A friend called recently to share with me an incident that had occurred at her son’s High School. While going down the stairs to his second period class, her son, Adam, lost his balance and plummeted down the metal staircase, twisting his ankle. He hobbled to the front office and was allowed to call home. By the time my friend got to the school to collect Adam, his ankle had swollen to twice its normal size, and he was in unbearable pain. Because there is no nurse on site at his school, first aid was not rendered – no ice applied or elevating of the ankle to alleviate swelling – thus exacerbating an already distressing situation. My friend was beside herself; weren’t school nurses mandatory?
As reported in the AP, July 2008, “Federal guidelines recommend that schools employ one nurse for every 750 students, but the national average is one nurse for every 1,151 students as reported by Amy Garcia, executive director of the National Association of School Nurses.” A quarter of schools in the nation have no school nurse – and Cherokee County in Northeast Georgia employs no school nurses in their High Schools(this is, unfortunately, the county where my friend’s son sprained his ankle).
Although there is no historical data regarding the number of school nurses nationwide, members of the profession state that there are fewer nurses doing a disproportionate share of the work – thus needing more teachers and other school professionals to pick up the slack. The average nurse splits her time between 2.2 schools, according to the association.
Kara Spinner, R.N., a school nurse in Gwinnett County, Georgia, reports that she treats an average of 100 students a day in her school clinic – ranging from handing out cough drops to replacing feeding tubes in seriously ill students in the Special Needs department. She also handles the needs for students with fragile diabetes. This includes testing their blood sugar, injecting insulin shots, operating insulin pumps and giving a glucagon shot if there is a rapid low blood sugar. These life-saving procedures all involve the potential of coming into contact with blood borne pathogens and can greatly affect the health of a child. In counties where there are no school nurses, should teachers be asked to shoulder this huge burden? Should other students lose their instructional time?
“If anyone thinks that being the school nurse is a cushy little day job where you make good money for bandaging cut fingers and handing out lollipops, they are sadly mistaken”, Ms. Spinner states. Kara works weekends as an on-call surgical nurse with the local hospital; she says that she doesn’t know which duties are more taxing – physically and emotionally – the school’s or the hospital’s.
Most parents don’t realize that nurses are managing life-threatening conditions as well as performing routine health screenings. Research has shown that school nurses increase student attendance, test scores and graduation rates. Many students do not have or cannot afford to go to the doctor. In many cases, it is the school nurse who identifies the need for medical treatment and can advocate for our students.
It is essential that we keep children who have chronic health problems in school, but it is also essential that we provide school nurses so that our teachers can teach! The state academic curriculum becomes more rigorous each year, and we are just adding to the responsibilities that teachers already have. Providing medical treatment during a lesson should not be required of our teachers!
In counties that do not hire school nurses, teachers have reported that about 15-25% of their schedule is spent monitoring and treating children with chronic conditions while the rest of the students are left unsupervised to finish their schoolwork. By law, schools without nurses are required to train two adults to monitor the medical needs of students with diabetes. As Speech Therapist, Diane Fowler says, “I am totally unqualified to help kids with special medical needs. That is not what I was trained to do. I am here to teach.”
Concerned citizens in Cherokee County have taken the time to express the need for school nurses at local meetings. What lies between achieving this goal and failing the students is funding.
There are always numerous issues that must be addressed during each budget cycle. However, the funds to staff more nurses to respond to these medically fragile cases would be far less than the cost of a lawsuit for not providing adequate care!
What do you do if your child is in a school with no nurse? As Adam’s mom had to find out the hard way, you are not guaranteed that someone with a medical background will be there to tend to your child should an emergency arise. Teachers may have to be the first line of defense until more funding is provided to the schools. How can we adequately prepare our teachers to shoulder this additional- and some would say, unfair – burden?
There are two things that all classrooms must have on hand to aid a teacher facing a medical crisis:
1.Each classroom should have its own First Aid Kit: Proper preparation begins with a First Aid Kit supplied with all the essential components necessary to respond to an emergency quickly and effectively. At the very least, this kit should include assorted bandages, gauze, alcohol swabs, antibiotic ointment, anti- itch cream, thermometer, and hand sanitizer. If your child has any special medical needs, make sure the teacher knows beforehand and has the proper instructions and medications as well as this kit. Since we are making teachers the first line of defense, then this is their number one weapon in the fight for the safety of our children.
2.Each classroom should have a phone: Seconds count in emergencies. When a medical crisis occurs, a teacher should not have to leave her classroom to summon help – a call to the office (or to 911 in life threatening situations) could save your child! With one phone call, the teacher has set in motion the machination that can save a student’s life – the teacher becomes the first responder to the immediate medical crisis and will try to stabilize the student’s condition until the medical team arrives. The teacher can also be instructed over the phone by the 911 operator in the proper way to deal with the situation – in administering CPR or keeping a child conscious. Thus, the phone becomes the lifeline for a child in medical crisis. Speech Therapist, Diane Fowler says, “Demand that your child’s classroom have a land line phone” (there is no guarantee that cell phones will have reception in all areas of a school).
Will these steps guarantee the safety of our children in school? Of course not- there are no guarantees in life; but until each school provides nurses to oversee the health of the students, we must arm our teachers with the right tools to handle the unexpected medical situations that arise everyday in our schools. Do not be silent on this issue – the safety and well being of our children demand our immediate attention.
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