Governmental Objectives of Bill 22.1-274

Governmental Objectives:The governmental objectives of House Bill 1896 is to amend Bill 22.1-274. The main purpose of this revision is to increase safety of students by ensuring that the nurse to student ratio legally is at least 1:1000. This is an important concept in that there needs to be a registered nurse in the school for administration of all medications, namely insulin and glucagon, first aid injuries, CPR/AED emergencies, and general illness.

Political Influences:Lionell Spruill Sr. has served in the Virginia House of Delegates since 1994, and is a chief patron of House Bill 1896. He was born in Virginia and has four children, so he is well aware of the issues in Virginia school systems. His committee assignment includes the Health and Welfare Institutions Committee, of which he is also a subcommittee member. He has been the chief patron for multiple other bills over the past five years that encompass both healthcare aspects and involvement with school boards. Delegate Rosalyn R. Dance has been a member of the Virginia House of Delegates since 2005, and a retired registered nurse. She is assigned to the Appropriations Committee, which is a jurisdiction of state budget matters for health and human services and public safety. (http://legis.virginia.gov/)

Potential Impact of the Policy Change on Nursing:

The current school nurse-to-student ratio has many school nurses questioning whether or not school administrators recognize their role as being more than just givers of first-aid. With decreased funding for healthcare in schools, school nurse positions are not meeting necessary standards for providing high quality care to students. These cutbacks suggest that the school districts are not recognizing the increasing, complex, and chronic health problems of the students or contributions of the school nurse.

Through a key-informant interview that we conducted at William Perry Elementary School in Waynesboro, VA, we learned that the school nurse provides many services to students that districts may not know of, including diabetes care, medication administration, tube feedings, and psychosocial support or counseling in addition to first-aid and wound care. School nurses are hassled by constant interruptions and not enough time to finish work because of the lack of role delineation between school nurses and teachers, which causes stress experienced by school nurses. The high student-to-nurse ratio not only increases the stress, but also creates an inadequate work environment for the nurse to provide all services needed. High quality nursing care is not just something needed in hospitals. It is needed in all health communities, including schools where there is an increased need for health services by school nurses.

With more evidence of childhood obesity, diabetes, asthma, and other chronic conditions, there has been an increase in the need for medical attention in the school environment that can only be treated by a medical professional, such as a registered school nurse. Due to the lack of registered nurses being hired in schools, there are many untrained personnel providing care to students. In order for the proper care to be given to students with such chronic conditions, the school has to accept the need for registered school nurses in the building because untrained personnel cannot provide specific services related to these conditions. Individualized high quality nursing care can only be given to students if the ratio of registered school nurses to students is decreased. Clarification of the school nurse role may promote more effective health services in elementary schools, allowing for better and more individualized healthcare given to students.

Sadik, Nancy, "The School nurse role as perceived by elementary and middle school teachers" (1992).Master's Theses. Paper 358. http://scholarworks.sjsu.edu/etd_theses/358