We are analyzing House Bill No. 1896 to amend and reenact § 22.1-274 of the Code of Virginia, relating to school health services. In § 22.1-274, the bill stated that each school board in VA should strive to employ nursing services consistent with a ratio of at least 1 nurse per 1,000 students as of 1999. The new bill requires rather than suggests this ratio in each school building. This bill also proposes that nursing services shall include the administration of all medication to students. The new bill would no longer require the Board of Education to determine how school health funds are allocated. In keeping with § 22.1-274, nursing services will still be required to have current certification and training in CPR, insulin and glucagon administration, and emergency first aid.
To view the entire text of the proposed bill, visit: http://leg1.state.va.us/cgi-bin/legp504.exe?111+ful+HB1896
The sponsors of this bill are Delegate Lionell Spruill, Sr. and Delegate Rosalyn R. Dance.
Delegate Spruill, the Chief Patron of the bill, is in committee assignments for:
- Counties, Cites and Towns
- Health, Welfare and Institutions
- Privileges and Elections
Delegate Dance, the Co Patron of the bill, is in committee assignments for:
- Appropriations
- General laws
- Privileges and elections
This bill was proposed on January 11, 2011 and was left in the Education Committee on February 8, 2011.
Having been submersed in the local school systems this semester for our Community Health Practicum, we have noticed there is a lack of licensed on-hand nursing services for the student populations. Although we did not know the number of students at each school, it was clear that the need for nursing staff was greater than what was available.
The issue at hand is, even though it was suggested in § 22.1-274, there is not a ratio of 1 nurse per 1,000 students in these schools. This presents a dilemma for school health screenings and individual student medical attention.
Reading this blog, we feel as though there should be 1 nurse to 1000 students. This bill is an appropriate topic for this specific semester because we are seeing with our own eyes the school nurses roles and responsibilities. We believe in order to adequately provide care to students and provide interventions there needs to be a limit to the ratio of nurses to students. It is evident from being at the school screenings, that they needed our help to have the screenings work efficiently. Also during our Key informant interview, we realized that students come to nurses for more than just the need for medications or nursing care. The school nurse we interviewed said students come to her for advice and guidance considering her good repoire with the students. In order to have efficient individual student attention, it is necessary to cut down the amount of students per nurse. Increased incidence of childhood obesity and the conditions that go along with childhood obesity present an increased need for school nurses. An increase in the number of school nurses available to students would allow more time for eduation, and would also facilitate educating smaller groups of students and encourage discussion and a thorough understanding among students.
ReplyDeleteAfter reading this blog and the bill being amended and reenacted, I had a few concerns regarding the 1 nurse to 1000 students ratio. Some area elementary and pre-school programs, such as the Dixon Pre-K program in Staunton, have a number of students with special needs such as autism and developmental delay. Does this population require more involved nursing care from the school nurse? Should these schools have a ratio closer to 1 nurse per 500 students? I also was wondering if these Pre-K programs already have to meet a ratio to receive federal funding since they many of these schools are Head Start Programs.
ReplyDeleteIn Staunton in particular I noticed that many school clinics were staffed with aides certified as EMT-B or certified from a local protocol course to administer glucagon, CPR, and other emergency first aide techniques. These aides cost far less to employ and can be a helpful addition in situations where the nurse has a large number of students. In the Shenandoah Valley, these aides can be a great supplement to the RN’s in rural areas where travel may make it more difficult for the nurses to meet the care needs of a large number of students. Could the ratio of RN to students be safely lowered if more aides were employed in these school systems? Would this impact the quality of the care the students receive? In theory providing a greater number of nurses would help this ratio out, but I feel as though factors such as student care needs and employing clinic aides should be looked into before establishing a standard RN to student ratio.
Lexi - We agree that, being submerged in schools this semester, there needs to be a lower ratio of school nurses to students. The school nurse that we interviewed also stated that she does counseling in addition to first aid and general nursing care. Many students are late to class or miss class completely while waiting for care from the school nurse, so adding more RNs will allow more time for education and more individualized attention.
ReplyDeleteJoe – We feel that the ratio regarding one nurse to 1000 students is appropriate for the current time considering that many schools are having a hard time meeting that requirement. We do agree that it would be better with more nurses, but it is unrealistic at the time to mandate that low of a ratio. Regarding your comment on more involved nursing care for children with autism and developmental delay, we agree that this would be beneficial to schools, but it is important first to meet the ratio requirement before examining the census of medical problems within each individual school. Also, we disagree that the ratio of RNs to students can be safely lowered with the employment of more aides. While they are cost-beneficial, they are not trained at the same level as an RN, which is why we are seeing problems in lack of available nursing care because aides do not have certification to perform all of the skills that RNs can.