Boston Globe: Officials see a shortage of school nurses in Mass.

[url="http://www.boston.com/news/local/articles/2005/08/30/officials_see_a_shortage_of_school_nurses_in_mass/"]http://www.boston.com/news/local/article...nurses_in_mass/[/url]

---------------------
[i]Officials see a shortage of school nurses in Mass.[/i]

With ailments rising, more funding sought
By Raja Mishra, Globe Staff | August 30, 2005

Even as childhood afflictions such as food allergies and asthma proliferate, many Massachusetts schools this year will be forced to share nurses, potentially leaving vulnerable hundreds of students who increasingly depend on schools for healthcare, officials and lawmakers said.

A recent internal survey by the Massachusetts School Nurse Organization found that about 1 in 8 school nurses in the state serve two or more schools. State lawmakers estimate that at least 150 of the state's 386 school districts do not have a nurse for each school.

Parents, children's advocates, and lawmakers worry that with youth health problems on the rise and health insurance coverage in decline, student health may be compromised.

The nurse shortage appears to be most severe in Western Massachusetts. Major urban areas including Boston, Salem, Springfield, New Bedford, and Worcester also fall short of having a nurse for every school, superintendents and nurses said.

A coalition of more than 40 state lawmakers has proposed requiring a nurse in every school, which would overhaul the century-old law that requires only a nurse for each school district.

In addition, lawmakers asked Governor Mitt Romney yesterday to approve $4 million this year for school nurses and school-based health centers. They want more than triple that amount in 2006.

''You are seeing kids with juvenile diabetes, cancer, allergies, asthma," Representative Jennifer L. Flanagan, a Leominster Democrat who sponsored the bill, said at a news conference yesterday, according to State House News Service. ''Those are not simple illnesses that can be taken care of by the teachers, and we shouldn't really ask them to. If you have a student on insulin, what happens if the child runs into problems and the nurse is across town?"

Far from simply taking temperatures and dispensing aspirin, modern school nursing has become increasingly complex, with rising childhood obesity, the mainstreaming of disabled students, and an increased awareness of allergies.

''There's some really unusual and life-threatening conditions that youngsters come to school with," said Lowell Schools Superintendent Karla Baehr, whose district has nurses in every school save for a few elementaries. ''In some cases, a school nurse provides primary care for many kids."

According to the state, 54,000 children lack health insurance.

State health officials said statewide school statistics are not rigorously kept. But the survey conducted by the Massachusetts School Nurse Organization and shared with the Globe offers a snapshot. The group surveyed more than 600 school nurses, about a third of the state total. In their replies, 560 said they covered just one school, while 56 covered two schools, and 13 covered three or more.

Compared with previous studies, the ''numbers have been improving," said Marie DeSisto, Waltham schools' nursing director and president of the Massachusetts School Nurse Organization. DeSisto said the survey indicated that nurses from Western Massachusetts were more likely to service more than one school than their counterparts in the eastern part of the state.

Many urban areas also had more schools than nurses, she said. For instance, Boston had 85 nurses for more than 140 schools. She said many school nurses leave the job because of money.

''Lack of equity in pay was the top reason for nurses leaving," said DeSisto. ''It can be demoralizing."

Over the last decade, budgetary pressures forced school districts to freeze nursing salaries or eliminate positions, said school nursing specialists. But pressure from parents has caused many districts to reallocate funds to nursing or find money elsewhere, they said.

''What we have found is that school districts are recognizing the importance of this. They look for the dollars and do the best they can," said Sally Fogerty, associate commissioner for the state Department of Public Health.

For the upcoming school year, 103 districts will get state grants to help fund their nursing programs, said Fogerty. Brockton is one of them. ''We have a nurse in every building," said Jocelyn Meek, spokeswoman for Brockton public schools. She said $184,000 in state grants and increased pressure to address health needs prompted the district in recent years to hire a nurse for each school.

''We have diabetics, medicines that need to be dispensed every day," said Meek. ''We've decided it's beneficial to have someone on site to handle those issues."

Waltham schools decided to place a nurse in each school in 1999, primarily because of increased food allergies, DeSisto said. Soon Framingham, then Lexington, then Belmont followed suit. Parent pressure played a key role in all these districts, she said.

''I think parents assume there is a nurse in every school. But it really isn't so," DeSisto said. ''The parents are the ones who have to speak up."