Six minutes into Janelle Stewart’s 4th grade physical education class in February, one of her students dropped her jump rope and bent over. She had asthma and couldn’t breathe.
The girl was new to the school and didn’t have a health care plan on file. She didn’t have an inhaler, and the school, Williams Elementary in Flint, Michigan, didn’t have a nurse on staff.
Without a nurse she could consult, Stewart wasn’t sure what to do, and the girl’s breathing wasn’t getting any better. Stewart stayed with her class while the girl’s homeroom teacher took her to the office and called 911. “It took about 10 or 15 minutes for the ambulance to get there,” Stewart says. “It was the longest 10 or 15 minutes of our lives.”
The student recovered, but those nerve-racking minutes might have been avoided if a nurse had been on site.
Faced with tough funding decisions and No Child Left Behind’s increased focus on academic basics, many states have cut school nursing positions along with other services.
In Michigan, there is one nurse for every 3,611 students; the two assigned to Williams Elementary are based in a middle school several miles away.
Nationwide, the average school nurse works in 2.2 schools and cares for 1,151 students, according to the National Association of School Nurses, which suggests the ratio should be one nurse for every 750 healthy students.
Legislators in Utah passed a bill in March that set aside $1 million to add 14 school nursing positions statewide; additional funding from districts will bring the total to 30. Lawmakers in the state—where the nurse-to-student ratio of one to approximately 6,000 is the worst in the country, according to NASN—voted in response to a grassroots campaign by a Tooele, Utah, mother whose daughter nearly died during an asthma attack at a school without a nurse.
Asthma’s not the only medical problem in classrooms these days; children whose conditions once kept them out of mainstream public schools are now more likely to enroll, and chronic disease rates have risen.
According to 2005 statistics kept by the Centers for Disease Control and Prevention and monitored by NASN, 5 percent of children have a food allergy, 12 percent have asthma, 13 percent regularly take prescriptions, and 5 percent will have at least one seizure.
Last year, one of teacher Becky Arnott’s special education students at the Floyd I. Marchus School in Concord, California, had type-1 diabetes. The on-site nurse taught Arnott to watch for warning signs and keep track of the student’s carbohydrate intake. Because of this training, Arnott noticed her student’s groggy behavior one day and knew to immediately give him some juice.
Teachers like Arnott have been active in the call for more school nurses. In 2002, the American Federation of Teachers passed a resolution calling for a full-time nurse in every school. The group also launched a public awareness campaign called “Every Child Needs a School Nurse.”
But such efforts face obstacles. Curtis Washington, a science teacher at Mills High School in Millbrae, California, testified before the California State Board of Education in February 2003 after a 17-year-old died of cardiac arrest on campus. Today, Mills High School still does not have a full-time nurse.
A version of this article appeared in the May 01, 2007 edition of Teacher as On Call