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When Schools Cut Nurses

As prepared as other staff may be, they cannot play the role that a high quality school nurse does.

Educators have all seen the student who are frequent flyers to the nurse's office. Perhaps they are there because they feel sick, to escape the school bully or a difficult class. Regardless of the reason, the school nurse plays an important role in the school system. They comfort children, aid when they are sick, and can help get to the heart of a problem.

Unfortunately, school nurses are not found in every school because they are often not mandated. Linda Davis-Alldritt, the President of the National Association of School Nurses says, "NASN's experience and the literature shows that the lack of school nurses in our schools is most often based on policy, funding, and prioritization decisions at the state and local level. What NASN's and other researchers have shown is that there is no shortage of school nurses, but rather a shortage of funded positions in states where the number of school nurses to students is low."

Over the past few years, most schools have had to work through budget cuts and decide what is mandated and what is not. Just because things are mandated doesn't mean they are more important than those things that aren't. It just means that someone was able to get them on the list. After all, most people would tell you that kindergarten provides early intervention to students, but it is not mandated in many states.

If you know what goes on in a school from day-to-day, then you truly understand the importance of a school nurse. School nurses should be mandated. A high quality school nurse is worth their weight in gold. They do more than just put band-aids on students and deal with tummy aches. School nurses are a vital part of the social-emotional team in schools, and let's face it, schools have increasing social-emotional needs.

How the Role Has Changed
There are a plethora of issues that schools see every day, and the severity does not always depend on the level. Schools have had to deal with students who come to school intoxicated as well as those who are under the influence of drugs. Other times nurses are giving medications to students, and playing the part of the doctor because parents do not, or cannot, pay expensive co-pays at the doctor's office.

And yes, that is true. When two parents are working and neither one can take the day off from work because they will not get paid, children get sent into school and are told if they don't feel well, "they should go to the nurse's office." The time spent at school will bide time at work in the hope that the school will not call to say their children are really sick. This is not a judgment, just a reality.

Schools also have parents who do not always understand how to take care of the health issues of their child or they may not understand the magnitude of the issue. School nurses work as educators for those parents to assist them in getting the help they need.

In addition, Davis-Alldritt says "There have been an increase in health-related issues" (Chart on health conditions of children in the U.S.). Those issues may include numerous students with ADHD in need of medication to students with Type 1 Diabetes or other moderate to severe health issues. And those are the issues that are diagnosed. There are other students who come to school with undiagnosed issues that their parents, and therefore the school, do not know about. One of these issues includes seizure disorders.

As prepared as other staff may be, they cannot play the role that a high quality school nurse does. Many staff may have CPR or other medical training, but they often have a class filled with students. School nurses are on-call and ready to intervene during medical issues, which do not just include children. A school is a building filled with staff who may have health issues, diagnosed or undiagnosed, of their own.

The role of school nurses:
Medical history - They know the health background of students and follow them from year to year. They have information that the child's new teacher lacks and needs to know.
Home-school connection - They often have a connection with families that school principals and teachers do not.
Child Study Team (CST) - Most schools have a Child Study Team where they discuss student issues. A school nurse has a perspective on children that other adults may lack. Any quality CST looks at the academic AND the social-emotional aspects of children and nurses have good input into those needs.
Social-emotional - Some students lack support at home or they need any escape from a tough teacher or tough subject. School nurses can help build a bridge to help a student out of their struggles.
Health resource - There is an increase in medical issues among children and nurses are one of the most important resources for teachers and administrators

In the End
Being without a school nurse is somewhat of a ticking time bomb. There are schools that have one in place every other day or one time a week. Health issues and health crisis do not wait for the one day the school nurse is in the building. They play out on any given day and can leave a lasting mark on a school if they are not handled correctly.

If schools are proactive by having school nurses on staff, they are safeguarding themselves and their students from issues that may arise. If they do not have one on staff they may be putting themselves at risk for when issues do arise...and issues do arise.

Students live complicated lives and they come to school with academic, health, social and emotional issues. Schools need a team of adults who can help those students, and their parents, with the issues. No building-level team is complete without a school nurse. They simply fill a role that others cannot fill.


ENGAGE with Peter on Twitter

Other resources from Linda Davis Alldritt:
Increases in chronic illness
School nurses in the U.S.
Making the Case for School Nurses
A Case for School Nursing
I am a Nurse. I am a Leader - NASN Member is winner of ANA's "I am a Nurse, I am a Leader" video contest! School nurse, Mandy Mayer from Vermont, made the winning video. Congratulations to Mandy for highlighting school nursing. View Mandy's YouTube video here.

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