One FullTime Registered Professional

1
Every Child in Montana Deserves A School Nurse

• One Full-Time Registered Professional
• School Nurse for Every 750 Students
• Sue Buswell, RN,MS,NCSN 2009

2
School Nurses as a Primary Source of Health Care

• For increasing numbers of children, contact with
  a school nurse is the only consistent access to a
  health care professional available, especially
  for preventive care
• 97 of American children spend their days at
  school
• The registered professional nurse is the only
  school staff member who has the skills, knowledge
  base, and statutory authority to fully meet the
  health care needs of children in schools.
  NASN, 2008

3
Federal laws ensure the safety of students and
provide access to education

• Individuals With Disabilities Education Act
• Section 504 of the Rehabilitation Act of 1973
• Americans with Disabilities Act of 1990
• Children with special health care needs have
  the right to be educated with their peers in the
  least restrictive environment.

4
The School Nurse RoleH1N1 Influenza

• Leadership and Collaboration
• Development of Protocols
• Education and Prevention
• Advocacy
• Vigilance
• Triage
• Active Surveillance

5
Research Suggests that Schools Employing
School Nurses Have

• Fewer Student Absences
• Decreased Drop-out Rates
• Higher Test Scores
• Maughan, E. The Impact of School Nursing on
  School Performance A Research
• Synthesis. The Journal of School Nursing
  19.3 (2003)163-171.
• Pennington, N. and Delaney, E. The Number of
  Students Sent Home by School Nurses Compared to
  Unlicensed Personnel. The Journal of School
  Nursing 24.5 (2008) 290-298.

6
Minimum Recommended National Standards School
Nurse to Student Ratio

• 1750 Well students in the general
  population
• 1225 Student populations that may require
  daily
• professional school nursing
  services or
• interventions
• 1125 Student populations with complex
  health
• care needs
• 11 Individual students requiring daily
  and
• continuous professional nursing
  services

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8
Montana Association of School Nurses
School Nurse Survey 2009

• Purpose to determine the current state of school
  nursing in Montana
• Grassroots effort
• Data collected by MASN members
• Telephone survey
• All 56 counties and 100 school districts
  reporting

9
Definition of A School Nurse in Montana

• A Registered Nurse whose specialized practice
  involves the application of the Nursing Process
  to school children , their families, and school
  staff members, primarily in the school setting.
• A Public Health Nurse (RN) who may provide
  services to schools as part of health promotion
  and disease prevention in the community and
  practices in a variety of community settings.

10
Montana School Nurse Numbers 2009

• 81 RN School Nurses, full-time and part-time
• 26 RN Public Health Nurses 1 hr/wk or more
  spent in schools
• Total 62.5 FTE RN School Nurses in Montana
• 144,000 Students in Montana Public Schools

11
Current Ratio in 2009

• School Nurse to Student Ratio in Montana
  12304
• Recommended 1750

12
How Does Montana Rank Now?

• 45
• Montana
• 12304

13
MT Counties without RN School Nurse
14
15,035 Students in Counties without RN School
Nurse

• 3,600 (24) have vision deficiencies
• 2,550 (17) are obese
• 1.954 (13) are prescribed medication more than
  90 days
• 1500 - 3000 (10-20) have mental health issues
• 900 (6) miss more than 11 days of school due to
  illness or injury total of more than 9,900 days
• 1800 ( 12) have a history of asthma
• 750 (5) have seizure disorder
• Approximately 30 have Type 1 diabetes

15
Nurse to Student Ratio in 12 Largest(Students)
Montana Counties

• 1. Yellowstone 11469
• 2. Missoula 13858
• 3. Flathead 12527
• 4. Gallatin 15607
• 5. Cascade 111,879
• 6. Lewis/Clark 11000

• Ravalli 13362
• Silver Bow 11320
• Lake 11140
• Roosevelt 03204
• Hill 13057
• Glacier 11063

16
American Academy of Pediatrics

• Increasing numbers of students enter school with
  chronic health conditions that require management
  during the school day.
• To optimally care for childrenappropriate
  staffing levels of school nurses are important
  factors for success.
• Improved student outcomes result where schools
  have a full-time nurse.
• 
  AAP Policy Statement 2008

17
Montana State Board of Nursing

• The words decision maker, problem solver,
  advocate and counselor come to mind.
• One of the toughest challenges is educating
  school administrators on the importance of the
  role of a nurse in the public school system,
  especially in a system that does not require
  nurses.
• Swehla, B. and Zeisler, M. School Nurses True
  Angels to the Children of Montana. Montana NURSE
  1.1(2008) 8

18
Endorsement from a parent

• Without the support and care of a registered
  nurse at school I really doubt if my daughter
  would have been ready to move on to college
• Having a chronic disease is hard enough but
  having an advocate at school allows the student
  to have a place to get help that can save their
  lives
• In the long run I believe this extra care
  saves the taxpayers money. Preventive care is
  always the best solution.

19
American Nurses Association

• ANA has learned that Montana schools are
  currently employing, on average, one school nurse
  to every 2300 studentsThe number of school
  nurses is inadequate to ensure daily
  availability. We believe Montana students
  deserve the opportunity to learn in an
  environment where their health care needs are met
  by a registered nurse.

20
MEA-MFT Statement

• MEA-MFT supports the Montana Association of
  School Nurses proposal that the ratio of
  registered, professional school nurses to
  students be 1 to 750. . . We stand ready to work
  with the Board of Public Education and MASN to
  achieve this standard.
• Eric
  Feaver, President
• January
  9, 2009

21
How Will This Standard Be Met?

• 144,000 students in Montana public schools
• Minimum of 190 full-time professional school
  nurses, additional to meet needs of high risk
  populations
• Currently 62.5 FTE RN school nurses
• 127 new full-time professional school nurses
  needed
• Salary equivalent to teaching professionals

22
Montana Association of School Nurses Timeline

• Presentations to MT Board of Public Education in
  January and March, 2009
• Montana School Nurse Survey completed in March,
  2009
• Chapter 55, Administrative Rules of Montana,
  currently undergoing revision by the MT Board of
  Public Education, will address a school nurse
  standard
• Development of a realistic school nurse standard
  for Montana schools by Spring, 2011
• Recruitment of 127 additional school nurses by
  2013

23
Montana School Nurses 2009

• Forging Ahead to Meet the Needs of Every Child in
  Montana Schools