County schools lack nurses

If it can’t be fixed with soap and water or involves real medical treatment, many schools in Douglas County have to call parents in or dial 911.

And for schools on the outer edges of the county, such as Glendale and Yoncalla, there is a heavy reliance on rural fire departments and EMT services.

Even in the Roseburg Public Schools, only the high school has regular access to a school nurse at its health center.

But a traditional school nurse, one who screens for head lice, provides health education and monitors students with complex medical conditions on a regular basis, is nonexistent in Douglas County schools.

Douglas County isn’t alone.

The Oregon Legislature established the Task Force on School Nurses in the 2007 session to look into the issue.

In 2007, the National School Nurse Association ranked Oregon’s school nurse-to-student ratio 49th out of 51 states and regions, excluding Hawaii and including the District of Columbia and an overseas chapter. Michigan is 50th and Utah is 51st.

The state task force’s report was released earlier this month and presented to a joint meeting in Salem Sept. 17.

Salem officials said the committee took no formal action on task force recommendations to either enhance existing structures or mandate funding to increase the number of school nurses in Oregon. The latter recommendation includes a provision to meet nationally set standards of one nurse to each 750 students or fewer. The report stated only 12 percent of Oregon districts meet that standard.

Portland Rep. Tina Kotek-D plans to draft legislation around the recommendations for the 2009 session.

In Douglas County, the Douglas Education Service District contracts with the local health department for a part-time nurse who serves all county districts, except Reedsport, which falls into another education service district.

Jennifer Taylor spends about 25 hours a week as the Douglas ESD’s school nurse coordinator, which involves serving a growing number of kids with complex health needs — such as gastric tubs, seizure disorders and severe diabetes, among other issues — along with training teachers and school staff on duties such as medication administration and treating bee stings.

Aside from training staff, Taylor also develops child specific protocols for children with higher medical needs. These spell out what staff needs to do regularly and in emergency cases.

When Taylor started her position in 2005, her predecessor gave her a list of 20 students who needed such protocols.

Now that list has ballooned to 142 children, plus 11 more with whom she needs to work one-on-one with teacher’s aides. That’s because some services, such as suctioning and using feeding tubes, require a nurse’s license.

Though she is actively seeking students, Taylor cited changing times as another reason her services are in more demand now.

“I guess, over the years, a lot of these kiddos wouldn’t even be in the school,” she said. “So across the nation, these kids are being integrated back into the schools, where before they would have stayed at home or been institutionalized.”

Leslie Currin, Oregon Department of Education school health specialist, said the number of student with asthma and insulin dependent diabetes is also rising across the nation, adding more pressure to teaching and school staff and underlining the school nurse shortage.

“If those students have the disease in control and stable, they’re going to be doing well in school,” Currin said. “If not, they’re going to do terrible in school.”

Three years ago, Mercy Foundation sought to add a school nurses to county schools and began the Healthy Kids Outreach Program that now has three nurses working in the South Umpqua, Winston-Dillard, Camas Valley, Riddle and Oakland school districts.

Program coordinator Pam Frank said nurses communicate with Taylor so as not to duplicate services. The program focus on two main objectives: health and wellness education that includes teaching how to wash hands and other healthy habits, and acting as a health resource to connect families with physician services. The latter includes educating some families on how students can be covered by the Oregon Health Plan.

While local schools do well using teacher’s aides and secretaries for most needs, Taylor said the potential for error is high and scary.

“A lot of the outlying districts take care of themselves and do a good job, but don’t utilize the services that are available,” she said.

Exactly that happened to the Glendale School District, which fell out of the county rotation quickly last year, said high school principal Patty Flemming.

Flemming and Yoncalla School District Superintendent, Marc Thielman, said day-to-day things nurses do in schools are needed and would be much appreciated in the rural and removed communities that are both almost an hour away from the local hospital.

“Having a nurse on hand often makes people more comfortable,” Thielman said.

Frank said only about 52 percent of school-age students have any kind of health insurance, and other school and public health officials added that nurses in schools are often a child’s only exposure to medical care.

In Glendale, Flemming said that because of distance or family circumstances, sometimes treatment simply doesn’t happen.

“We grow ‘em tough out here,” she said.

• You can reach reporter DD Bixby at 957-4211 or by e-mail at dbixby@nrtoday.com.