During an April 25 meeting of the Mobile County School Board, more than half of the district’s school nurses said inadequate staffing and the lack of permanent nurse substitute program were creating a “dangerous” situation for students.
According to Dr. Wanda Hannon, supervisor of health and social services, there only 53 registered nurses and 38 licensed practical nurses working the system’s 89 schools and multiple bus routes.
However, because some of those facilities cater to students who require one-on-one care, Hannon said there are currently 55 schools in the district that don’t have a full-time nurse. In some situations, a single nurse is responsible for thousands of students at multiple schools.
Tracy Polk, an RN with the Mobile County Public School System, said she can’t be two places at once. Caring for two diabetic students in the four schools she covers, Polk said the nursing shortage is creating a dangerous situation.
Polk gave the board an example of a close call she had after diverting from her normal schedule to check on a diabetic student at another school.“If I had not done that, her blood sugar would have dropped, and she would have never went home that night,” Polk said. “This is only one of my children. It’s happened to other children, and I’m afraid we’re going to wait until we lose one of these kids before we do something about it.”
Since January, registered nurse Candace Robbins said she’s had to fill in gaps at schools and on buses more than 200 times, and in some cases had to coach support staff over the phone on how to administer medicine to students while she was away.
“Yes, we have care plans in place, but it takes the four years of college and 15 years of experience to be able to recognize a problem and then to treat and react,” Robbins said. “It’s not up to the bookkeeper or the principal to be able to recognize when a student is having symptoms. It’s not their responsibility.”
After the meeting, Hannon told Lagniappe it would take 50 additional RNs just to get the system to a functional level, but even that would be “a long way” from national nursing standards.
Hannon said it’s recommend that an RN be available for every 700 students in the general population with an additional nurse for every 125 students with special needs. At MCPSS, more than 59,000 students are being covered by just 38 RNs.
Additionally, Hannon said the geographic size of the school district and the metropolitan traffic around Mobile can make the problem worse.
“Distance plays a big factor. We cover a lot of ground,” she said. “Today, I was in North Mobile. Sometimes we go from Dauphin Island to Citronelle, and that’s 100 miles.”
The shortages of bus aides — usually LPNs — force registered nurses to leave their assigned schools and accompany children who require monitoring or medicinal assistance. That means, even more students are without a full-time nurse on standby during certain points of the day.
Further, nurses who work full days at multiple schools are being asked to arrive hours before school starts and leave later without being compensated for the hours of the mileage to the bus yards.
Judy Lovelace, a 25-year nurse with the system, is currently in charge of scheduling nurses to fill in the staffing gaps. She said even on days when everyone is working, there are seven buses requiring an RN to fill in.
“It’s not that we’re overworked,” Lovelace told the board. “We know everyone feels like they’re overworked. It’s just that the staffing has reached a critical level.”
While Lovelace did acknowledge the student services department provided some funding to pay for nursing substitutes, that money is already gone. Currently, there is no permanent funding for a substitute program, unlike Baldwin County Public Schools, which annually allocates $125,000 for the service.
Alabama Education Association representative Jesse McDaniel, who has been discussing the issue with MCPSS nurses since January, said the lack of substitutes compounds the problem and the nurses who contacted AEA are at a “breaking point.”
“While they try to balance the most critical needs with what they are told must be a priority, their normal duties are being neglected to an unhealthy degree,” McDaniel said.
Breaking standard protocol for their meetings, some board members spoke directly to the group of nurses, and board member Robert Battles insured all of them their cries were heard.
“We know the urgency. My mother was an LPN for 40 years, but more importantly, the students are our priority,” Battles said. “I’m sure you’ll get the wholehearted support of this board in trying to come up with some kind of solution.”
While Superintendent Martha Peek agreed nurses and student health are priorities, she said “everything, unfortunately, deals with funding,” and a long-term solution would likely have to come from the state.
According to Peek, a meeting was called on Tuesday with administrators in the student services department to address “what we can, as soon as possible.”
“The needs of the students are prioritized. We have some students that require one-on-one nurses, but a lot of the needs you heard tonight were about diabetic students,” Peek said. “In this area, that’s an issue, and there are new regulations regarding those students we still need to work on.”
While McDaniel agreed limited state funding can put systems in a financial bind, he said at a certain point it comes down to “what your priorities are.” He added that other school districts manage to pay for adequate nursing programs with local funding.
“Local funds manage to cover these high administrative salaries, so the money could be there,” he added.