Sick Day: A School Nurse Shortage

Why a lack of school nurses could be making your child ill.

School nursing services are only mandated for children living Alabama, Arkansas, Connecticut, Delaware, Louisiana, Massachusetts, Minnesota, New Jersey, Pennsylvania, Rhode Island, Tennessee, Vermont, and West Virginia, according to the National Association of School Nurses. If you reside in any other state, a nurse's aid, teacher, or even a secretary may be caring for your sick child -- dispensing medication and evaluating symptoms.

Just how prevalent is the problem? In a nationwide survey of more than 600 school nurses by the University of Iowa in Iowa City, 3/4 said that non-R.N.s administer medications to students in their school. The researchers also found that when these unlicensed personnel give children medication, they are three times more likely to make an error than an R.N. You should find out who wears the stethoscope in your child's school and how often that person is present. (Some nurses rotate among several schools, spending no more than one to two days a week in one building.) Then, if need be, lobby the school's principal and your congressman to improve school nursing services.

Your congressman may be interested to hear that one of the goals of Healthy People 2010 -- a set of national health objectives created under the direction of the U.S. Department of Health and Human Services -- is one school nurse for every 750 students. Now, the nurse-to-student ratio is all over the map, with an average of about 1 to 1,500, according to the University of Iowa survey. In New Hampshire, there's a school nurse in every building. Not long ago in Utah, however, one school nurse covered an entire county. That was a ratio of 1 to 15,000. Urge your congressman to find out whether your state meets the federal government1s goals -- and to do something about it if it doesn't.

You should also consider joining the Asthma and Allergy Network Mothers of Asthmatics' (AANMA) fight to secure a federal mandate for a nurse in every school building -- a cause that will benefit all children, asthmatic or otherwise. Last May, AANMA held a Congressional field hearing to bring the issue to the attention of the Hill. At press time, no legislation was in the works, but the movement was gaining momentum. For an update, go to www.aanma.org.

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