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If you’re laying off nurses, you better have a backup plan

Submitted by on Friday, 24 June 2011 2 Comments

The lack of health-care workers in schools is nothing new.

We saw the impact when Big Guy was in kindergarten and cooled his heels in the office for half a day after a snooty secretary diagnosed him with “highly contagious” eczema and refused to let him go back to class until the health tech arrived and cleared him.

We saw it again this year when Big Guy hacked until he threw up because the health tech had left early and no one else recognized the cough as asthmatic and gave him his inhaler. I’ll admit I got a little testy when I was told he’d have to stay home the following day because he’d thrown up at school.

Nationally, look for the things to get worse as districts from Connecticut to California cut school health positions.

“You are putting the children in a very unsafe condition and you are putting the nurses in a terrible predicament. They are putting their license on the line,” a school nurse told the New Raven Register. Her district is down to 29 nurses spread over 53 school. That ratio’s probably not unusual.

Given what’s happening with classroom sizes – Boots’ kindergarten has 23 students while Big Guy’s had 18 just two years earlier – I’d be the last to suggest laying off teachers in order to keep nurses.

I will argue, though, that there has to be a plan to ensure that students keep the help they need when they need it. It’s going to be a question a lot more parents will have to ask next fall – I know I will, even though our district has been relatively sheltered from the layoffs that have roiled the country.

The biggest impact of cutting health staff will be on children who need medication either regularly or in emergencies. CNN says that’s 300,000 with epilepsy, 4.5 million with ADHD, 15,000 with Type 1 diabetes, 3 million with food allergies and 9 million with asthma.

Some schools already have backup plans, some with multiple layers. According to a parent whose allergic child goes to school in Los Gatos, Ca., the entire staff there is EpiPen trained. Big Guy’s kindergarten teacher also volunteered to be trained and to keep an inhaler and EpiPen locked in her desk. That didn’t save him from bouts of “contagious eczema,” but it reassured me that help was available if a health tech who divided her time among several schools wasn’t around.

California law does allow school personnel other than nurses or health techs to be trained to  administer epinephrine.  Of course, that same section also allows schools to skip the training and decide they’ll just rely on calling an ambulance. That’s really not the way they should go, though. If EpiPens didn’t save lives, there wouldn’t be so many of us carrying them around.

California also allows students to carry their own asthma inhalers and EpiPens once parents sign releases. Big Guy is not ready for that yet. He could handle his inhaler, but the EpiPen is an entirely different matter. In light of last year’s incident, if I can’t get an assurance that someone will be around to administer the medication when he needs it, I will be completing that paperwork.

Copyright 2011 Debra Legg. All rights reserved.

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  • diabetes mom said:

    A nurse in every school for California or 1:750 as is their plan costs up to $459Million according to the Ca School Boards Association unless you want to pay them less than their hospital nurses started getting with mandated ratios in 2004. Competition to hire them away will have a higher price tag. 5,722 would need to be hired, more if 1:225 were desired. There is no money!

  • Debra said:

    I realize the cost. That’s why I wrote, “Given what’s happening with classroom sizes – Boots’ kindergarten has 23 students while Big Guy’s had 18 just two years earlier – I’d be the last to suggest laying off teachers in order to keep nurses.” In fact, we’ve never been at a school that’s had a nurse anyway. At best, we’ve had a full-time health tech.

    There does need to be a plan, though, that doesn’t involve letting an asthmatic 7-year-old cough until he throws up while he sits within yards of his rescue inhaler but no one helps him. My plan for next year is to have him self-carry. That won’t help if he goes into anaphylaxis, though.