CBS News report highlights crisis of too few nurses in U.S. schools
The piece explains that only three in five schools have a full time school nurse and that this presents serious risks to students. It does a good job consulting nurses, who describe the cause of the problem—budget cuts—as well as some of the effects on student health. The piece might have also explored how the shortage affects education, since kids can’t learn as well while they are needlessly sick.
April 11, 2019 – Today CBS News ran a good piece by Hilary Lane about what the headline calls the “nationwide shortage of school nurses” and the potentially deadly effects. The common description of this crisis as a “shortage” does tend to obscure the fact that the problem is not so much a lack of qualified nurses as it is a lack of will to pay for them, but to its credit, this report makes that root cause clear after the headline. The piece says that only three in five U.S. schools have a full-time nurse. And it stresses that school nurses are more important than ever in light of the higher number of students with chronic health conditions like asthma and diabetes. The item highlights the case of a Philadelphia boy who died of heart failure in 2018 at a school with no nurse. The piece has good quotes from several nurses, including a Maryland nurse who has to try to cover two schools, as well as an Ohio nurse whose hospital has tried to fill the school nurse gap by opening health centers in local schools. And the piece relies on the executive director of the National Association of School Nurses, who says the shortage is a “crisis” driven by budget cuts and emphasizes the risk to student health when nurses are overwhelmed. The piece might have done much more to explain how inadequate school nursing harms students, not only in terms of poor health (for example, in a lack of preventative care like vaccinations and screenings) but also in the education students miss while they are sick. On the whole, though, the report is a valuable look at an enduring public health problem, and we thank those responsible.
Crisis
The report is “Nationwide shortage of school nurses called a ‘crisis’ that may be putting kids’ lives at risk.” Although most of it is based on comment from nurses, the piece does offer a general overview and a few additional elements. It leads with the note that only three out of five U.S. schools have full-time nurses, which “forc[es] school administrators, with no medical training, to step in and provide some level of care.” Later, the article notes that no federal laws regulate nurse staffing, although a bill to be introduced in Congress soon called the Nurse Act would at least provide additional funds for schools to hire more nurses. The report explains that school nurses are “more critical than ever,” with one quarter of all “young children” (it does not define that) having some chronic illness, such as asthma or diabetes. And in recent years, it says, children have died at schools where there was no nurse available. To suggest how that happens, the report outlines the case of Rasheen Pressley’s son Hasoun, a Philadelphia 9-year-old who collapsed in the school cafeteria and was later pronounced dead of heart failure in October 2018. There was no school nurse there that day, and although the school district said that a staffer certified in CPR tried to revive the boy, Pressley says the school “failed” her son, noting that things might have gone differently had a school nurse been there. The piece says the district is working with a local hospital to determine if it should provide “additional health support.”
The report describes an example of such support in the comments it gets from one of several nurses. The piece explains that Cincinnati Children’s Hospital has a partnership with local schools to provide health centers, quoting the hospital’s “clinical manager” Lisa Crosby as saying that they provide “routine primary care services for all of the students in the building as well as any child in the community.” The piece attributes to Crosby the idea that this allows students to get the same services they would “in a pediatrician’s office.” Ouch—because in fact Crosby is herself a nurse practitioner, with a doctorate of nursing practice, who serves as APRN Program Lead, Division of General and Community Pediatrics at the hospital. The piece fails to adequately identify her—even as a nurse, much less a nursing leader—and wrongly suggests that a “pediatrician’s office” is the standard that her program should be measured against.
The other nurse appearances are better. Donna Mazyck, “executive director of the National Association of School Nurses,” is quoted as saying the problem is “a crisis.” And she appears to be the source of the data that 2 in 5 schools lack a full time school nurse, expressing that as 40% of the schools. She adds that 25% of schools have no nurse at all. Mazyck blames “shrinking budgets” and emphasizes the burdens on kids and nurses: “If you have a workload that doesn’t enable you to care for the students in a way that you need, it’s like drinking water from a fire hose.” The piece tries to capture some of that experience with a section about Denie Gorbey-Creese, a school nurse in Howard County, Maryland who is responsible for two schools every day, with the aid of “health assistants” who call with questions. Gorby-Creese says: “I’m often stressed because I have to figure out the safest way to balance it. … If I’m busy with an emergency at my other school, I’m not available right away, so it might delay their care some.”
This short report is generally strong. Despite the somewhat problematic description of Crosby and her work, the piece includes a number of powerful indicators of the scope and importance of the school nurse “crisis.” These include the use of key statistics, the description of the tragic example of Rasheen Pressley’s son, and the many good quotes from nurses who explain the difficult situation they face. The piece might have done more to explore the range of negative effects on kids, from the lack of preventative care to the threats to their education as a result of needless illness. It might have included some discussion of whether hospital-affiliated health centers are more of a stopgap or a good long-term solution to the school nurse funding crisis. And it might have provide some historical context. We have been analyzing pieces like this for many years and it’s not clear there has been much improvement in the situation. Still, the piece sends many of the core messages that the public needs to hear about school nursing in the U.S.
See the article “Nationwide shortage of school nurses called a “crisis” that may be putting kids’ lives at risk,” posted as part of the School Matters series on “CBS This Morning” on the CBS News website April 11, 2019.
