One school. One nurse.
That is the policy being recommended in a report released today by the American Academy of Pediatrics (AAP).
The organization says the current standard of one nurse for every 750 students is inadequate because it allows for nurses to be spread out over several schools in some instances.
The AAP says it’s crucial with today’s obesity epidemic and rising tide of chronic illnesses to have a registered nurse (RN) stationed full-time on every campus.
“Kids don’t schedule their emergencies. You never know what’s going to come in the door,” Anne Sheetz, R.N., the retired director of school health services at the Massachusetts Department of Public Health and a co-author of the AAP report, told Healthline.
The Need for Nurses
According to the National Association of School Nurses, about 82 percent of schools in the United States have a part-time or full-time school nurse, said Beth Mattey, a school nurse in Delaware who is also president of the National Association of School Nurses.
However, many of those nurses work at several campuses throughout a district and are at any one school only part of the week.
Sheetz and her report co-author, Dr. Breena Welch Holmes, a pediatrician and clinical associate professor at the University of Vermont, say nurses are trained to make the quick decisions and provide the essential treatment needed at schools.
“It’s one of the last open door clinics for kids,” said Sheetz.
The co-authors added school nurses are even more crucial these days because of the increase in chronic conditions.
More children suffer from obesity as well as asthma, autism, eating disorders, food allergies, and attention deficit hyperactivity disorder (ADHD).
In addition, children with problems who used to attend separate classes on another campus are now more often being mainstreamed into regular classrooms.
“A nurse can really get to know all the children in a building,” said Sheetz.
Mattey echoes the sentiments. “It’s a need in our schools. I see it every day.”
She added that school nurses could also counsel students as well as make sure medication is taken on time.
“School nurses are many times the only practitioner at a site,” Mattey said. “Children don’t leave their healthcare needs at the door.”
Show Me the Money
The big question is how to pay for this full-time school nurse staffing.
For the past couple decades, nurse positions have been cut as school districts grapple with tightening budgets.
The National Education Association and the National School Boards Association didn't reply to Healthline's request for an interview for this story
Nurses, though, told Healthline the money spent on school nurses is well spent.
“We can’t afford not to,” said Holmes.
For starters, she said, nurses help keep children in class. That not only helps schools with average daily attendance funding, it also helps keep students on track in their courses.
“Healthy students are better learners,” Holmes said.
It also reduces the need for parents to leave work or home and come to school to pick up a sick child.
A 2014 Kaiser Health study determined that without a school nurse on campus, teachers spend 26 minutes a day each on health-related matters. With a school nurse around, that number drops to 6 minutes a day.
That, the study authors concluded, saves school districts significant money.
Mattey says some districts are using creative methods to find funds for school nurses.
Some education officials are seeking Medicaid reimbursements for putting a nurse on staff, she said. Other districts are forming partnerships with local hospitals to get nurses on campuses.
Another survey concluded that for every dollar spent on school nurses, $2.20 is saved in potential loss of time for teachers, principals and, other educators.
“It’s such a small investment for such a huge payout,” said Holmes.