Nationwide School Nursing Shortage

Budget cuts have left many school districts understaffed for nurses, having only one district nurse available for 30+ school campuses. What is a child to do when s/he needs immediate care and the nurse is miles away?

Currently, no nationwide standard exists for School Nurses and the services that must be offered or provided at primary education campuses. In fact, mandated requirements vary widely from state to state. Federal guidelines, which are only guidelines and not requirements, and the National Association for School Nurses suggest a ratio of one nurse for every 750 students. The national average is one nurse for every 950 students. More alarmingly, some nurses have the responsibility for thousands of students. With the overburden of that one nurse and the under-education and lack of preparation by unlicensed administrative staff, costly errors are more likely.

As a result, thousands of students with a variety of chronic medical issues, acute physical distress, and even emotional or mental health issues are left without coverage. Many nurses now attempt to educate school staff to leave behind some level of care when they are not available. However, panic and pressure often lead to critical and even deadly mistakes.

• A 17-year old senior in Millbrae, CA collapsed during badminton practice and died of cardiac arrest. The school had no nurse on site.
• An 11-year old student with a severe asthma attack alerted the administrative staff. In the panic, no one knew how to assemble his nebulizer. The 5th grader died.
• A 13-year old girl with cerebral palsy was sent home on the school bus with an urgent health note. The young girl died on the way home.
• An 11-year old child died due to child abuse. The school nurse was charge with failing to report suspected child abuse. The parents were later charged with the murder.
• A 10-year old girl who suffers from seizures panicked during an asthma attack and, accidentally, overdosed on her reliever medication. The school had no nurse on site that day.

The state of Utah is the most challenged, having the worst recorded nurse to student ratio. The National Association of School Nurses estimated that in 2004, the nurse to student ratio was one nurse for every 5,834 students. Many people believe that there is a nurse in every school. Clearly, that is not the case and as students come in with injuries and more complex chronic issues, an answer needs to be found.

Horovitz, B. Instead of a Nurse, A Locked Door.
USA Today: December 13, 2005, p. 13A

Horovitz, B. and McCoy, K. Nursing Shortage Puts School Kids At Risk: Schools Try To Get By With No Nurses At All Or Just One To Care For Thousands Of Students, In Some Cases With Dire Consequences.
USA Today: December 13, 2005, p. 1A

McCoy, K School Blamed in Boy’s Death.
USA Today: December 13, 2005, p. 13A

McCoy, K. Utah Mom on a Mission in State with Few Nurses.
USA Today: December 13, 2005, p. 13A