Thursday, June 04, 2009
Student caretakers
Two dozen nurses treat about 14,700 students in Roanoke County.
KYLE GREEN The Roanoke Times
LaVern Davis (center) observes as Northside Middle School nurse Karen Switzer (left) assists student Kara Jones.
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LaVern Davis remembers a time when she barely needed one hand to count the number of Roanoke County public school nurses.
Davis is associate director of health services for the school system, but when she started in 1992, the county had only two nurses and she was one of them. A few years after that their numbers finally increased. To three.
During that time, secretaries, coaches, principals and other staff were called upon to take temperatures, dispense medication, treat head lice and make health assessments.
"But it's evolved," Davis said. She applied for a grant early on that brought four more nurses into the system. "One year we got six, some years we didn't get anything."
Now they have 26, she said. "The county also employs 13 occupational, speech and physical therapists.
"People really come to expect to have the nurse there, and they look to them," said Barry Trent, coordinator for health, physical education and driver's education for county schools.
Davis hadn't worked in school health administration before she started -- she has a master's degree in medical-surgical nursing -- but said the staff, too, is diverse: "We have such a hodgepodge of backgrounds -- critical care, ER, psychiatric nursing, the OR. No matter what their background is, they can make it apply to the role of school nurse."
That's good, considering the two dozen nurses treat about 14,700 students within the school system. According to Davis, 46 of those students are diabetic, 1,260 have asthma, and more than 130 experience seizure disorders. Nurses also help about 2,400 faculty and staff members.
That works out to about one nurse for every 660 potential patients.
"Which isn't bad," Davis said. At some county schools, "you've got one nurse with 1,200 students, and then another with 250. It's all relative."
Compounding the challenge is the fact that all the nurses are part-time employees who work no more than five hours a day, despite the fact that elementary schools operate six hours a day and middle and high schools seven hours a day.
"They don't feel they have enough hours in the day to do all the things they need to do," Davis explained. "They get sick before the nurse arrives and after they leave. I'm grateful, but there are unmet needs."
Roanoke County isn't alone. Salem's school system has six nurses for 3,900 students. Its nurses are all employed full time. Of the 27 Roanoke school nurses, who treat about 13,000 students, 12 are full-time employees.
Roanoke County Schools Superintendent Lorraine Lange said it's been an ongoing concern.
"We have a part-time nurse in every school, and we'd love to have full-time nurses, but with funds being the way they are, we just can't afford it," Lange said. "She's been a great asset to our school system."
Even so, the staff is finishing up a busy year in which it concluded stereopsis testing for kindergartners and third-graders, looking for weakening of the eye muscles.
"If you detect it early, it can be treated," Davis said.
For the past five years, they have also screened the body mass index of five grade levels to generate statistics that track, among other things, student weight averages.
When the new school year begins, the system will also start using a new health documentation system, paid for with federal stimulus money, that Davis said represents a major upgrade from the current record system.
