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

By Maura McInerney on May 28, 2014 08:59 AM

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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Comments (3)

Submitted by Eileen Duffey (not verified) on May 28, 2014 11:16 am
Thank you for this article Maura. One clarification. While 179 nurses to 179,000 students is accurate, it may mislead the reader. Most certified school nurses have caseloads approaching 1,500 students. Some nurses have schools with fragile populations resulting in smaller caseloads.
Submitted by pat h (not verified) on June 26, 2014 9:56 am
The lack of full-time licensed nurses assigned to one building for the entirety of the school day is more widespread than people are aware of. It is spread throughout many districts with varying levels of income. We need to ask questions and receive answers. Don't assume anything. There are many laws to enforce when it comes to children in the school setting with health issues. Many districts find loopholes in order to get around the requirements. There will always be budget concerns that is no longer an acceptable answer! Contact health department if your child has a health condition. They have a division specifically for health and school safety. I will leave everyone with this question - Does administration need $155.000 a year for a salary?
Submitted by Grace Emmanuel (not verified) on June 26, 2014 11:46 am
I also read that story from I deeply understand the importance the presence of Nurse in a school and in any other establishments like hotel. They must work full time and readily available for any emergencies. I used to work in a hotel before and there was one guest who needs medical assistance during midnight. Unfortunately, the duty of the nurse is only is from 8am to 5pm only. The guest file a complaint for this. I believed they started to implement the new schedules of the nurses. There is already a Nurse during night time as well. I hope with what happened in this school, will serve a lesson to the administration.

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