Nurse-student ratio too low
© St. Petersburg Times
published October 6, 2002
The Hernando County School District lags far behind the state average in the important categories of how little it pays teachers and how little money it keeps in reserve funds. Those shortcomings have been widely reported and discussed, yet they remain challenges to be overcome.
Now residents must add student health care to that list of insufficiencies.
The Times reported Friday that in the 2001-02 school year, there was only one registered nurse per 6,324 students in Hernando County. That's more than twice the state average of 2,660 students per registered nurse and by far the highest of all counties in the Tampa Bay region. (See accompanying chart.) It also is four times less than the state Department of Education's recommendation of one registered nurse for every 1,500 students, and nowhere near the National Association of School Nurses' standard of one RN per 750 students.
Hernando County's numbers are a little better now because the district has hired two more registered nurses since the state Department of Health released its figures. But even with those hires, there is only one registered nurse per 4,500 students in the county, and that is a problem that needs to be addressed by the School Board and the Florida Legislature.
There are 18 schools in the district, and there are only four registered nurses, four licensed practical nurses and seven certified nursing assistants. In addition, each school has a "school health professional" that is trained in CPR, first aid and dispensing medication. In addition, the county Health Department has three registered nurses who are on loan to the district and travel from school to school as needed, with emphasis on educating the other schools' caregivers.
The district's health care budget for salaries and benefits is only about $314,000, and that does not include clinic supplies such as bandages and thermometers. All that money is taken out of the same coffers that are used to buy books and pay teachers.
Clearly the district is not paying the nurses as much as they can earn at hospitals or nursing homes, which makes it difficult to recruit and retain qualified workers. That problem is a national one.
Just as clear, however, is that without designated funding from the state, the school district could not hire more nurses, or pay the existing ones what they're worth.
Four years ago, state Sen. Ginny Brown-Waite, R-Brooksville, and Rep. Les Miller, D-Tampa, sponsored a bill mandating that every elementary school in the state employ a full-time registered nurse. It was a good bill, but it was defeated, partly because of the $60-million price tag, but mostly because the Legislature's leadership had its priorities misplaced.
The need for on-site registered nurses is greater now than ever before because there are more special needs students being mainstreamed into classrooms. Instead of bandaging cuts, soothing tummy aches and preventing the spread of head lice, school nurses today are changing gastro-feeding tubes, injecting insulin, and dispensing mood-altering drugs such as Ritalin.
Parents are asking, and expect, more of the nurses, and the School Board has a responsibility to meet that demand. While it may not be financially feasible to place a registered nurse in every school in the county now, the board should not shy away from that goal, including setting a timetable to reach it.
For now, though, the board should do what is necessary to bring Hernando County up to at least the state average.
At the same time, the School Board should lobby state legislators to develop a designated funding source to help local districts pay for the health care of students, including sharing the cost of school nurses. Resurrecting the 1998 bill introduced by Brown-Waite and Miller would be a good start.
Number of students per registered nurse last year:
-- Source: Florida Department of Health
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