Utah’s school nursing shortage slightly worsened over the past year, leaving school nurses with six times the recommended students under their care, according to a new state report.
Utah’s school enrollment continues to grow every year, but school nursing levels have not kept pace amid tight school budgets, leaving multiple schools relying on a single nurse and sometimes putting children at risk, parents and advocates say.
“For one nurse to be between three or four schools, that’s just ridiculous,” said DeAnn Kettenring, the health commissioner of parent-teacher group Utah PTA. “Especially when you have accidents, when you have different situations going on that require some kind of medical attention and people who are not really medically trained are doing these things.”
An annual report on school nursing from Utah’s Department of Health shows Utah had one nurse for every 4,543 students — up from last year, when Utah had one nurse for every 4,318 students.
The numbers are far above recommendations from the U.S. Department of Health and Human Services and the American Academy of Pediatrics that there be one nurse for 750 students.
State lawmakers are exploring whether Utah should use Medicaid money to pay for nurses, adding about $3 million.
BettySue Hinkson, the Utah Department of Health’s school nurse consultant, said Utah’s nurse-to-student ratio is the best way to measure the workload for school nurses but the numbers and the national recommendation don’t tell the whole story.
The numbers don’t take into account special education students with dedicated nurses, and some districts may not need as many nurses if they have few students with complex health problems, she said.
The National Association of School Nursing, of which Hinkson is a board member, recommends there be a school nurse in every school all day long.
For Utah to meet that goal, it would have to hire more than 950 nurses, at a cost of about $91 million, according to the health department. That’s 10 times more than what the state currently spends.
Hinkson, also a member of the Utah School Nurse Association, said that group plans to ask state lawmakers in their session next year to increase spending by $10 million, allowing the state to double the number of school nurses.
Strapped government budgets have left a shortage of school nurses around the country and in Utah because scarce education dollars are often used to hire more teachers instead of support staff like nurses, Hinkson said.
“We’re all fighting for that same bucket of money, which makes it difficult,” she said.
When a school doesn’t have a full-time nurse every day, it puts a huge burden on teachers and administrators, particularly if they don’t have medical training, and it can put kids with complex medical needs at risk, said parent Michelle Fogg of Murray.
Six years ago, when Fogg’s daughter was in second grade, the girl had an allergic reaction to cow’s milk in pizza. Her throat started closing and she had trouble swallowing. There was no school nurse in the building because the school shared a nurse with several other schools in the district, and staff in the school’s front office didn’t recognize the girl’s symptoms and had the child phone Fogg.
Fogg said she had trouble understanding her daughter but when she arrived at the school soon after, she realized the girl, who has a number of food allergies, was having an allergic reaction. She administered an epinephrine to her daughter while asking the staff to call 911.
Fogg, the co-founder of the Utah Food Allergy Network, said her daughter was ultimately OK but because so much time was lost before the girl got treatment, the situation could have been much worse if the girl had had a more severe reaction.