Kentucky voices

Ky. Voices: Don't rush to cut nurse staffing at Fayette schools

June 21, 2013 

Carol Komara, a former Fayette County school board member, is a registered nurse.

A recommendation to reduce school nurse services will be before the Fayette County Board of Education on Monday evening.

Currently, there are 26.5 full-time registered nurses that serve over 50 schools. The proposal before the board is to reduce that number to 13 RN's and to hire two full-time, licensed practical nurses and several other LPNs to cover peak times for three hours per day.

Prior to this current proposal, the board planned to oversee the nursing program with a school health coordinator and seek other models of care. Because of the decision to revert to a contract with the Fayette County Health Department, the coordinator has decided to resign. The current proposal is much lower than the staffing guideline of one nurse per 750 children, as recommended by the National Association for School Nurses.

There are many questions that parents of school-aged children should be asking if this is approved.

First, if your child needs medication, who will administer it, or will it be possible to have it administered?

If your child becomes ill at school, who will be there to assess his or her condition and determine if it is an emergency, if the child is contagious or if the child needs immediate care? Additionally, there are many children who have special needs. Parents of these children in particular should be asking about school health nursing services.

There are many models that could work for Fayette County schools. Many school systems hire their own school nurses, and several employ Advance Practice Nurses who oversee teams that deliver school health services. With the changes in health care, school systems can bill directly for APRN services, just as they currently do when children require occupational or physical therapy.

I find it interesting that school-based personnel without medical or nursing knowledge are making this decision based on financial needs and once again deferring to contract negotiations with a financially strapped health department rather than engaging those who work daily with children in the schools.

More importantly, there are many teachers who consult with the school nurse to determine if a child is ill, has allergies, is having trouble hearing, needs vision testing, or has a health problem (physical or emotional) that could impede learning. A team approach works best for assisting these children and school nurses should be a part of that team.

As a former school board member (1978-84) and a current member of the Kentucky Board of Nursing, I implore the school board to delay action on this matter and spend more time developing a model that will best serve the children. It would be helpful to convene a group of community health leaders and experts (particularly pediatricians and school nurses, along with health regulators) to assist with a model that may provide better and more comprehensive school health services.

It is unfair to teachers, school secretaries and others in the school system to be burdened with health matters related to school-age children. More importantly, the well-being of children should be the focus. I hope the school administration and board will embrace their current motto, "It's about kids," and vote down the proposal on Monday's agenda.

Carol Komara, a former Fayette County school board member, is a registered nurse.

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