School nurses key to student health, successful education

School nurse checks student's ears

"Investing in school nurses is an investment in student health that will pay huge dividends in the future … Without school nurses, many kids would go without basic physical or mental care. Learning becomes much harder for students in poor health. Keeping kids healthy will help them stay focused and achieve their full potential." 

Sen. Jon Tester (D-Montana)


School districts across the Commonwealth and the nation have something in common, something that could pose a problem to the health of the students and staff in the schools.  It is a shortage of school nurses.  According to the National Association of School Nurses, the shortage of school nurses is a nationwide problem with only 39.3 percent of schools across the nation, according to a 2017 study, having a full-time nurse.  The other 60.7 percent of schools either have a part-time nurse who works in multiple buildings across the school district or the schools have no nurse at all. 

The standard recommended by the Centers for Disease Control and Prevention states that, in ideal situations, there should be one school nurse for every 750 students.  Nationally the average is over 1,100 students for each school nurse.  In Kentucky, however, with the school nurse shortage, there is, on average, one school nurse for every 1,877 students.  Kentucky ranks 36th in the nation for the student to school nurse ratio.  With full-time nurses in every school, the Rowan County School District is a rarity when compared to districts across the Commonwealth and the nation. 

After the Gateway District Health Department ended its cooperative agreement with the Rowan County School District to provide nurses for the schools in the district, the members of the Rowan County School Board approved a decision that would allow the District to hire its own nurses, health reimbursement clerks and director of nursing/school health services to serve a student population of over 3,000 students. 

“The members of our School Board have made an investment in the health and well-being of our students,” said Superintendent John Maxey.  “The School Board has shown that it understands the correlation between a student’s health and his or her ability to learn.  If a student doesn’t feel well, how can we expect them to learn?”

Currently, the Rowan County School District has 7 nurses who serve the District’s students.  These nurses are: Rachel Manning, R.N.Rowan County Preschool Center and Bluegrass Discovery Academy; Angie Smart, R.N.Clearfield Elementary; Melissa Grimm, R.N.McBrayer Elementary; Christy Inscho, R.N.Rodburn Elementary; Sandy Williamson, R.N.Tilden Hogge Elementary; Kathy Catron, R.N.Rowan County Middle School; and Missy Polley, R.N.Rowan County Senior High School.  The District also has two health reimbursement clerks – Patricia Lambert and Debbie Griffin – to take care of filing the necessary paperwork to apply for federal reimbursement for the health services provided to the students.  Renée Smith serves as the Director of Nursing and School Health Services for Rowan County Schools.

“When I go to conferences and meet with other school health coordinators and nurses, they are amazed that our district has made the commitment to have nurses in every school,” said Renée Smith.  “So many districts might have one nurse to serve an entire district, but when they hear that how many nurses we have and the commitment that our district has made to our students, they are stunned.”

“In addition to having all our school nurses, we also have two valuable assets to the health services program in this District -- Patty Lambert and Debbie Griffin, our health reimbursement clerks,” added Renée Smith.  “The knowledge that they have and the work that they do is essential to the financial existence of our school nursing program.”

Being a school nurse is far from just taking a temperature every now and then.  School nurses are on the front lines of helping to maintain the health of a school. Providing preventative and diagnostic exams, checking blood pressure, assisting with a students’ medication or medical procedural needs, performing school entry physicals, and updating students’ health records are just some of the responsibilities of the school nurse.  The nurses also work with staff members to train them on various medical procedures.  Working closely with the school staff, the nurses keep a close eye on the health of the students.

As the nation looks to improve the health and well-being of its citizens, it is more important than ever that students have access to a school nurse. 

Superintendent John Maxey stated, “Our school nurses serve as an important connection between the parents and the schools, giving parents the tools they need to help their children stay in school and stay healthy.  They are also working with teachers to help their students become successful in their education.”

Maxey then added, “We also have some medically fragile students in our school system – students with diabetes, seizure episodes, breathing difficulties, dietary issues.  It is the work of the nurses who are giving these students the medical support they require that allows our students to stay in school and achieve their goals.”

Finding the necessary funding to place nurses in schools, though, can be a limitation for many school districts.  The Rowan County Health Board has offered financial support for the past several years to help maintain the nursing program in Rowan County Schools.  Nationally, though, those funding sources are often difficult to come by.  In March 2018, Senator Jon Tester (D-Montana) and Rep. Dina Titus (D-Nevada) introduced companion bills that would help alleviate the school nurse shortages across the nation.  H.R. 5251 and S. 2532, the Nurses for Under-Resourced Schools Everywhere Act, or NURSE Act, would authorize federal grants through the U.S. Department of Education to ensure that schools have the necessary funding for school nurses based upon the number of students who qualify for free and reduced-price meals.  These companion bills are currently stuck in their respective legislative committees, but bill authors are eager to see passage of the bill that would help students in under-served areas across the nation.

Rep. Titus was quoted as saying, “School nurses are on the front lines, promoting wellness, managing chronic diseases, administering medication, and addressing issues that affect students in and out of the classroom. This bill will ensure that we have more medical professionals focusing on smaller numbers of students. We can all agree: Healthier students are better prepared to learn.”


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