AFT campaigns for a nurse in every school

Two years ago, Pat Christie, a school nurse in Aptos, Calif., talked with her superintendent about a problem that plagues school districts nationwide: too many students and too few school nurses to care for them.

Although the superintendent was sympathetic, the problem remained. In fact, it worsened. Budget cuts have reduced the school nurse staff even more.

“The stress can get to you, but I keep plugging away because it feels good to know that a student is healthy and ready to learn,” she says.

Still, the situation frustrates Christie. There aren’t enough school nurses, so “we can’t be as effective as we can be, and then we’re seen as insignificant. It’s a pretty vicious cycle.” Christie, a member of the Pajaro Valley Federation of Teachers, is responsible for a high school and the local community college, but also fills in regularly at two elementary schools and a middle school.

Hundreds of school nurses across the country are caught in this same vicious cycle, and the problem is exacerbated by the staggering number of state budget shortfalls that have forced cuts in education funding. And all too often, school nurses are deemed expendable by school district leaders looking for further cuts to solve their budget woes.

School nurses are not expendable. In fact, they are needed now more than ever. Increasing numbers of students today have chronic conditions like asthma, life-threatening allergies, or seizure disorders that require medication or special medical procedures performed during the school day.

So much to do, so little time

“A school nurse’s day is filled with episodic care, but things are vastly different from 10 years ago,” says AFT member Sue Will, a certified school nurse in St. Paul, Minn., and president-elect of the National Association of School Nurses. “We deal with everything from head lice to heart transplants.”

The willingness to cut nurses from a school budget reflects a lack of awareness about what school nurses do, says Aurelia Barney, a certified school nurse in Cleveland, Ohio, and a member of the Cleveland Teachers Union.

Although every Cleveland school is assigned a nurse, not every nurse is assigned a single school. A nurse often is responsible for students at several buildings and divides her time among them. Barney has three schools, and time is always an issue. Health classes and prevention programs, a source of “great joy” for Barney, often take a back seat to other more pressing duties.

Barney also worries about the students who lack health insurance. School nurses are often the first to identify health problems in children, she says. “For many children, we are the only medical person that the child sees.” For that reason, “we have to go out and educate the community about what happens when we aren’t there.”

Absent a school nurse, someone else—a teacher, paraprofessional or office staff member—must assume the role of caregiver. This approach is unsafe, says Will. “There is a huge difference between someone with a nursing degree and someone with two hours of training. We’ve created something that looks like a solution but it’s a bigger problem. We need to do some rethinking and invest in appropriate personnel for the safety of our students.”

The lack of full-time school nurses has been a major issue for the AFT. Last year, the national union launched the “Every Child Needs a School Nurse” campaign to call attention to the issue. The goal is state-level legislation that will mandate a school nurse in every school.

Since the program began, school nurse members have lobbied their legislators and have had bills introduced in California, Louisiana, New Mexico, New York and South Carolina.

The AFT also is working with researchers at the University of Pennsylvania’s School of Nursing to study the link between student performance and the presence of a nurse in school. In addition, school nurse members are lobbying their state lawmakers to prevent non-nurse personnel from administering medical treatments to students. In fact, AFT Healthcare is working to stop legislation in several states that would require schools to train their employees to provide routine and emergency care to diabetic students.

“It is a morale booster to know that someone is listening and understands the importance of what we are doing,” Christie says of the AFT’s campaign. “No one can bring the same quality of care that a school nurse with nursing education and experience can bring.”

Parents are among the best advocates for school nurses. A recent national survey by the Center for Health and Health Care in Schools found that most parents—88 percent—support school healthcare services. Parents also said it is important to have a nurse in the school to provide basic care.

Unfortunately, says Barney, many parents don’t realize that there is not always a nurse in their child’s school. But that is changing as parents with medically fragile children become more sensitive to the need for school nurses.

“There is a groundswell” taking place, says Will. “School nurses know that parent support is essential for change.”