CALIFORNIA’S SCHOOL NURSE CRISIS: Thousands of schools lack a campus health worker. With budget cuts threatening existing programs, parents need to act.

Op-Ed by Kathy Hundemer | LA Times

May 28, 2010 | Can you imagine one adult taking care of 2,100 children?

In California, that is what we ask of our roughly 3,000 credentialed school nurses who serve the state's 6.3 million public schoolchildren, some of whom have debilitating physical conditions that demand specialized healthcare. Our students with epilepsy who may need Diastat administered during a seizure are only one of the examples. However, the controversy surrounding who should be allowed to administer the drug to students in an emergency — the subject of Steve Lopez's May 26 column, "Down the Capitol rabbit hole" — illustrates the crisis that our students and our schools face with respect to providing care to our most fragile children.

To be honest, even within the nursing community there are divided opinions on whether it is appropriate for Diastat to be given by trained but unlicensed personnel such as teachers, health aides and secretaries. The true concern is the slow erosion of safe and appropriate care that is provided during the school day to students who have health needs. There is no requirement in California for a school or even a school district to employ a school nurse. On any given day, there are about 7,000 schools throughout the state where a nurse is not present, and about half of California's school districts have no nurses at all. California ranks behind 40 other states in the school nurse-to-student ratio.

This situation is unacceptable. School nurses are often the only source of care for disadvantaged children, and by intervening early, they can prevent easily treatable health conditions from becoming major problems requiring costly treatments. School nurses meet the needs of about 678,000 children with multiple and severe disabilities currently enrolled in California's public schools. They are also on the front line for communicable disease control; don't forget it was a school nurse in New York who encountered the first cases of H1N1 influenza last spring. Her knowledge of disease patterns and assessment of the situation led to the beginning of a nationwide control and prevention strategy aimed at the new virus.

We are all aware of the budget mess that the state and our educational institutions face. Our most vulnerable students are being put at risk because health services in the schools are often among the first services to be considered for reduction when money gets tight.

The charge to our community is to contact your school district administrators, local school boards and legislators and advocate for the healthcare services that our children deserve. Remember, healthy children learn better.

• Kathy Hundemer, a credentialed school nurse, is government relations chair of the California School Nurses Organization.