Districts seek alternatives to full-time school nurses

Districts seek alternatives to full-time school nurses

(N.C.) When a second grade teacher in Oregon noticed one of her students was far more distractible than the average 7-year-old and often appeared to be daydreaming, she was sure the boy had attention deficit disorder.

The school nurse, Nina Fekaris, dug further into the child’s symptoms and asked his parents to follow up with a neurologist, who found that the boy actually had a brain disorder that caused him to have seizures for up to 30 seconds every several minutes.

But that sort of medical success is less likely to happen as many districts throughout the nation slash school nurse positions when budgets are tight.

“Teachers go into education because they care about kids and they want to help children, but they aren’t medically trained, and it takes the eyes of a medical person to be able to catch things that educators will miss,” Fekaris, who also serves as president of the National Association of School Nurses, said in an interview. “But due to declining education budgets across the country, school districts often have to decide between having a teacher in the classroom or a school nurse for their building–it’s a difficult choice for districts to have to make.”

While the shortage is often worse on the West Coast, where the ratio of school nurses to students tends to be higher and regularly exceeds one nurse for more than 2,000 students, states throughout the nation are facing challenges.

In North Carolina, state data shows that out of 115 school districts, only five have school nurses, many of whom cover multiple sites within the district. Statewide, the average school nurse is responsible for two or three schools, with some covering as many as six schools. Currently, only one district in the state employs a full-time nurse at each campus.

Without the funding to hire a school nurse full time, districts have instead turned to local community and government agencies to fill some of the gaps in student healthcare needs. According to Kelly Haight, a spokeswoman for the North Carolina Department of Health and Human Services, many districts across the state partner with their local health department, and a handful of others partner other community organizations that provide school nursing services.

Those sort of partnerships can help provide students with some of the care provided by a school nurse, but they can also act as a springboard for districts to find funding to fill campus nursing positions.

School nurses help local healthcare providers by providing preventative care and chronic disease management for students, which can help reduce the number of unnecessary emergency room visits a hospital sees, Fekaris said. Because of that, she noted, some hospital systems have begun to funnel community outreach dollars into helping schools fund on site nurse positions.

Still, in states like North Carolina, where the ratio of school nurses to students is higher than 1:1,000 and teachers or office staff are often responsible for student health needs in addition to their regular duties, mistakes are more likely to happen.

Earlier this year, for instance, a 5-year-old was rushed to the ER after a bookkeeper at her school mistakenly gave the child a double dose of an ADHD medication prescribed to a different student. According to the Raleigh-based WRAL-TV, it isn’t uncommon for clerical workers in North Carolina schools to administer first aid or even give students shots on top of their administrative tasks.

And as students are increasingly diagnosed with asthma, life-threatening allergies, attention deficit disorders and other medical issues, school staff without medical training are often left to handle even more complicated student health needs.

Fekaris said that more students are being diagnosed with Type I diabetes, the care for which involves a complicated system of measuring activity, carbohydrates, sugar and insulin levels, and balancing them takes a significant amount of time and medical knowledge.

“Without a school nurse, teachers and office staff are the ones who spend a significant part of the day dealing with student health, rather than teaching or focusing on attendance and other things,” she said. “School nurses provide the specialty knowledge to a school system that promotes health and learning.”