Education Law

School Nurses Are Rare

Kids get sick and they play rough. They're simple facts of life. Put hundreds of children in the same building, all day long, five days a week, and the odds of your child becoming ill or taking bumps and bruises go up dramatically.

Who does your child go to when she's sick or gets hurt at school? Your knee-jerk answer is probably, "A trained medical professional, like a nurse," right? You may be surprised.

Rare Breed

According to the National Center for Education Statistics and the National Association of School Nurses (NASN), only 45 percent of the public schools in the US have a full-time nurse, 30 percent have a part-time nurse and 25 percent have no nurse at all. Also, the NASN recommends, as a minimum, that there be one registered nurse for every 750 students. Not many states meet this goal.

What happens when there's no nurse at all? The task of caring for the students usually falls on the school principal, a secretary or a teacher.

Types of Nurses

When it comes to school nurses, you'll most likely come across one of two types of nurses: registered nurses (RNs) or licensed practical nurses (LPNs). Each state has its own laws about education and licensing requirements for each type. There are also laws on what medical activities each type can and can't do. In general, though:

  • RNs have a two- or four-year college degree and pass an examination to become licensed or certified in the state where they work. Because of their advanced training and education, RNs can perform a variety of medical activities, such as create health care plans for patients, administer practically any medication and make independent decisions about how and when to treat an injury or illness
  • LPNs must have a high school diploma, complete a one-year nursing program and also pass an examination for a license. The test is much different than the RN test. LPNs have to be supervised by a doctor or an RN, and they usually perform duties like taking temperatures and administering some medications

Both RNs and LPNs have advanced training in emergency first aid and CPR.

School Rules are Different

When it comes to school RNs and LPNs, the states have different laws, too. For example, some states, like Connecticut, require school boards or districts to hire at least one school nurse. Other states, like Texas, have no such requirement.

The rules vary on other matters, too. In Connecticut, for example, the school district nurse must be an RN, have at least one year of experience and a valid state license. In Texas, if a school or district decides to hire a nurse, he must be licensed by the state.

The NASN recommends against having only an LPN in a school setting. That's because they don't have the training RNs have at recognizing the differences between minor and major health problems and determining the proper amount of medication to use, for example. However, many schools follow Connecticut's lead and hire LPNs to help RNs.

An Even More Rare Breed?

The Great Recession had an impact on school nurses. And it may be long lasting. States and cities are dealing with budget cuts and crunches, and school nurses are an easy target to cut costs and save money. Obviously, this means your child may not get quality, immediate medical assistance if something happens at school.

It's even more bleak for parents with children with pre-existing or chronic problems, like diabetes. They typically rely on school nurses to make sure their children get the proper medical attention.

What You Can Do

Your child's health and safety are your primary concerns, right? Take steps to protect them.

All Parents

Every parent, whether your child is healthy or has a chronic illness like diabetes or asthma, should:

  • Find out exactly who's in charge of medical care at your school and that person's qualifications
  • Ask about the school's policy or guideline on how, what, when and by whom any medications may be given to your child

Students with Chronic Conditions

Your child's chronic illness or medical condition may require some extra steps:

  • Make sure there's someone at the school who's qualified and able to help your child, if needed
  • Be certain the school has on hand a supply of any medication your child needs
  • To the best extent possible, teach your child when, how and how much medicine to take

Fix the Problem

Take action to fix the situation at your school:

  • Go to PTA or PTO and school board meetings and let them know what you think needs to be changed and how
  • Contact your state lawmakers and ask them to find the money to pay for a school nurse or find other budget cuts
  • Consider volunteering some of your time at the school if you're a nurse or have medical training

Certainly no one wants their child to get sick or injured at school, but the fact is, it happens. Do everything you can to make sure your child gets the proper medical care and attention when it does happen.

Questions for Your Attorney

  • Can a nurse or anyone else at school give my child over-the-counter medication without my permission?
  • Is my school legally required to allow me to come to school each day and help my child take his medication?
  • Is there anyway parents can check to make sure a school nurse's license is valid and in good standing? What about if he's been part of a disciplinary proceeding?
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