In an effort to streamline the traditional position of the school nurse, the D.C. Department of Health plans to change the way nurses are assigned to city schools – reducing many full-time workers to part-time status. And while the new approach to in-school health care for students would incorporate a more preventative and community-based model, parents fear the changes would eliminate a necessary first-responder in cases of emergency.
The new strategy, which goes into effect January 2017 – based on the CDC’s “Whole School, Whole Community, Whole Child” model – will maintain schools’ nurse coverage based on the overall health of the student body and the number of chronic health conditions within the student population. According to LaQuandra Nesbitt, who leads the city’s health department, there would be no actual reduction in school health care but instead a redistribution of staff and resources.
“[We are] transitioning from a model that is about 20 years old to a newer model that improves the structure of the program to provide a more comprehensive service to our children and families,” said Dr. LaQuandra Nesbitt, director of D.C. Department of Health. “What we are doing here is we are transitioning from a nursing-only model to a more comprehensive approach.”
But many parents, including Courtney Solomon whose daughters attend Amidon-Bowen Elementary school in Ward 6, said reducing the number of hours that nurses are on duty at schools is tantamount to crossing a highway while blindfolded. “The school nurses are necessary functionaries of every school because too many variables are unknown when dealing with children, too many potential dangers are around them,” Solomon told the AFRO. “What galls me is that as soon as DCPS became majority minority, the very critical administrators we’ve always relied on are being classified as ‘optional,’ which could be of detriment of our kids.”
The District of Columbia Nurses Association (DCNA) announced support for legislation requiring a nurse in every school for 40 hours per week, in a statement that read in part that students in other jurisdictions, including Philadelphia, have died in the absence of a school nurse. “DCNA believes that the District of Columbia will cut the funds of nurses in the school system which could lead to fewer nurses in the school system. The bottom line is that it is the duty of the DC Public Schools to protect our children and that means we need a nurse in every school throughout each school day,” the statement read. “The District of Columbia law only requires a school nurse in every school for 20 hours per week. We need a nurse in every school for 40 hours per week. It is time for the District to put the health of the children first. They deserve it.”
Many jurisdictions do not have an adequate number of nurses in the school system because of cost-saving measures, despite an increase in the number of students with chronic health conditions, including as many as 18 percent with diabetes, hypertension, asthma, and food allergies. School nurses monitor asthma, diabetes, and many more chronic diseases.
“Students with life-threatening allergies and/or asthma have complex medical needs. Nurses provide a vital function in keeping these students safe and healthy. Although laypersons are often instructed about and tasked with medication administration, they can never fully replace the school nurse,” Asthma and Allergy Foundation of America President and CEO Cary Sennett said in a statement to D.C. Council member David Grosso (I-At Large). “The school nurse has the unique skills and training to evaluate medical situations and make appropriate care decisions. For children with life-threatening conditions, this could mean the difference between life and death.”
On Oct. 27, Grosso introduced emergency legislation to push the January implementation until the new academic year, in August. However, more than 1,500 parents have signed an online petition calling for a full-time nurse at every D.C. school.