Iowa schools stretched to meet nursing law

[cougarnurse]

OK....: Iowa schools stretch to meet nursing law | DesMoinesRegister.com | The Des Moines Register

Dozens of Iowa school districts have come up short on a 2007 law that requires them to hire registered nurses, which administrators say are expensive and in short supply.

At least 38 small school districts have no qualified nurses, state records show. State waivers have bought most of them more time.

Other school officials hire nurses for a few hours a week, which often leaves secretaries to treat sick students or call for help in emergencies.

"We wouldn't think that's appropriate in a nursing home or in a hospital," said Sharon Yearous, who heads the Iowa School Nurse Organization. "Why do we think it's OK in schools?"

Today's school nurses deal with a lot more than head lice and tummy aches. More U.S. children are overweight, uninsured, disabled or depend on prescription drugs.

Public schools are also bound by regulations on everything from peanut allergies to student vaccinations.

School nurses or health services were mandatory in 28 states in 2006, according to the National Association of School Nurses.

Iowa schools could get by without nurses until 2007, when state lawmakers agreed every district should have at least one.

The positions must be registered nurses, who are specially trained and licensed.

School officials say the nurse requirement is a stretch, particularly for rural districts that can't afford competitive salaries. Iowa's registered school nurses earn, on average, more than $35,000 a year.

"There seems to be a shortage of them in all areas right now, and they could earn a pretty good wage going to the hospitals or clinics," said Rick Pederson, superintendent of the Sumner and Fredericksburg school districts. "How does the school compete with that?"

Officials in Fredericksburg, a Chickasaw County school district of 341 students, didn't have a nurse when the law passed, so they bought a fifth of the school nurse's contract in nearby Sumner.

The nurse, Erica Luebbers, spends four days a week with children in Sumner. She splits her fifth day between two schools 13 miles away in Fredericksburg.

"I don't think it meets the spirit of the law," said state Sen. Michael Connolly, D-Dubuque, who pushed for the requirement in 2007. "One day a week isn't sufficient."

Luebbers worries that children in one district will suffer if she's tied up in the other. She also worries that her nursing license is on the line if something goes wrong.

"I think that a lot of people perceive school nursing like when they were in school," she said. "Times have changed so much. Rarely do kids come in with just a little owie."

Iowa's school health care costs have skyrocketed from $9.9 million in the 1987-88 school year to $32 million in 2006-07, state records show.

Much of the increase stems from federal efforts to mainstream mentally and physically disabled children into public schools, health officials say.

Nurses see children who have diabetes, seizures, cystic fibrosis, autism and scores of other health conditions.

"With these chronic health needs come the need for special transportation, more special education teachers and associates, and more health care providers," said Barb Allen, a nurse at Summit Middle School in Johnston.

Nurses in Iowa's largest school districts say the workload is overwhelming - one registered nurse for 2,000 students in some cases - but at least the expertise is there.

That hasn't been the case in many small school districts.

Nearly 100 Iowa school districts had no nurses in 2006, state records show. The next year, state lawmakers agreed that school districts should have at least one registered nurse.

"They are as important in the high school as the teacher in the classroom," said Connolly, the Dubuque lawmaker.

Rose Foubert doesn't see it that way.

Her son's small school district, English Valleys, has no nurse. But it has employees who are emergency medical technicians, secretaries who are trained to dispense medicine and teachers who know their students' parents, she said.

"I feel comfortable with what we have," said Foubert, a business owner in North English. "I would say it doesn't need to be mandated."

Several Iowa school districts have taken advantage of state waivers that provided them time to meet the nurse requirement.

State records show officials in 44 school districts asked for waivers in the 2007-08 school year. Thirty-eight of them asked for waivers this school year.

The option will disappear by next fall.

Judy Jeffrey, director of the Iowa Department of Education, predicts that school officials will ask lawmakers for more time to hire nurses. "If they can't fill it, we should give them more time but not take the requirements away," Jeffrey said.

School officials say lawmakers should have set aside money for nurse salaries, especially for rural school districts that are battling budget problems fueled by declining enrollment.

"We don't have the luxury of new money because we don't have new students," said Superintendent Russ Freeman, whose Battle Creek-Ida Grove school district received a nurse waiver this year.

Connolly, the Dubuque senator, said schools receive a bigger chunk of state money through allowable growth each year.

School officials can also turn to a state school budget review committee for permission to spend more money than they're authorized.

Between that and a two-year deadline to meet the law, "we've tried to cushion the blow," Connolly said. "They can do it if they really want to get it done."

Again, read this thread: Teachers become 'nurses'