A few months ago, a school nurse in San Diego e-mailed California Connected with the following account:
“School nurses in California are often the primary health care provider of students. They carry caseloads from 500 to 3000+ students. There are many students who are medically fragile and require extensive nursing procedures… School nurses are not mandated by law. They serve at the pleasure of the School Board. When APIs [standardized test scores] must go up in order to continue State and Federal revenues, the first cut are those services not required by law—school nurses. The evidence indicating, ‘healthy students will learn better’ gets lost in the money scramble.”
We listened to her dire outlook and took action. We revisited “Our School,” Mount Vernon Middle School in Los Angeles, the school we continually followed last year, and decided to spend a day with the school’s nurse.
Her name is Belinda DeShay, and she handles the bumps, bruises, headaches and leg breaks for all 1,850 students on campus. But De Shay actually has it better than most. On average in California, there is one school nurse for every 2,281 students. In fact, more than 25% of public schools in California have absolutely no school nurse.
More problems are created at inner-city schools dealing with poverty, where families are less likely to have health insurance, and the school nurse may be their primary source of health care. That also may explain why De Shay has less than 20 prescribed medications in her office—that’s out of 1850 students.
In a survey of 23 states conducted by California’s Department of Education, California was third from the bottom with regard to nurse to student ratio—followed by Florida and Utah. Those states topping the list, including Massachusetts and New Jersey, have legislation mandating at least one nurse for every school—averaging less than 550 students to every school nurse.
Nurse De Shay says she would love to handle only 750 students, as recommended by the National Association of School Nurses. However, in the current climate, she does not expect that to happen any time soon.