From Houston Public Media:
The number of nurses in Houston ISD shrunk by nearly 50% this school year, prompting concerns about students’ access to medical attention during the school day — especially for kids with chronic illnesses, allergies and special needs.
According to records obtained by Houston Public Media through a public information request, HISD currently has 140 school nurses. This is nearly half the number from last year, when the district had nearly 270 school nurses.
Experts said school nurses have higher turnover rates because they’re often older and retire sooner. And school nurse salaries struggle to compete with positions at hospitals, where they could make up to $30,000 more a year.
Many school districts across the state, including HISD, are also operating with budget deficits.
But Kate King with the National Association of School Nurses said campuses without a strong health care team risk students’ health — and in the long run, their education.
On top of providing first-aid care, school nurses are responsible for conducting health screenings, tracking vaccination records and serving as the main public health point person for hundreds, sometimes thousands of students, she said.
“Data shows that ratios of school nurses (to students) is a safety issue,” King said. “We know that the best model of healthcare is a school nurse all day, every day in every school.”
HISD downplayed the importance of having a nurse in every school.
“School nurse staffing levels are NOT a measure of student safety or health service quality,” an unnamed district spokesperson said in a written statement. “It is critical to understand what school nurses do and do not do in our schools. Nurses do not distribute medicine, cannot write prescriptions, and cannot deliver most medical treatments.”
King said HISD has it wrong. According to her, state law allows school nurses in Texas to administer some medications prescribed by students’ physicians.
“I’m surprised and a little bit amazed at that statement as a whole,” King said.
“Whoever is making the statement doesn’t understand or have a knowledge of what school nurses do … and maybe that’s why they made the statement,” she later added.
The district spokesperson did not immediately respond to King’s critiques, nor did they provide an explanation for the drop in school nurse numbers.
The reality of school medical needs became all too real last August, when a student collapsed and died during a P.E. class at Marshall Middle School in north Houston. It was later revealed that the pads for the automated external defibrillator (AED) in the school’s gym had expired months before the incident — and it’s unclear whether they were replaced before the student collapsed.
More than ‘just Band-Aids, ice and lice’
Texas is one of 30 states that don’t require K-12 schools to have a full-time nurse, according to nonprofit The Network.
School districts nationwide are experiencing nurse shortages.
Although Houston ISD is down nearly 130 nurses from last year, the district spokesperson said it has only 12 campuses with nurse vacancies — and that nurses only work for one campus apiece. Campuses that don’t have a designated school nurse include Deady Middle School and Atherton Elementary School.
Too often school nurses are left on the chopping block during times of economic stress, said Texas School Nurse Organization Executive Director Becca Harkleroad.
Last school year, HISD’s first under state-appointed leadership, thousands of campus and district-level jobs were eliminated in response to a financial crunch.
“When they’re looking to cut costs, who are going to be the first to go? It’s going to be the non-required positions in a lot of instances,” Harkleroad said.
And she warned that students with special needs or disabilities are going to be hardest hit by the shortage.
“Any family that thinks that school nurses are just Band-Aids, ice and lice — how fortunate they are that that’s their interpretation of school nursing,” Harkleroad said.
Parents with students who have chronic diseases such as asthma, diabetes and allergies — along with children who have mental disorders such as depression and ADHD — trust certified school nurses much more than other staff faculty who have received medical training, according to a survey by NASN.
“If a parent had a child who had a chronic disease, I would be very concerned to send them to a school where there’s no trained medical professional,” Harkleroad said. “And sometimes parents don’t even know that.”
King argues that school nurses play “a large role in attendance and keeping children in school rather than sending them home.”
She cited a study from the Journal of School Nursing that found students with illnesses or injuries were sent home 18% of the time when evaluated by an unlicensed school employee. Meanwhile, 5% went home after being seen by a school nurse.
Another study found that school nurses save districts money. According to NASN, every dollar spent on school nurses saves $2.20 in medical costs and lost productivity of parents and teachers.
Legislative push
State Rep. Christina Morales, a Democrat who represents part of Houston, has filed a bill that would require all schools to have a nurse for at least half a school day every day.
This is the second time she’s filed this bill, but Morales isn’t hopeful that it’ll even get a hearing this time around because of how expensive it would be for the state.
“If the state paid for it, it would be a huge fiscal note and of course, when a Republican-led legislature sees that huge note, it will be flagged and they’ll vote against it,” she said.
In 2017, Gov. Greg Abbott vetoed a bill that would have required schools to tell parents if they didn’t have a full-time school nurse.
“Our public schools should be focused on educating students in the classroom,” Abbott wrote in his veto letter.
The same bill has been filed again by state Rep. Venton Jones, a Democrat from Dallas, and legislators are expected to discuss it this week.
