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What we do know: More school nurses are needed to protect our children





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Our hearts go out to the family, friends, fellow students,and teachers of Sebastian Gerena, the 7-year-old boy who died at Andrew Jackson Elementary last week. In the absence of a school nurse on duty (a nurse is present only on Thursdays and every other Friday), school staff called 911. We know they did everything they could with the resources they had to respond.

This is the second tragic death of a child in a Philadelphia school that lacked a full-time nurse on duty in the last eight months. We know that the health and safety of Philadelphia's students has been and will continue to be in peril because lack of funding forced the elimination of more than 100 school nurse positions, leaving a current total of 179 nurses to serve 179,000 students. We know that the current ratio of nurses to students is inadequate to address the health and education needs of students.

Pennsylvania’s state law, which was adopted in 1965 and requires a ratio of one school nurse per 1,500 students, is also woefully insufficient and far below the federal recommendation of one school nurse per 750 healthy students. In addition, research discloses that full-time nurses are six to 12 times more likely to be asked to respond to both critical and non-emergent incidents than part-time nurses.

We know that our children must be protected. Their health and safety should not be placed in jeopardy by lack of funding. And yet it has been.

In May 2013, the Education Law Center, in collaboration with the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) Program at Children’s Hospital of Philadelphia released a report warning of the impact of the school nurse shortage. Through that report, we highlighted the importance of school nurses to our schools and the community.

We urged increased funding to the District and urged that the School Reform Commission consider strategic approaches to assigning school nurses, including taking into account the known medical needs of student populations and partnering with universities and medical centers to perform discrete tasks with supervision, ensuring ongoing communications with school nurses even when they could not be physically in the building, eliminating reliance on untrained school personnel to perform school nurses' duties.

The fiscal crisis facing the District is endangering the lives of Philadelphia’s children. The impact of a school nurse shortage is felt more acutely in Philadelphia, where students are disproportionately impacted by poverty and by environmental and socioeconomic factors -- which often result in more widespread chronic and acute health-care needs.

For example, an estimated 20 to 25 percent of Philadelphia school-age children are diagnosed with asthma and there has been a 30 percent increase in the incidence rate of Type 1 diabetes since 1985. And recent studies show that 30 to 40 percent of children in cities like Philadelphia enter school with a history of elevated blood lead levels in a dangerous range. Our schools must be equipped to deal with the needs of these children.

We cannot afford to wait for the next tragic loss. School nurses are a critical investment in the life, health, and future of our children. We must make a financial commitment to ensure that there are enough full-time nurses available to the schools of our city.

Maura McInerney is a senior staff attorney at Education Law Center, a nonprofit legal advocacy organization.

The opinions expressed are solely those of the author.

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