Strapped schools may cut registered nurses

10/10/2013 10:01 AM

10/10/2013 10:01 AM

Wichita school officials are considering a proposal to replace registered nurses with lower-paid licensed practical nurses in schools, a move they say would save about $2 million.

Some nurses say the change could endanger students, particularly those with serious or chronic health conditions, because licensed practical nurses lack the training and experience needed in schools.

"What scares us the most is that the people making these decisions are educators and not medical people," said Mandy Pilla, a registered nurse who worked in Wichita schools until last year.

"I know we're not generating any measurable test scores, but there's so much going on with the children of our district, you wouldn't believe it. . . . Nurses are a crucial part of schools."

In Kansas, the registered nurse, or RN, is a more advanced designation and takes two to four years of study to earn. Wichita's 80 school nurses have bachelor of science degrees and are covered under the teachers' contract.

Licensed practical nurses, or LPNs, typically complete one year of study and training at a hospital, community college or vocational school. State law requires that LPNs work under the supervision of a doctor or registered nurse.

Wichita district spokeswoman Susan Arensman said administrators are exploring the idea of LPNs at schools but that no formal recommendation has been presented to board members.

The idea is part of the district's proposal to the United Teachers of Wichita for contract talks that began earlier this month.

"When you are considering cutting $30 million because of a lack of state and federal funding, the district has to evaluate everything," Arensman said. The district has an annual budget of about $630 million.

She said school nurses are not part of a $13 million budget reduction presented to board members Monday, which included 65 to 70 as-yet-unspecified district jobs.

Bernadette Fetterolf, associate dean of nursing and allied health at Newman University, addressed the board Monday on behalf of registered nurses.

"Our children in the health care system transition back into the community and the school system with complex and sometimes multiple health care issues," Fetterolf said. "Most LPN programs have little to no clinical pediatric experience."

". . . What is the best and safest solution to providing health oversight in our schools? I believe from both a pediatric and educational perspective that the RN role should be maintained in the school system," she said.

Pilla, the former school nurse, recently launched a blog aimed at advocating for registered nurses in schools. She said many people don't realize the critical, sometimes life-saving, role school nurses play.

It's typical for a nurse at a large Wichita high school to see 75 students a day or more, Pilla said, with common ailments such as colds or stomachaches as well as more serious conditions such as asthma, food allergies, cystic fibrosis, diabetes or seizure disorders.

Budget cuts over the past several years have reduced the number of school nurses. Some split their time between two or more schools. In some cases, school secretaries are trained to administer common medications such as antibiotics, as well as inhalers or epinephrine injections for asthma attacks or severe food allergies.

Nurses also conduct or supervise regular vision, hearing and dental screenings.

"A lot of research out there shows that an RN in a school makes a huge difference in a child's ability to learn," Pilla said. "A child has to have those basic (health) needs met if he's going to be able to pay attention and learn anything in the classroom."

Board member Lynn Rogers said he understands nurses' concern, adding, "If nurses aren't there, it drastically affects the condition of the classroom."

But with the district facing a $30 million budget shortfall, he said, officials have to look at every possibility.

"We're going to have to look at every position, every task. What can we do without?" Rogers said. "We're going to have to make decisions between bad and worse, and they're not going to be fun. And this is just the beginning."

If registered nurses are replaced with LPNs at Wichita schools, families may not notice a change "until there's a crisis," Pilla said.

"Until their child gets hurt at school — hit in the head with a tennis racket or falls off the jungle gym with a broken bone," she said. "Then they'll panic because there might be nobody there with any medical knowledge."

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