge from some of our wealthiest Americans to give away a large portion of their assets before or after they die. How about using some of that money to fund a school nurse in every United States school for the next 10 years? These wealthy Americans have accomplished great things and continue to do so every day. Let’s keep some of it at home and promote the health and welfare of American children.)
Peggy McDaniel is an infusion practice manager who occasionally writes for this blog.
Further reading: for a page showing all Off the Charts posts on issues related to school nurses, including the issue of whether non-nurse personnel should or shouldn’t be allowed to give students insulin shots, click here.