Red River United is interested in forming a Healthcare Committee so that your specific issues are addressed.
School nurses today take on a variety of roles in providing healthcare to our nation’s children. As often the only healthcare professionals a child sees except in emergencies, we serve as gatekeepers for entire families to a healthcare system that is complex and sometimes unmanageable. We must be knowledgeable in private insurance reimbursement, Medicaid, and other government programs for low-income or special needs children.
School nurses are the watchful eyes and ears for the nation’s children during the many hours they are in school. More and more children with special healthcare needs and illnesses are now mainstreamed into schools. In fact, of the 52 million students in our schools, 10 percent to 20 percent have chronic social, emotional or other health problems. It is our responsibility to develop, implement and monitor care plans for these students.
The Typical Day of a School Nurse
Few people realize what a school nurse does on a daily basis. Gone are the days of the school nurse who simply responded to students’ complaints of tummy aches or bumps and bruises.
School nurses today are on the frontlines of identifying child abuse, illegal drug use and depression. We insert catheters, gauge pacemakers and monitor blood sugar counts. We do tube feedings, monitor ventilators, console children from broken families, and counsel students who think they could be pregnant or have a sexually transmitted disease. We administer prescription medications to almost 3 million students every single day.
We screen for vision and hearing impairments, and provide assessments and referrals for health problems and behavior issues. We control communicable diseases by ensuring that your children and their classmates are immunized in accordance with state laws and recommendations.
We are the first responders in the event of a tragedy or medical emergency, which may involve violent offenders. We give physical examinations and, in our spare time, we teach classes on health and nutrition!
In the evenings, when most people believe our workday has ended, we complete mounds of required paperwork.
We attend conferences and school meetings, and sometimes make home visits.
And we do all this while under constant pressure to do more with less—fewer resources and fewer fellow school nurses.
Too Few School Nurses
In the United States, there are approximately 45,000 employed school nurses—nowhere near enough to properly provide the care needed by the nation’s 52 million students. Government agencies and professional associations agree that no school nurse should be responsible for more than 750 students. Yet, currently, there is only one school nurse employed for every 1,155 students. And some of us must provide care for several times that many students.
Some of us are responsible for several schools—often at great distances from each other.
Some students have only a part-time school nurse or no school nurse assigned to their school at all! In fact, almost half of all school nurses are responsible for students attending at least three different schools. Unfortunately, at a time when more students need the services of a school nurse, school districts are cutting these positions, relying more and more on non-skilled employees to perform the duties that should be performed by a school nurse.
What happens to those children who don’t have access to a school nurse? Children who become ill or injured while in school are often sent home, forcing them to miss out on learning opportunities. For more serious cases, an ambulance is summoned and the child is taken to the emergency room—even if the problem is not a true emergency. Students at risk for pregnancy, suicide, substance abuse and other problems often fall through the cracks.
A record 5.6 percent of all students receive prescription medications while at school. Without a nurse on the premises, the duties of administering these medications and monitoring the children afterward often fall on the shoulders of school personnel ill-equipped to perform these tasks. School secretaries, teacher’s aides, even coaches have been put in this position. A study by the Centers for Disease Control and Prevention (CDC) found that in 39 percent of schools nationwide, someone other than an RN administered students’ medications.
We know this is dangerous. A University of Iowa study showed that medication errors in schools were far more likely to occur when someone other than a school nurse was involved.
There are 86,000 public schools in the United States, with over 53 million students enrolled, and over 20 million of them have chronic health conditions.
School nurses are the watchful eyes and ears of the nation’s children during school hours. They are often the only primary care providers that children see on a regular basis. Children who used to stay at home when ill now go to school instead, often because both parents work. Many children with severe health problems who used to be enrolled in special schools or receive tutoring now are enrolled in classes with healthier children.
School nurses don’t just dole out bandages anymore. They administer medication and monitor medication response, respiratory status, seizure patterns and blood glucose levels. School nurses monitor students for parasites, skin infections, infectious diseases, and sexual and physical abuse. More than 97 percent of school nurses care for students with diabetes; more than 95 percent care for students with seizures; and more than 93 percent care for students with chronic and severe asthma.
Unfortunately, there are far too few school nurses in our schools to care for the children who rely on them. In July 2002, the AFT Convention adopted a resolution calling for a fulltime school nurse in every school building. As a result, the AFT recently launched a new campaign, ‘Every Child Needs a School Nurse.’ Public awareness is a key component to getting a full-time nurse in every school building. Many parents are completely unaware that there is not a school nurse in their child’s school. The campaign includes materials to help educate the public and policymakers on the vital role that school nurses play in the health and education of our children.
AFT Healthcare provides policy, collective bargaining, research and legislative support to the AFT’s 15,000 school nurses. School nurse representatives sit on the AFT Healthcare Program and Policy Council, and the AFT Healthcare School Nurse Subcommittee meets regularly to advise the union on school nurse issues. ~ http://www.aft.org/yourwork/healthcare/schoolnurses/
Every Child Needs a School Nurse (Resolution adopted by the AFT Convention 2002)
EVERY CHILD NEEDS A SCHOOL NURSE
WHEREAS, every child must be ready to learn, having their basic needs first met so that they may achieve optimal physical, emotional, social and educational development and be prepared for full participation in society; and
WHEREAS, a professional registered nurse certified by the appropriate state agency provides unique and valuable services to students, parents and school personnel; and
WHEREAS, through public schools, communities can work together in unprecedented ways to eliminate barriers to learning and to provide access to healthcare for children and families; and
WHEREAS, the country’s school nurses are pivotal members of a coordinated school health system, delivering services to children and, thereby, eliminating health disparities and barriers and supporting academic success for all children; and
WHEREAS, school nurses provide vital links between public and private resources and programs, collaboration between schools and health and human service agencies to bring school and community services to schools, and support efforts to connect families to insurance programs to meet the needs of children and families; and
WHEREAS, school nurses create and maintain safe school environments; provide mandatory health education, health screenings and immunizations; deliver early intervention services; design wellness-driven programs; and provide vital medical services to students with chronic and acute illnesses; and
WHEREAS, these essential services require specially educated and experienced professional personnel:
RESOLVED, that the AFT support school nurses as providers of necessary healthcare for children that ensures academic success; and
RESOLVED, that AFT Healthcare, through its program and policy council and school nurse subcommittee, develop and implement a public relations campaign to educate policymakers and the public about the significant role that school nurses play in the lives of our nation’s children; and
RESOLVED, that to enhance the educational process for students, the AFT support the services of a professional certified registered nurse in every school; and
RESOLVED, in addition to having at least one full-time school nurse in every school, AFT support the ratio of students for each professional certified registered nurse to be 1:750 or fraction thereof for regular students, 1:225 or fraction thereof for mainstreamed students, or 1:125 or fraction thereof for severely/profoundly handicapped students; and
RESOLVED, that the AFT, its affiliates and locals lobby state legislatures for legislation requiring a school nurse in every school to provide necessary medical services to our children; and
RESOLVED, that AFT locals work to negotiate language in public school contracts calling for the employment of at least one school nurse in every school.
Forging ‘a new kind of nurses organization’
A vote by members of the Oregon Nurses Association on March 16 completed the affiliation process started by leaders of the National Federation of Nurses and the American Federation of Teachers just over a month ago.
The NFN is active in Montana, Ohio, Oregon and Washington state. In the past several weeks, each of these states voted to approve the affiliation agreement, which means that 34,000 registered nurses now will join the more than 48,000 nurses and healthcare professionals who are already members of the AFT.
Bruce Humphreys, a registered nurse at St.Charles Medical Center in Bend, Ore., and a member of the Oregon Nurses Association, believes the agreement between the AFT and NFN will be beneficial for everyone involved. “I feel positive about the affiliation and the fact that we are now part of the AFT and AFL-CIO.”
Nurses, like Humphreys, who work on the frontlines of patient care need to be heard on the issues that affect the quality of healthcare and their jobs, AFT president Randi Weingarten says. “These affiliations by organizations that are respected leaders in their states represent a vote of confidence in the AFT as a union with a proven track record of standing up for professionals.”
AFT’s reputation for organizing was one of the main reasons Humphreys supported the partnership. He’s excited about the prospect of having a real voice in the implementation of the Affordable Care Act. “We will have a bigger platform to keep ACA in the forefront, so it will not be diluted,” says Humphreys.
The U.S. now is facing a shortage of primary care providers, and the ACA will extend coverage to an additional 32 million Americans over the next several years. To prevent that shortage from becoming a crisis, nurses are expected to play an even more central role in the delivery of care. The changes brought about by the ACA will require some redesign of the healthcare system to eliminate restrictions on nursing practice, as well as changes in coverage and payment rules to recognize this expanding role for nurses.
It’s critical that nurses have a strong union in this time of transition for America’s healthcare system. “Nurses are the most trusted healthcare providers, and this new partnership with the AFT will enable us to continue to be the voice for the patients we serve,” says Barbara Crane, president of the NFN and a registered nurse.
Affiliation with the AFT will augment the NFN’s advocacy in the workplace, and with state and national policymakers, because nurses will play an even larger role in maintaining high-quality patient care in a changing health system. “This affiliation is an unprecedented opportunity for staff nurses across the country to enhance their professional influence through collective bargaining,” says Crane.
This affiliation agreement “holds the potential to create a new kind of nurses’ organization,” says Candice Owley, president of the Wisconsin Federation of Nurses and Health Professionals, a registered nurse in Milwaukee and an AFT vice president.
The fast-paced changes of the healthcare industry require that nurses on the frontlines have the ability to speak up on behalf of their patients, says Kelly Trautner, deputy executive officer of the Ohio Nurses Association. “Whether in Columbus or on Capitol Hill, nurses stand for quality care, for high standards and for improved working conditions,” she says.