Schools struggle to find nurses
By MELANIE AVE, Times Staff Writer
TAMPA -- The little girl in capri pants complained to her teacher all morning before she finally ended up in the school clinic.
"What hurts?" asked registered nurse Scottie Gursky, slipping a thermometer under the girl's arm.
"My throat," the girl answered, muffling her words with her fingers.
"Your toe?" Gursky asked.
"Throat. It hurts bad," the girl said. Then she opened her mouth to say, "Aaaah."
On this day, the aching kindergartener was one of more than 20 children who streamed through the Foster Elementary School clinic hoping to be helped or sent home by school nurses.
Their complaints were varied: Headaches. Tummy pains. Asthma. Diabetes. Injured hand. Even a loose tooth.
But at least this school has a nurse. Two, in fact.
Because of money, many schools in the Tampa Bay area have none. The nationwide nursing shortage is a big problem for local school districts. Hillsborough has struggled to fill as many as 17 nursing vacancies this year. Pinellas County is looking for only one registered nurse, but that's because the school district has relatively few positions.
Most Pinellas schools have a nurse only one day a week. The district average is one nurse for every 3,615 students.
Karen Brown, Hillsborough's director of student health, describes the hiring problem as serious.
Though local school districts have few problems recruiting highly trained registered nurses, hiring and keeping licensed practical nurses is difficult.
Hospitals, nursing homes and home health care companies can pay almost double the $10 hourly wage paid by most local school districts.
"Hospitals are paying bonuses," Brown said. "We don't do that. We can't do that."
Marilyn Koop, supervisor of Pasco County's student health services, says scheduling is another problem.
Not only do school districts pay less than the private sector, they offer nurses fewer hours. Instead of working year-round, school nurses only work when school is in session.
"Because of that, we sometimes have trouble holding on to" them, Koop said.
The National Association of School Nurses recommends one registered nurse for every 750 students. The Florida Department of Education standard is one registered nurse for every 1,500 students.
Only Pasco, which has one registered nurse for every 1,495 students, comes close.
Hernando County schools have one registered nurse for every 6,324 students. The ratio in Hillsborough is one registered nurse to 2,341 students.
Those numbers are particularly problematic these days, when increasing numbers of children with severe medical needs are attending school. Some come with catheters; others come with feeding tubes or colostomy bags.
When asked whether she needs more nurses, Diana Dameron, the school health supervisor in Pinellas County, said "always."
"It's just a matter of funding," she said.
The nurse-to-student ratio is somewhat better in Hillsborough, but that can be deceiving. Many schools are still grossly underserved.
Pride Elementary has no assigned nurse for its 950 students. Neither does Bellamy Elementary, which has 800 children enrolled. Plant High School serves its 1,900 students with one registered nurse.
At Pride, office workers often have to administer medications and help with medical emergencies.
"It does take a toll on the office staff," said principal Tanly Cabrera. "It's just a better state of mind when we know someone is here with a medical background."
Brown said the nursing shortage means more children are being sent home or to hospitals, perhaps unnecessarily.
"Do I think there have been dire outcomes? No," she said. "But you don't want one. We've been very fortunate."
-- Melanie Ave can be reached at (813) 226-3400 or firstname.lastname@example.org.
Number of students per registered nurse last year:
Source: Florida Department of Health
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