When Teri Saurer sent her first daughter to school, she didnt think twice about school nurses.
But when Saurer enrolled her second child at Ballantyne Elementary last spring, thats one of the first things she checked. Five-year-old Hannah has severe food allergies and a history of epilepsy, and her mom was shocked to learn there would be no nurse at school half the week.
Now Saurer is leading a group of Mecklenburg and Union county parents lobbying for a full-time nurse in every school. Not only do nurses care for a growing number of students with such chronic conditions as asthma, allergies and diabetes, the parents say, but their expertise could be vital in case of accidents and unexpected ailments.
It should affect parents of healthy children, too. You never know when an emergency is going to happen, Saurer says.
Several years ago, state legislators and Mecklenburg County officials began adding nurses, working toward the national standard of one nurse for every 750 students. But the recession stalled that effort while Charlotte-Mecklenburg Schools enrollment continued to grow, a common pattern across the state. At the most recent state tally in 2010-11, both CMS and Union County were doing slightly better than the state average of 1,200 students per nurse.
Last spring, Saurer spoke to county commissioners about hiring more nurses in 2012-13. She quickly learned her efforts were too little and too late: Its not like, Oh, Teri spoke, lets give her some money.
This time around, she and other parents of chronically ill or allergic children are gearing up early, hoping to make a more sophisticated push to get their cause considered when the county starts planning for 2013-14. Theyve created Parents Advocating for School Health to reach out to PTAs and other parent groups and make their case to candidates, office-holders and key staff at the state and local level.
Few dispute the value of school nurses. But as the economy begins a slow recovery and governments move out of crisis mode, the competition for new money is likely to be fierce.
At a recent CMS school board meeting, for instance, parents pleaded for the district to restore transportation money to undo cuts in magnet busing and changes in school hours. Board member Eric Davis said its nice to be talking about additions instead of cuts, but our appetite to put things in far exceeds our ability.
Mecklenburg County Commissioner Bill James, who represents the south suburban area where Saurer lives, said hell only consider adding nurses if it can be done without a tax increase.
Many parents picture school nurses tending to skinned knees, sore throats, upset stomachs and the occasional broken bone. But for a growing number of families, the nurse also oversees care for chronic conditions that can be life-threatening.
They monitor inhaler use and handle nebulizer treatments for students with asthma, the most common chronic illness among students. They help students with diabetes monitor blood sugar, which can fluctuate dramatically.
They help students with food allergies avoid exposure, and can administer an Epi-pen injection in case of anaphylactic shock.
Those conditions cross all geographic and economic lines. A recent meeting at Providence Pointe clubhouse in southern Mecklenburg County drew parents who said theyd left public schools for private or charter schools to ensure a school nurse is always on duty.
Saurer says shes delighted with Ballantyne Elementary and its nurse, Patty OBrien. But she worries about the 2 1/2 days a week when OBrien is stationed at Providence Spring Elementary, about 8 miles away. She and her husband, Craig, have talked about moving across the state line to Fort Mill, where there are nurses at school every day.
Fort Mill uses district money to supplement state spending at its 13 schools, said spokeswoman Kelly McKinney.
We decided for the safety of our children that we wanted to have full-time nurses, she said.
CMS has 69 schools that have a nurse every day. Eighty-eight smaller schools share, with nurses onsite one to four days a week, says Maria Bonaiuto, school health director for the Mecklenburg County Health Department.
Kerrie Sperduto, who has children in Union Countys Sandy Ridge Elementary, also worries about having one nurse split between two schools, with a total of 1,600 students. Two of her five children have food allergies, and she worries that theyll have a reaction while the nurse is away.
North Carolinas response to the gaps in nurse coverage has been to require school staff to be trained to handle some of the most common student needs.
Bonaiuto said all CMS schools have at least two first responders educated by a nurse to respond to specific needs of children with issues like asthma, severe allergies and diabetes. In addition, every child with a high-risk condition has an emergency action plan the nurses develop with the parents.
While its not ideal, it really works nicely. They all have CPR training, Bonaiuto said. Its about a building of adults looking after children who need their help.
Cheryl Herberg, president of the N.C. School Nurse Association, says the train someone else to do it for free approach isnt one adults would find acceptable for their own medical needs.
School nurses are not an extra, says Herberg, who works at Unions Sandy Ridge and Kensington elementaries. When she started in 2002, she said she had to cover five schools.
Finding the money
Money for school nurses comes from a mix of federal, state and local money. In most of North Carolina, the nurses work for the school district. In Mecklenburg and a few other counties they work for the health department. That means the budget decisions are made by county commissioners, not the school board.
Saurer has been handing out contact information for county commissioners, key staff, and school board members, in hopes of getting their blessing. Her goal is to get more nurses included in the county managers plan, which would boost the chances of commissioners approval.
Budget planning begins in January, after the November election. County Health Director Wynn Mabry said he will remind new commissioners that in 2007 the board said it would work toward the federally recommended ratio of one nurse per 750 students. Mabry said while the county does not have to meet that ratio immediately, it would mean adding 20 nurses to the budget per year for the next few years if the number of chronically ill children does not increase.
We always look for funding opportunities to increase the availability of school nurses, including state funds and local money, said Bobby Cobb, Mecklenburg deputy health director.
Ultimately, Herberg and others say the best solution is a state law like one the Georgia state legislature passed this summer providing money for schools to reach the national standard. Parents Advocating for School Health plans to work at persuading North Carolina legislators, as well as local officials.
For now, the group is working with a mixed blessing: There havent been any tragedies with the current staffing levels.
It will be dramatic, Saurer says, when some child dies in CMS and the nurse wasnt there.