NPR reports on apparent link between school nursing and lower absenteeism
A January 2020 report on Tennessee NPR affiliate WKNO looks at the state of school nursing. The piece highlights the struggle for funding. But it also focuses on a new study that has placed nurses in five Memphis-area schools to see if there is a link between more nursing and less absenteeism. Early results suggest there is.
January 22, 2020 – Today National Public Radio’s affiliate WKNO ran a good piece by Katie Riordan about efforts to increase funding for school nurses in Tennessee. The focus was on one nurse who is part of a small study measuring the possible link between more nursing and less student absenteeism, which is a key factor in student achievement. The research, a collaboration with a local hospital and a charity, has placed full-time nurses in five Memphis-area schools that did not used to have them. Early results suggest that students with regular access to a school nurse are far less likely to be taken out of school by their parents; the great majority can return to class. The piece describes the work of school nurse Rachel Norris. She provides basic acute care, administers medications, completes health screenings, and helps students manage serious chronic conditions like diabetes. A few elements of the item may feed the impression that Norris’s work does not require a lot of skill, such as the note that some patients are “in search of a friendly face.” Of course, psychosocial care is important, and Norris herself stresses that her work is “a lot more than band-aids and boo-boos.” The report also includes input from the district’s director of nursing, an advocate for more funding for school nurses, and a state legislator pushing for funding to hire 1,000 new nurses, so there would be roughly one nurse per school statewide. Overall, the piece conveys that increasing nurse staffing in schools would greatly enhance the health and educational achievement of students. We thank those responsible for the report.
The print version of the report is headlined “Underfunding for School Nurses May Have Link to Chronic Absenteeism.” Although the core of the piece is the account of Norris’s work, it spends more time on the the overall situation of school nurses in Tennessee, consulting other nurses and relevant persons. It explains that before Norris came to the Riverview K-8 school in South Memphis, a nurse was there only once a week, because of funding issues, so teachers and administrators had to deal with health issues themselves. The study that has placed nurses in five local schools to look at the effect on “health-related absenteeism and in turn academics” is a collaboration of the Urban Child Institute, Le Bonheur Children’s Hospital, and Shelby County Schools. The piece says health and education advocates argue that the state needs more full-time RNs “not just to stave off minor medical problems, but also to help students manage chronic conditions like asthma, high blood pressure or attention deficit hyperactivity disorder (ADHD). They say unmanaged health issues feed absenteeism.” The report explains that Tennessee currently has only one school nurse for every 3,000 students, so some nurses must handle five schools. It says advocates are urging the state to meet the “nationally-recommended” ratio of one nurse per 750 students.
Meanwhile, in Shelby County, one in five students misses more than 18 school days a year, which is considered “chronic” absenteeism. But so far, the piece says, students in the schools with nurses seem much less likely to have their parents take them from school for health reasons. According to Charnece Brown, identified as “a supervisor for the nursing program, 90 percent of the students who saw the nurse last semester returned to class.” Brown gets a couple good direct quotes, to the effect that this allows teachers to focus on teaching. Another nurse who seems to get only a photo in the written version of the piece is “Nurse Practitioner Lanetra Wiley,” described in the caption as “visit[ing] the study’s schools once a week to check on students.” The piece also relies on “Patrica [sic] Bafford, a former school nurse who now manages health service programs for Shelby County Schools.” Bafford explains why school nurses are so critical for student health at a time when more students attend with chronic conditions that require close monitoring. Bafford says that because nurses know the kids, they are able to keep symptoms from conditions like asthma and diabetes under control; they know what the kids “look like when their blood sugar is high.” The piece might have noted that Patricia Bafford has a doctorate, and it also might have correctly spelled her given name. The article quotes Mike Carpenter, an education advocate who seems dubious about the cost of adding nurses. Hiring 1,000 more nurses, apparently to meet the recommended nurse-to-student ratio, would cost about $39 million. So, Carpenter asks, where would the state get that money “in addition to all the other things that we need to address?” Finally, the piece quotes Republican State Representative David Hawk. He also stresses all the other funding priorities, including “the need for more resource officers,” but even so, he is reintroducing legislation that would fund about one nurse per school. Hawk explains: “Seeing a school nurse may be the only healthcare that these individuals get.”
A significant part of the piece describes Norris’s work. One summary appears in a photo caption, which says Norris “sees between 20-30 students a day … some need their prescription medication, some aren’t feeling well, and others are in search of a friendly face.” The report also notes that her clinic “fills up throughout the morning; she has daily meds to dispense and state-mandated health screenings to complete. Not to mention she must tend to a bumped head, scraped knee and a 5th grader who’s been throwing up.” (Too bad the piece fails to explain that a nurse would know the vomiting might be caused by a bumped head, while a teacher or parent might not. A third-grader tells “Nurse Rachel” that she has been coughing and sneezing for two days. Norris says she will call the girl’s mother and also get her some cold medicine. A few elements might not suggest great skill if viewed in isolation: the references to scraped knees and such, as well as the “friendly face” part, although in fact psychosocial care is critical. Norris does a pretty good job of explaining some of the difference she has made, noting that before her arrival, students who were ill would just have to go home. Norris emphasizes that parents know they can trust nurses for health assessments: “I can tell the parents exactly what happened… how severe it is, if they are contagious, if they need to see a doctor or if they are okay to return to class.” Teacher Andrea Dandridge says students and faculty have become more “health conscious,” with more hand-washing, since Norris arrived. And there is Norris’s quote: “There’s just a lot more than band-aids and boo-boos.”
The piece paints a helpful picture of the difference school nurses can make. It relies partly on personal anecdotes about Norris’s technical and psychosocial skills. The report also explores the larger context—especially the study on the effect of more school nursing on absenteeism, but also benefits like freeing up teachers for teaching, and improving health practices that may seem minor (the handwashing) but can make a critical difference in infection control. The piece consults more senior nurses and other advocates, who make clear the importance of school nurses in managing chronic conditions, and in a telling point, that the school nurses may be the only health providers that some students see. And the piece highlights the underfunding that has long undermined the work in a competitive budget environment; even the limited study here had to be funded in part by a charity and local hospital. We thank those responsible for this report.
See Katie Riordan’s article “Underfunding for School Nurses May Have Link to Chronic Absenteeism,” from WKNO, the Tennessee affiliate of National Public Radio, posted on January 22, 2020.
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