As insurance costs soar, more parents rely on school nurses for children's health care

[NRSKarenRN, BSN, RN]

Found at the Philadelphia Inqurier

Peg Quann

April 18, 2018

As insurance costs soar, more parents rely on school nurses for children's health care

... With the cost of medical insurance skyrocketing, district officials have noticed that more parents now are using school nurses as gatekeepers for their children's health care.

The Bensalem School District has more than 6,300 students. Nurses in the district handled almost 68,000 student visits to the health offices during the 2016-17 school year, treating about 40 to 60 children a day at each school. In the 2015-16 school year, there were 66,000 visits and 63,000 in 2014-15.

The school district, which borders Northeast Philadelphia along the Delaware River, is home to a wide variety of students, including children whose families have lived in Bucks County for generations, as well as newcomers from the city and immigrants from other countries. With 55 percent of the children in the district receiving school-lunch subsidies, the economic status of its families varies widely, as well.

In the nurses' offices, Monday mornings are especially busy - sometimes with injuries or illnesses that happened over the weekend.

"Families can't afford to go to the doctor all the time with copays. ... They tell their kids to go see the school nurse," said Tammy Wood-Moghal, Bensalem school district's director of pupil services.

Pennsylvania law requires each school district to have one certified school nurse for 1,500 students, but individual schools can use other registered or licensed practical nurses, as well, called staff nurses. Certified nurses, who have taken courses on school nursing, are on the same pay scale as teachers, said Valerie Wendell-Wesolowich, president of the Certified School Nurses of Bucks County association. Salaries for staff nurses may be less.

At most of the schools in Bensalem, there is only one nurse on site. It's a lot of responsibility, especially when a medical emergency arises. It can be a lonely role, Thim admits.

More 'medically fragile' students

Since 1975, when the federal government enacted the Education for All Handicapped Children Act - renamed the Individuals with Disabilities Education Act in 1990 - youngsters with serious health problems have been mainstreamed into public schools.

So, nurses such as Thim care for children who may have cancer, diabetes, epilepsy or another serious, chronic health problem, as well as those with autism, hyperactivity and psychological disorders.

"People don't realize the volume of services nurses provide," Wood-Moghal said. "Because of the least restrictive environment regulations, we have more and more medically fragile children in our public schools." ...

[JenTheSchoolRN, BSN, RN]

Yep. Not surprising. I know I am the main medical care for several students at my school. I am in an urban area. My health office visits have increased nearly 50% in the time since I started at my school 5 years ago. Some of it is teachers, sure, but some of it increasing and more complicated parts of a student's overall health. Mental health related visits have increased the most by far.

But parents sometimes expect me to be able to do more and some are frustrated when I can't do things like diagnose, for example.

[OldDude]

"My mom/dad/grandmom/granddad told me to go to the nurse when I get to school," is a statement I hear on a weekly basis. The article rings true.

[Farawyn]

Too bad for them. No to be flip, but, yeah, I'm being flip. I d what I can, but I cannot diagnose.

We have some docs on sliding scale I recommend. Or, the DOH.

[LikeTheDeadSea, MSN, RN]

Guess who knows the nurses in that district! And that's the end of my statement and commenting on this thread before it becomes anymore identifying...

[GdBSN, RN]

I hear comments like this all the time..."my mom told me to come see you to figure out if I really need to go to the doctor." With the cost of office visits and co-pays rising, I can understand the financial strain that some families are in.

[ruby_jane, BSN, RN]

Yep. Not surprising. I know I am the main medical care for several students at my school. I am in an urban area. My health office visits have increased nearly 50% in the time since I started at my school 5 years ago. Some of it is teachers, sure, but some of it increasing and more complicated parts of a student's overall health. Mental health related visits have increased the most by far.

But parents sometimes expect me to be able to do more and some are frustrated when I can't do things like diagnose, for example.

^TRUTH!^

I love Nurse Thim. Can't imagine doing this job and the district nurse job, too. But the headline is misleading, as many are. Legally, I can provide very little health "care." I can provide a lot of assessment and maybe some treatment. My answer to "Do you think s/he needs to go to the doctor" is usually "YES," though.