Channel 3000 story on School Nurses

The following story aired on Channel 3/9 a few weeks ago and was recently posted on the Channel 3000 web site. This story discusses the impact of cutbacks of in-school staff, in this case school nurses, and reflects a serious issue that affects all of our schools. I urge you to read the extended story, which includes data on the number of students with serious chronic medical conditions in our schools.
When I was growing up, the school nurse was the lady in sturdy shoes and white opaque stockings who administered hearing and vision exams. We avoided her like the plague.
Today’s school nurses are a far cry from what I grew up with in the 1960s and 1970s. They often are the primary health care providers for students. For students with chronic diseases, trained nurses are the key link between families and schools. In many of our schools, nurses provide gently used clothing – everything from underwear to mittens – for students who come to school without proper clothing, or who need emergency replacement clothing. They serve as de facto counselors for students who visit them with health problems that may come from stress at school or at home.
School Nursing Shortage Affects Madison Students
POSTED: 12:50 pm CST November 22, 2005
UPDATED: 10:30 am CST November 23, 2005
In the Madison School District, up to 700 kids a day need medical attention. But as News 3’s Dawn Stevens reported, sometimes the person taking care of them doesn’t have official medical training.

The lives of 450 children at Muir Elementary School are in the hands of Nurse Lisa Keller. She helps kids with asthma feel better, and takes care of any other medical needs.
More than 50 Muir Elementary students can walk into her office on a busy day. Six take daily medication, and a handful are profiled in a special book, because they’re at a higher risk for a life threatening situation.
“There’s a book with emergency plans in it so if there’s a sub, or if Alice our secretary had to take over, they could pull it, see their picture and see their plan,” said Keller.
Another part of the plan is in the lunch room. Pictures are posted on the wall of kids who may be at-risk for food allergies. If a child has a bad reaction an epi-pen — an injector used to fight an allergic reaction — is right there.
“It’s in a hidden place but the lunch lady has actually been trained,” said Keller.
The lunch lady isn’t the only one whose trained to tackle life threatening situations. If Nurse Keller or the nurse’s assistant isn’t around, like at most schools, the secretary takes over.
“It is very stressful, there definitely could be life-or-death situations,” said Alice Leidel, school secretary at Muir Elementary.
Alice has taken CPR. She realizes if a child is having a seizure, an allergic reaction, or any other potentially deadly situation, she’s not as qualified as the nurse or nurse assistant.
“It isn’t always real easy to make those split second decisions,” said Leidel.
“They don’t have the assessment skills that a nurse or nursing assistant would have. That’s a problem,” said Keller.
It’s a problem facing schools across in the Madison area and across Wisconsin. While Keller’s office is covered most of the time, the Wisconsin Department of Public Instruction says many rural schools have no coverage most of the time. That means secretaries, principals and teachers must make crucial medical decisions.
The National Association of School Nurses recommends a ratio of one nurse to every 750 kids. Madison’s kindergarten through fifth grade schools have a ratio of 1 to 782, while Monona is at 1 to 909. Verona has one nurse to every 1650 kids. In Middleton, the k through 12 nurse ratio is one to every 1556. In Janesville, there’s one nurse to every 1659 students.
“I think schools would like more help,” said Nurse Linda Caldart-Olson of the State of Wisconsin Department of Public Instruction.
But because budget cuts won’t allow more help, schools have to come up with their own life saving plan. Just this year in Madison schools, budget cuts resulted in the elimination of one nursing position.
To put this story in to perspective, here’s a look at how many children in the Madison School District have serious health issues:
# 22,000 students have asthma
# 1394 students have allergies and may use epi-pens
# 103 students have seizure disorders
# 68 have type 1 diabetes

5 thoughts on “Channel 3000 story on School Nurses”

  1. I don’t have much confidence in the MMSD’s assertion that this year’s budget reduced nursing staff by one FTE. Granted, the theoretical “cost to continue” budget would have allocated 55.24 nursing FTEs and the balanced budget allocated 54.24 FTEs, but we don’t know how many FTEs were allocated during the last school year. For all we know, the previous school year budget may have had more or less FTEs than the “cost to continue” budget. I asked Roger Price for the 2004-05 nursing FTEs compared to the FTEs approved in the final budget. It will be interesting to see how they stack up.

  2. I first heard about the pressure on nurses from a friend who works in our schools.
    Even IF we had the same number of FTEs, my guess would be that the nurses’ workloads are increasing as a result of the changing physical and mental health needs of our student populations. Any increase in population needs would be heightened by district decisions to cut social workers and psychologists, since nurses, teachers, and aides are in most cases taking on the roles that the cut staff would have filled.
    The entire story underscores my sense that district priorities need to be realigned to give highest job security to the people who work in the schools.

  3. 22,000 students with asthma? Really? How many students do we have in the district again? I know that asthma is an exploding problem in school-age children (due to allergies, contaminents like cigarette smoke and pests like mice ad cockroaches, etc.), but that sounds like most of our students have asthma. Can that be true? We have three elementary-age children, and one has asthma. But she does have several other kids in her class (a small class) who also have asthma….

  4. From two previous school districts my children attended I was suprised by the number of Social workers and Psychologist in the MMSD system. A specialized School Nurse program provides a wonderful base of psychological and social work training. In all the other schools we experienced the nurse was full time at the school, one person that all the students knew was there to help with any problem, she then had a “downtown” social worker and psychologist to request assistance from if a students needs were greater than her skill. It is amazing to me that there is a psychologist and social worker at every elementary school but not a full time nurse. I am sure each middle school and high school would need one if not more of each but each elementary seems to be excessive. I have made this suggestion many times but the district seems to like the current arrrangement. It is a sad state of affairs if for every 300 students we need a full time social worker and psychologist.

  5. Mary: I can only speak for the schools on the north side of Madison. Frankly, one social worker, one psychologist and one nurse are not enough- unless, of course, you expect the classroom teacher to be skilled in social work and psych. These staff members make it possible for teachers to teach. On a daily basis, social workers diffuse problems that emanate from the home and are brought to school, they get homeless or transportation-less kids into cabs, they interface with citywide social service agencies, and they run support groups within the schools. This isn’t something you can *consult* with a centralized downtown staffer. Ditto with psychologists. If I have one MAJOR gripe with the MMSD, it is that our schools have to use a staff allocation for social work and psych (which often means our schools don’t get that extra reading or special ed specialist). In middle school, take everything I’ve written and multiply it times 5. Without social work and psych, NO learning would be accomplished due to disruptions in the classroom:(

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