Nurse on Staff at School
Imagine this scenario: You're the parent of a type 1 diabetic child enrolled in a public elementary school. Every school day, your little girl has to administer her daily insulin injection without the supervision of a full-time nurse on duty.
Unfortunately, this scenario plays true in many of our nation's schools. Parents today often are under the false assumption that a nurse is on staff for the entire length of their child's school day. According to a survey conducted in 2001 by the National Association of School Nurses (NASN), only 14 states in the United States have mandated, full-time nurses in their elementary to senior high schools. This comes during a time when more school-aged children are in need of specialized medical care and supervision than ever before.
Why School Nurses?
"School nurses are in a unique position to coordinate care for a child, both for physical and emotional issues, across the lines of home, school and the health care community," says Sally Schoessler, RN, SNT and the New York state representative to the National Association for School Nurses.
She believes school nurses help create a special bond between parents and children who require specialized care. "School nurses have the opportunity to really know and care for students as well as their families, since you often care for several siblings over a period of years," she says. "The relationships that I develop with the students and their families is incredibly rewarding and it is important to me to have the chance to make a positive impact on a child's life."
The impact to which Schoessler refers may involve something as simple as providing a bandage after a fall on the playground or as difficult as administering life saving CPR. Unfortunately, cash-strapped school districts around the nation are cutting school nurses from their budgets, along with the valuable services they provide. Presently, these same districts may rely instead upon untrained school personnel to perform duties they are not medically qualified to provide.
"The community, even the school community, is not aware of the role of the school nurse," says Harriet Weinbaum, RN, BSN and legislative chairperson of the New York State Association of School Nurses (NYSASN), who believes the public has to "ensure that the staff who service their school children are the most highly trained to deal with the health issues brought to school everyday."
Current Legislation and Campaigns
School nursing services are presently governed on a state level. "Every school should have a full-time nurse, but the problem is in the funding, of course," says Congresswoman Carolyn McCarthy (D-Mineola, N.Y.), currently serving her fourth term representing Long Island, New York's 4th Congressional District, and who worked for 30 years as a nurse. The congresswoman was a key figure in the passage of the Elementary and Secondary Education Act, which contained specific provisions to fund school nurses.
Currently, there is no legislation pending in our nation's capital that would initiate a national mandate requiring all states to have a full-time nurse in every school. The American Federation of Teachers (AFT) health care division is presently spearheading a national campaign to ensure every child in the United States has access to a full-time school nurse.
"This campaign came about after the delegates of the AFT unanimously passed a resolution at its 2002 convention which called for a full-time school nurse in every school in our country, as well as a school nurse for every 750 students," says Joni Tanaciev, assistant director of the health care division of the American Federation of Teachers. She believes this campaign is striving to educate parents, the public and policymakers in our country about "the many facets of today's school nurses. They no longer just tend to bumps and bruises. They take care of critically ill children in addition to children on medications. Our 1.4 million members strongly support having a full-time school nurse in every building and at least one school nurse for every 750 students."
Representatives from the NASN and the AFT believe changes will not happen overnight, especially when dealing with state and federal governments. "There has been legislation that has been introduced several times that would mandate school nurses, especially in New York State, but for various reasons, the legislation has not passed," says Schoessler.
Tanaciev agrees, saying that although legislation is currently being introduced in six states (California, New York, New Mexico, West Virginia, South Carolina and Massachusetts), they have "no illusion that these bills will pass in the current fiscal situation facing most states."
How You Can Help
There are ways parents of school-aged children and the general public can help bring this current situation to light.
Tanaciev believes it is important that "parents become educated about who is taking care of the health needs of their children while they are in school," she says. "If it is anyone other than a school nurse, they should work to change that. They should work with school nurses and teachers to educate school board members about the need for school nurses. They must make their voices heard."