An eight-year-long dispute in Rhode Island over a state requirement that nurses working in schools also hold teacher certification and be paid as teachers has been stilled temporarily by the legislature, which has voted to appoint a House commission to study the matter before it will consider requests to amend the law.
Local school committees argue that the requirement, which affects several hundred nurse-teachers across the state, adds unnecessary salary costs to strained district budgets. But teachers’ and nurses’ groups counter that schools have asked nurses to take on teaching and counseling roles in addition to their traditional nursing functions, so their salaries should reflect this.
Proposals advanced by Rhode Island school officials would get around the requirement that every school nurse who does any teaching in health programs also be certified by creating a separate category for practical or registered nurses who command lower salaries. It is an idea, its opponents believe, that will probably surface in other states, as school officials seek to continue services with less money.
Under the Rhode Island law, nurse-teachers assigned to health-education programs must not only be licensed by the state to practice nursing but also must have teaching credentials. According to Mary E. Cole, executive director of the Rhode Island Association of School Committees, the dual-license requirement has been “a pretty costly arrangement’’ for local school systems. She estimated that the dual-certification provision has added nearly $6,000 to the salary of each nurse-teacher.
As a result, local school boards in the state have fought for the past eight years to change the law so that they could have the option of hiring school nurses without teaching certificates to work in the clinics rather than in the classroom.
“We feel we don’t need a certified nurse-teacher in every school,” said Suzanne M. Henseler, a member of the North Kingston school committee, adding that most parents in her community believe that a licensed practical nurse or a registered nurse would provide “better coverage” in the schools.
In 1980, this belief plus the high cost of dual certification led the Cranston school committee to hire registered nurses to replace nurse-teachers, despite the state department of education’s warning that the action violated state law. A year later, the state supreme court upheld the department’s interpretation of the law.
Following that court decision, the state association of school committees drafted a bill, introduced in the the state legislature earlier this year, that would have remedied the problem, Ms. Cole said, by amending the law to permit local school committees to hire licensed practical nurses or registered nurses to work in school clinics.
The bill was opposed by the Rhode Island Federation of Teachers (rift), the National Education Association-Rhode Island, and the state professional nurses’ association.
‘Grandfather Clause’
Ms. Cole said the bill contained a “grandfather clause” that protected nurse-teachers currently employed by state-run schools from being fired.
That bill, however, never got out of committee because of pressure from nurse-teachers and intense lobbying by the two teachers’ unions. Instead, a proposal for an 11-member commission to study the issue was endorsed by members of the House.
Calling the association of school committees’ proposal “regressive legislation,” Robert E. Casey, field representative for the Rhode Island Federation of Teachers, said that the bill would have “adversely affected a couple hundred” union members.
Mr. Casey said the committees’ attempt to establish “two different categories of employees” would not have precluded action to abolish the nurse-teacher positions and then to force the nurses to accept clinical nursing positions for lower wages, despite the legislation’s grandfather clause.
“When the regulations were first issued, requiring that nurses who worked in schools had to be certified as teachers,” Mr. Casey explained, “most of them had to enroll in college programs, and as a result, they were paid salaries commensurate with their training.” As nurse-teachers, he said, they were able to teach family education, health, and first aid, as well as to attend to the medical needs of students and staff.
Their value to the schools has increased along with their duties, according to Mr. Casey, because of federal laws protecting handicapped students. He said many nurse-teachers help assess students who must have individual education plans, required by P.L. 94-142, the Education for All Handicapped Children Act of 1975.
“No one has said the reasons [for dual certification] are not sound,” Mr. Casey said. “It’s strictly financial. It’s all part of the bigger picture prompted by Reaganomics.”
Although the requirements for school nurses vary throughout the country, there has been a trend in the past five years to reconsider the role of school nurses, according to Judith Igoe, an associate professor at the University of Colorado’s school of nursing who has studied the problem. Some states, she said, are upgrading their requirements because of the increase in health ser-vices provided in the schools.
Katherine E. Kruckel, a school-nursing consultant for the New York State Education Department, said declining enrollments and budget reductions increase the desire of local school systems for less stringent state laws pertaining to school nurses. But, she noted, if regulations are substantially weakened, the role of school nurses could be reduced to “Band-Aid and buttonhole operations.”
