Every child needs a school nurse

An increasingly complex range of chronic illnesses plagues children today.  

• About 1 in 3 children is obese.
• About 1 in 10 kids has asthma, which is also the leading cause of absenteeism.
• Diabetes is one of the most common diseases in school-aged children.

Psychosocial issues such as drug abuse, sexual abuse, violence, family dysfunction, poverty, homelessness and teen pregnancy also affect a student’s ability to thrive.

A school nurse can keep students’ blood glucose levels under control, intervene in a crisis, secure counseling for a child with emotional distress, manage a student with a seizure, and follow up to see if medications have been effective. In short, professional nurses in schools play a critical role in assessment, intervention and monitoring.

School nurses are frontline workers in a hidden healthcare system: schools.

In the 1890s, the first school nurses began to identify and remove contagions from schools. Today, the school nurse plays a very different role. Among their many tasks, these frontline workers:

• Complete tube feedings and monitor ventilators;
• Counsel students on sexual health, such as those who think they may be pregnant or have a sexually transmitted disease;
• Identify symptoms of family dysfunction, such as child abuse, illegal drug use and depression;
• Monitor and ensure appropriate immunization schedules;
• Screen for routine growth and development, vision and hearing impairments, and height and weight abnormalities;
• Teach classes on health and nutrition; and
• Track students with ongoing health or emotional issues that need attention.

When the school day ends, another phase of work begins for the school nurse: paperwork.

School nurses deliver clear benefits to students, schools and families.

With the help of a school nurse, children can control symptoms, manage diseases and avoid trips to the hospital. Studies show that students in schools with a school nurse perform better academically, as well. School nursing makes financial sense: A recent study found that for every dollar invested in registered school nurses in Massachusetts, schools delivered $2.20 of social gain by reducing families’ healthcare spending and increasing productivity. Furthermore:

• When a registered school nurse is present, 6.2 percent of students are sent home from school due to illness or injury. In the absence of a registered school nurse, that proportion more than doubles.
• When a registered school nurse is present, teachers spend an average of 6.2 minutes per day dealing with injured or ill students. Without a school nurse, that rises to 26.2 minutes per day.  
• 5.6 percent of students receive prescription medications at school. Without a nurse on campus, administering medications often falls to untrained school personnel. A study by the Centers for Disease Control and Prevention found that in 39 percent of schools nationwide, someone other than a registered school nurse administered students’ medications.

Despite increasing need, school nurse staffing levels are low.

According to the National Association of School Nurses, less than half of the nation’s public schools have a full-time school nurse. Thirty percent have one who works part time—often dividing the school day between multiple school buildings—and 1 in 4 has no nurse at all.

Cuts in school budgets and a lack of clarity in Medicaid reimbursement are major obstacles to school nurse employment. To protect and promote children’s health, the AFT fights to identify and protect school health funding streams, such as through the recent Medicaid “free care rule” change.

The union also fights for clarity in the roles assigned to non-health professionals. More students need the services of a school nurse than ever before, but school districts increasingly turn to minimally trained and unlicensed employees to perform duties that should be performed by a nurse, including insulin administration, insulin pump adjustments and administration of anti-seizure medications.