School Nurses and Sicker Children

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School Nurses and Sicker Children

A lesson for kids' health

By Elizabeth Hanink, RN, BSN, PHN
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At the same time as the state’s budget deficit is leading to cuts in school staffing, HealthyCal is reporting that school nurses are caring for sicker students and more of them.

State of Concern

California state law does not mandate a specific school nurse-to-student ratio, but according to statistics from the National Association of School Nurses, the current numbers are 2,187 students per nurse, placing California 42nd in the nation. Vermont ranks best with one nurse for every 331 students. It is not uncommon in California for one nurse to cover children at four different schools. Many private schools have no nurse at all, either on site or on call. In the past year the number of California school nurses dropped 9 percent while the number of students dropped only 1 percent.

All this while more and more advances in care make it possible for children who are severely disabled or ill to attend regular school. There are many children in school now who as recently as 30 years ago would not have lived long enough to attend school. Nurses now routinely care for children with insulin-dependent diabetes, cerebral palsy, and children who require assistance with urinary catheters, gastric tubes or tracheostomies.

Band-Aid Solutions

Nurses are not the only ones affected. Classroom teachers now deal with minor cuts and scrapes, and nurses have less time to focus on issues of health education, malnutrition, and child abuse. The nurse’s office, once a place to get help for menstrual cramps or a sinus headache, now more resembles an urgent care center.

Other problems get neglected altogether. About 30 percent of the children seeking help have mental health issues that often take a backseat to those more fragile physically.

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