By Betsy Todd, MPH, RN, CIC, AJN clinical editor

by woodley wonderworks, via Flickr.

by woodley wonderworks, via Flickr.

In the December 1903 issue of AJN (reprinted, with an editor’s commentary, in September 2014), Henry Street Settlement nurse Lina L. Rogers described the impact of the first school nurse program in the United States. Ms. Rogers, who worked with Henry Street founder Lillian Wald to establish the program in New York City schools, emphasized that their purpose was not only to improve children’s health but to decrease missed school days.

Wise community leaders have long acknowledged the importance of school nursing in accomplishing these goals. But in recent years, this hasn’t prevented cutbacks that eliminate or severely limit the care that nurses can provide to their school communities.

An  October 10 article in the Philadelphia Inquirer describes an acute shortage of nurses in Philadelphia schools. Detailed here are multi-school coverage by individual RNs, wildly unrealistic caseloads for many of the nurses, and the significant responsibilities for “medical care” now borne by non-nurse teachers and administrators. In the article, Terry Jordan, president of the Philadelphia Federation of Teachers, underscores the complexities of school nurse work, noting, “We have so many families living in deep poverty, and for some of these families, the only medical attention they get is from the school nurse.”

The state of California, on the other hand, is supporting innovations in school nurse programs. Last week, Governor Jerry Brown signed into law legislation that will allow Medi-Cal (the state’s Medicaid program) to reimburse schools for providing a wide range of primary care health services to Medi-Cal–eligible students.

What kind of nursing coverage is available in schools in your own community? As a school nurse and/or parent, what do you think of the state of school nursing in your district?

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