Homage to an Unsung Hero
It's back to school time again. You can bet of all the back-to-school reports in newspapers, local TV or radio, you won't hear one on school nurses.
And I want to know why? With nurse-to-patient/student ratios of 1-to-1,000 in some communities, why isn't the school nurse the hero we all want to thank?
Fifty years ago, the job of a school nurse was much simpler than it is today. Caring for scrapes and bruises, checking for fever in the occasional child, doing annual scoliosis and wellness checks! The job was not without major complications - such as the child who would present mid-day with symptoms that look suspiciously like polio, which entailed contacting the family and notifying parents of other children in the classroom - but to the school nurse of today, that would constitute a slow day.
In the 21st century, school nurses deal with the usual, such as fever and allergies, but also with the less than routine such as child abuse, diabetes, sexually transmitted diseases, HIV, H1N1, meningitis, severe disabilities that require constant monitoring and actions such as suctioning trachs. The list goes on and on. According to the Robert Wood Johnson Foundation (RWJF) report, the CDC estimates 13 percent of school children were taking prescription medications for 90 days or longer in 2008. Who was monitoring that during the school day? School nurses!
Sadly, in today's economy, often the school nurse is the only healthcare provider a child sees regularly. A recent segment of the RWJF report "Charting Nursing's Future" deals with school nursing. "Unlocking the Potential of School Nursing: Keeping Children Healthy, in School, and Ready to Learn," quotes research by Child Trends that "low income children are more likely to face health risks such as poor nutrition, exposure to environmental toxins and domestic abuse."
The RWJF report makes several suggestions, including:
- federal legislation to provide competitive grants to states with nurse-to-student ratios better than one nurse per 1,000 students;
- comprehensive national data collection that would allow for gauging the intensity of school health services and their impact on student health as a step toward developing stronger policies; and
- creation of an office within the U.S. Department of Education that would provide school nurses, school social workers, school psychologists and others with a point of contact dedicated to identifying best practices, providing technical assistance and offering professional development opportunities.
From my vantage point, it's about time school nurses got some respect.