Tuesday, September 16, 2008

Where's the Nurse??

Oregon ranks 49th in the nation for nurse to student ratio in our schools. This is appalling! We have kids with physical disabilities who are having medical intervetions done by people who have had these tasks "delegated" to them by nurses? How can anyone possibly say that students receiving Special Education services are in good hands in the state of Oregon? And... It's not just students with disabilities who are being short changed. It's ALL our students! This comes from Oregonlive.com.

Oregon faces a severe shortage of school nurses
by Don Colburn, The Oregonian
Monday September 15, 2008,
Oregon faces a severe shortage of school nurses as growing numbers of students have chronic illnesses or conditions that require special medical attention, a state task force warns.
Seven of eight Oregon school districts fail to meet the widely accepted national guideline for nurse staffing, the task force found. Students in 54 districts have no access to a school nurse.
Oregon ranks 49th among states and the District of Columbia for its low nurse-to-student ratio: 1 nurse per 3,142 students. Only Utah and Michigan score worse, the National Association of School Nurses says.
Availability of school nurses in Oregon
• 54 districts representing 21,006 students don't have access to a school nurse.
• 42 districts representing 38,221 students have access to a school nurse less than half the time.

• School nurses serve an average of four to six schools (16 percent serve more than 10 schools)

• The average school nurse's caseload is 1,000 to 2,000 students; 21 percent serve 3,000 to 5,000; 9 percent serve 5,000

For the full report, click here.

By contrast, top-ranking Vermont has one school nurse per 275 students.
"If Oregon is invested in the academic success of the state's children, the health needs and associated requirements at school must not be overlooked," the Task Force on School Nurses said in a report to be presented to legislators today in Salem.
Oregon lacks enough school nurses to address students' day-to-day needs and meet required health policies, "let alone adequately serve the students who have serious health needs," the task force warned.
A coalition of education and health groups, including the American Academy of Pediatrics, supports national guidelines for school nurse staffing levels, which call for one nurse for each 750 students -- more nurses if a school has a high percentage of students with special medical needs.
Only 12 percent of Oregon school districts meet that. Several factors are at work, including budget cuts dating to the early 1990s, school growth and increased mainstreaming of children with disabilities and special needs.
"Schools have changed," said Nina Fekaris, the task force co-chairwoman and a nurse in the Beaverton School District for 20 years. Federal law requires all children to attend school in the least restrictive environment and receive individualized education, as well as related health services, if necessary.
"But if we really want kids to learn up to their potential, we've got to keep them in their seats -- and healthy," Fekaris said. "And if you have a full-time nurse in the building, absenteeism decreases."
About 60,000 Oregon children have no access to a school nurse for at least half the year. That is especially worrisome, Fekaris said, because an estimated 116,000 Oregon children have no health insurance.
Ideally, all schools would have an assigned nurse available every day, the task force said. But school nurses in Oregon "are assigned to multiple schools and not always on site." As a result, they delegate nursing care to staff without nurse training.
"It is frightening for many to perform nursing procedures such as oral suctioning, injection of medication and replacing a colostomy bag," the report said.
The traditional role of the school nurse centered on health screenings, shots and prevention of communicable diseases. Today's school nurse must handle those tasks -- and more. Some children come to school with feeding tubes, tracheotomies or heart shunts.
Additionally, a survey of Oregon teenagers found that 14 percent of eighth-graders reported missing at least one day of school during the previous month because of asthma.
And an estimated 1,800 Oregon children ages 10 to 17 were treated at hospital emergency rooms after attempting suicide in 2004.
The Legislature established the eight-member task force last year through legislation co-sponsored by Rep. Tina Kotek, D-Portland, and Sen. Laurie Monnes Anderson, D-Gresham.
Task force leaders will present their findings and recommendations at a joint hearing of the House interim committees on education and health care.
The task force recommends that the Legislature mandate increased numbers of school nurses to bring Oregon up to the recommended national staffing standard over the next 10 years.
But officials face two big challenges, said Dr. James Lace, a Salem pediatrician and task force member. One is the shortage of trained nurses, and the other is budgetary.
"Where in the dickens," he said, "are we going to get this extra money?"

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