Giving a voice to school nursing in Georgia

Georgia Nursing, Aug-Oct 2002 by Carmon, Myra

Present Status of School Nurses in Georgia

Data collected by the Children's Health Care of Atlanta shows that 100 districts in Georgia have some School Nurse Program with over 1000 school nurses in place in the state. There are several model programs in Forsyth County (Gainsville), Camden County (St. Marys), and others where they have an all RN staff, while in many other school districts there is a mixture of RN's, LPN's, and Unlicensed Personnel. The School Nurses continue to make a difference in the health of Georgia's children. In Fulton County, within a six month period there were a total of 236,998 visits (mostly ill and injury) to the school nurse: of those visits 183,234 students returned to class and only 36,704 were sent home. There are thousands of dosages of medication given each day in all of the schools. Some of the most prevalent medications include Ritalin, asthma inhalers, and insulin for the diabetic children. School Nurses giving and supervising the administration of medication ensures decreases in medication errors that have been reported in the past.

There are many children with chronic conditions that are in the classroom and requires special care from the school nurse during the school day. There are many procedures to be performed by the school nurse for these and all children in the school. Some of these procedures include catherizations, tube feedings, colostomy care, suctioning, care of child on the respirator, dressing changes, and care of children due to accidents and injuries.

School-Based Nursing and the Nursing Shortage

Nurses applying for the school nurse positions are not nurses presently employed in agencies, they are mothers who have been stay-at-home mothers who want to work the hours that their, child is in school. They are willing to work for low salaries to keep the same schedule as their children. At this time, low salaries are a point of contention and discussion among school nurse groups. The budget crunches over the last year has prevented any possibilities of adding funding for the school nurse positions.

Some Legal Aspects of School Nursing

It is within the scope of practice of the RN to be a school nurse and function independently in school clinics but the scope of practice for the LPN requires supervision by a RN or physician. There are other screening restrictions for the LPN, also. Dental screening can only be performed by the RN, dental hygienist, or, dentist. At present, the legislation is not being enforced as to personnel. Continued efforts are being made as to recommendations to the State Board of Education.

Continuing Efforts Toward School-Based Health Programs

There is an Advisory Panel on Student Health Achievement appointed for this purpose and I serve on the committee. The Advisory group has representation from health, education, hospitals and other agencies. The group will make a recommendation to the DOE Board of Directors.

School Health Program with School Nurses do make a difference in decreasing absenteeism, decreasing emergency room visits, and better compliance with chronic illnesses such as asthma and diabetes. School nurses need to increase their voices, gain power through visibility, viability, and value. This can be achieved through marketing and political involvement in communities and at the state level.