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Schools suffer from nursing shortage

WORTHINGTON -- The idea of a school nurse's office often conjures images of ice packs and thermometers, of third-graders dramatically clutching their tummies in an effort to skip out on math class. But today's nurses face much more than that -- eating disorders, autism, seizures and mental illness to name a few -- and, according to a recent study by Minnesota 2020 and the School Nurse Organization of Minnesota (SNOM), there simply aren't enough to go around.

The non-scientific, online survey was created in May and sent to members of SNOM. Responding were 131 school nurses, nursing administrators, supervisors or coordinators representing urban, suburban and rural areas.

Nearly 81 percent of those surveyed said that a nurse shortage exists, and nearly 82 percent believe insufficient funding is to blame for the deficit.

Registered Nurse Wendy Donkersloot agrees.

Donkersloot is an employee of Sanford Regional Hospital Worthington who is contracted by District 518 to provide care to students at Prairie Elementary School, Worthington Middle School and Worthington High School. She is quick to tell you how much she loves her job, but just as quick to lament that she can't do more, or at least have some help.

"To stay afloat I do the day-to-day stuff. There's not enough time to research and investigate the deeper needs of the kids, I just try to get them to a doctor or counselor," she said. "I would really like to be able to go to the classroom and teach these kids how to be healthy now."

But if Minnesota continues to rank below the national average in nurse-to-student ratios, her dream of finding more time for health education may remain just that.

The Center for Disease Control and Prevention and the National Center for Health Statistics recommend one nurse for every 750 students. The most favorable estimates from that group put Minnesota's average ratio at one to 1,404. In Worthington, Donkersloot is the only nurse for the more than 2,200 students in the public school system.

Since she can't be in three places at once, she has a health secretary at each school to assist students. They are trained in first aid and CPR and know how to distribute medication.

Donkersloot said she's confident in her staff's ability to respond while she's en route to help, but is well aware of the risk the arrangement poses both to her secretaries' jobs and her own.

"It's risky for kids and that should be a concern for parents," she said.

She usually plans to go to one school each day but often ends up in meetings at others. In addition to dispensing medication and seeing what she describes as a constant flow of ill students, she is expected to coordinate vision and hearing screenings and develop individualized health plans for all students with special health needs.

In Donkersloot's two years with the district, she and a group of volunteers have identified 50 students in need of glasses. She developed a Prairie Kids Health Club last year and has now mounted a campaign to reduce the district's teen pregnancy rates. And she still wishes she could do more -- wishes for even another part-time nurse.

"Teachers tell me all the time, 'We need a full-time nurse at Prairie," she said.

Yet the District 518 school board, like many school boards, is at a loss as to what to do.

"Obviously we'd like to increase that staffing level but at this point we don't have the funds to do that," said David Skog, director of management services. "We have the discussion every year of what we would cut and we do look for possible funding sources, but there's not very many of them outside of the regular district budget." The big stumbling block, he said, is finding funding that could be used on a consistent basis.

Some educators blame No Child Left Behind legislation for the deficit, arguing it forces schools to cut back in needed areas like social work and nursing in order to channel money into ensuring students pass tests in core subject areas. Donkersloot said she knows the district's budget is tight, but suggested putting some of the money used for testing toward hiring another nurse.

"I have a favorite saying," she said. "Healthy kids make better learners."