A nurse in every school
Pictured above is UK College of Nursing alumni and 2019 Kentucky Nurse of the Year Eva Stone, DNP, APRN
Many of us can remember a time when every school—elementary, middle and high school— had a school nurse who looked after students during the school day. School nurses cared for sick children and tended to playground scrapes and bruises. But after decades of budget cuts and changes in Medicaid funding, many schools have lost their nurses.
UK College of Nursing alumna Eva Stone (MSN 2005, DNP 2019) is trying to bring back the school nurse at a time when, she says, they are needed more than ever. “My dad was an elementary school principal, and so I just assumed that because his school had a nurse that all schools had a nurse,” says Stone, who is district health coordinator for Jefferson County Public Schools. “But when I left public health and started working in a local school district, I realized this was not so.”
When Stone looked into the matter further, she discovered Kentucky schools were not required to employ nurses, and so when school districts reduced their budgets to meet rising costs, school nurses were dismissed. Some of these nurses moved to roles within local health departments, but due to changes in Medicaid, health departments have lost their ability to send nurses into schools.
But thanks in part to advocacy by Stone and a group of dedicated nurses from the Kentucky Nurses Association, the state’s school health situation could improve. A recent decision by legislators to allow Medicaid funds to be used for both mental health and physical health in schools could help districts start hiring nurses again.
“In past years, the Medicaid money could only be used to pay for students with physical disabilities and an Individualized Education Plan or IEP,” Stone says.
A 2018 school health report showed roughly half of all middle and high schools in the state have a full-time registered nurse on site. Accurate data regarding the number of nurses in elementary schools is difficult to find, Stone says. However, the state does track how many 5- and 6-year-olds have had eye and dental screenings by the time they start kindergarten, and a majority are arriving in the classroom without. The same goes for the state’s sixth-graders, roughly half of whom are missing regular health exams, Stone says.
“There are so many barriers to health care, including parents who work multiple jobs or lack health insurance,” Stone says. “School nurses could cover many of these exams and help children stay healthy so they can learn."
While she no longer heads the state nursing association workgroup that is leading the charge to put a nurse in every school, Stone says she is happy with the group’s work to educate legislators about the risks of inadequate health care for the school-aged children. A bill to require a nurse in every school is slated for introduction in 2021.
The current COVID-19 pandemic has further highlighted the need for health care assistance in schools. Having daily on-site care and expertise would be a huge help to schools in their efforts to safely reopen and mitigate the spread of disease.
"If a child is sick or there’s broad fear surrounding health safety at schools, then children’s education will be impacted,” says Stone. “Nurses are well equipped to be on the front lines in schools to ensure that all students are healthy and ready to learn.”
The above article was written for and appeared in the UK College of Nursing's Winter 2021-21 edition of Engagement.
