Only a few reasons account for the shortage of school nurses, mainly continued cuts to the position from school district budgets and very low pay when compared to nursing positions in clinics and hospitals. Responsibilities are continually increasing while the populations that each individual nurse serves increase as well, leading many to leave the field out of frustration.
Identification
"USA Today" examined census responses in 2004 and found that there is about one school nurse for every 950 students, while a study by the National Association of School Nurses showed the ratio to be much greater, with one nurse for about every 1,400 students. Federal guidelines recommend one school nurse for every 750 students. Since these are averages, some nurses are actually responsible for even larger student populations--more than 7,000 students in some instances. About 56,000 school nurses were working full-time in 2004. Almost half of the schools in the United States have more students per nurse than the federal recommendations call for.
Size
An all-around shortage of nurses adversely affects the health care industry, not just in schools. Demand for nurses is much higher than nursing schools can accommodate and is expected to increase by 2 to 3 percent each year through at least to 2025, mainly due to the aging baby boomer population. An additional 30,000 nurses would need to graduate each year to fill these needs. A 2007 report from the American Hospital Association stated that nearly half of U.S. hospitals were having problems recruiting enough registered nurses.
Considerations
School nurse salaries are low compared to that of nurses elsewhere. In 2004, the median salary for school nurses was about $36,000, compared with $56,000 for a staff nurse at a hospital or clinic. At top hospitals, registered nurses with at least 15 years experience can make more than $140,000 a year.
Effects
Years of school district budget cuts have combined several districts under one nurse, or eliminated nurses from schools altogether. However, the need for school nurses is greater than ever, as children with challenging medical needs are being mainstreamed into school systems, including those with cerebral palsy and scoliosis. More children are being treated for severe asthma, diabetes, food allergies, attention-deficit disorder, depression, bipolar disorders and autism--many of these students are taking regular medication. Overworked and frustrated nurses feel overwhelmed and leave the field, choosing more lucrative positions in clinics and hospitals.
Prevention/Solution
A study published by the American Nurses Association recommends federal legislation to solve the problem. This report says the federal government should require school districts to hire nurses and also provide funding for hiring and retention. In addition, the report recommends that school districts be directed to comply with the guideline of one school nurse for every 750 students.
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