School Nurses

From the Pittsburgh Tribune. Here's a look at one of the unsung heroes of the educational system: The school nurse.

PA state laws on school nurses are not tightly defined. That's probably not the best response, but with so many other fish to fry, like equitable funding of school systems, I could see how the nurse could be an afterthought. After all, who really needs the nurse anyway? A teacher or someone can slap bandages on the skinned knees. It's all about the money.

Just wait until you need the nurse.

School nurse plays vital role

By Carol Hackenbracht
Saturday, September 6, 2008

Not long ago, a school nurse was called away from her Montgomery County elementary school to give medication to a student in a school a few miles down the road. Not wanting to leave her building because of the number of children with medical problems, she delayed her departure for a few minutes.

As she prepared to leave, a young student entered her office, scratching his stomach. Aware that the student had a food allergy, she instinctively checked him for hives while asking him if he had eaten anything he shouldn't have. He shook his head no. Within a matter of 30 seconds, he grabbed for his throat, and the nurse again asked him if he had eaten anything he shouldn't have. This time he nodded his head yes.

Taking the epinephrine out of the medication closet, she injected the youngster with the life-saving medication. She felt chilled by the realization that she could have been en route to the other school during the child's anaphylactic reaction instead of being there to save his life.

This true story brings up some very important questions. Do you know if there is a school nurse in your child's school? Is the nurse there every day? For how many students is the nurse responsible? Is it a reasonable number? Will the nurse be there for your child, should he or she need emergency medical help?

There are no laws in Pennsylvania that require a school nurse to be in your child's building on a daily basis. The current mandate, established in 1964, states that a school nurse may serve up to 1,500 students. Realize that if your school district has three elementary schools with fewer than 500 students each, your district could potentially direct the school nurse to be responsible for all three buildings. Or your district could assign just one nurse to care for all 1,500 students in a single school.

Every day, more and more students with special health-care needs and chronic illnesses enter the school population. School nurses, who provide specialized care for students dependent on medication and medical technology, develop, implement and monitor health care plans for these students. In Pennsylvania many school nurses regularly provide technical medical procedures, including nebulizer treatments, blood sugar testing, insulin-pump management and bladder catheterization.

Children with special needs often require additional services, including tracheotomy care, intravenous therapy, tube feedings, suctioning, rectal Valium administration and oxygen therapy.

School nurses serve a unique role in the school setting. They assist children and their families in obtaining needed medical and social services. They also address the physical and emotional needs of students suffering from cancer, infectious diseases, anxiety, eating disorders, physical and sexual abuse, homelessness, mental health problems, teen pregnancy and substance abuse.

The National Association of School Nurses and the U.S. Department of Health and Human Services recommend a maximum school nurse-to-student ratio of 1 to 750 students, with a decreasing ratio as the population of children with special health needs increases. The American Academy of Pediatrics, the American School Health Association and the American Nurses Association also support a maximum ratio of one school nurse for every 750 students.

Will there be a school nurse for your child, should he or she need emergency medical help? Does your child's school nurse have a safe, reasonable assignment? If you have any questions about your school's nursing services, don't hesitate to contact your school district.