No laws require districts to keep nurses in schools
Peanut allergies. Insulin spikes. Epileptic seizures. Asthma attacks.
School nurses have much more than runny noses and stomach aches on their plates these days.
Despite a rise in allergies and serious medical conditions among school-age children, and zero-tolerance policies that don't allow students to carry their own medications, Illinois schools, by law, are not required to have a nurse on staff.
The combination, experts say, is a dangerous one.
"We have so many children getting medications, and so many children with needs: not only the diabetics, but the allergy students. It's kind of an accident waiting to happen," said Linda Gibbons, coordinator of school nursing and health at National-Louis University and a director of the Illinois Association of School Nurses.
The Illinois Administrative Code mandates that nurses working at schools must be registered professionals.
The code requires school boards develop and keep a job description of a school nurse's duties.
The code also talks about preventing communicable diseases, maintaining health records, conducting vision and hearing screenings, and acting as a liaison between homes, schools and communities.
It says nothing, however, about requiring a nurse to be a part of a school's staff.
On the federal level, several laws, including the Individuals with Disabilities Education Improvement Act, the Rehabilitation Act and the Americans with Disabilities Act, require school districts to provide nursing services to students with special needs.
Still, nurses are not required to be at schools for the entire school day. According to the American Academy of Allergy, Asthma and Immunology, about 2.2 million school-age children have food allergies in one form or another.
Both Type 1 and Type 2 diabetes are also on the rise among kids.
Despite this, many area districts do not feature full-time nurses at their schools.
Elgin Area School District U-46's 40 elementary and eight middle schools all have nurses from 10 a.m. to 1 p.m., a period the district has deemed a "critical time," Assistant Superintendent Lalo Ponce said.
Like the district's high schools, some of these schools have a full-time nurse on staff. But others that have smaller enrollment counts don't have a nurse in the early morning or afternoon, Ponce said. Those lapses of coverage are a major source of worry for Kim Stover, whose sons attend Clinton Elementary School in South Elgin.
Stover's 8-year-old son, Andrew, suffers from mitochondrial disease, a progressive fatigue-inducing condition. Fed through a surgical tube, Andrew doesn't eat at school, but he encounters problems when the tube is bumped or jostled.
Ten-year-old Nathan Stover suffers from eosinophilic esophagitis or EE, a severe allergic condition that causes his throat to close if he eats certain foods. For the past two years, Stover has battled U-46 to increase nursing hours.
While Clinton has added hours, there is still a portion of the school day where no nurse is present, she said.
"I have a hard time. I don't want anybody else to take care of my child that is not a nurse."
At Des Plaines Elementary District 62, five nurses are assigned to the district's 11 elementary and middle schools, Human Resources Manager Nancy Jenkins said. Health aides trained in CPR and first aid supplement the nursing hours.
Woodridge Elementary District 68 has just one nurse for its seven schools.
Like in District 62, health aides work at each campus.
In Naperville Community Unit School District 203's 21 schools, one nurse is assigned to every two elementary schools, and two nurses to each high school, with health aides at every campus, Health Services Director Ellen Wolff said.
School nurse Pam Breslin splits her weeks between Kennedy Junior High in Lisle and River Woods Elementary in Naperville.
"It really is difficult," she said of juggling her schedule.
"The job is so unpredictable. You just don't know when an emergency is going to come up."
Wolff said the district had 52 diabetic students during the 2007-08 school year. This year, the number has risen to 70.
The National Association of School Nurses provides guidelines that one nurse should be provided for every 750 healthy students, one nurse per every 125 students with complex health care needs.
Yet, more than half of public schools across the country do not have a school nurse, according to the association.
In Illinois, a 2008 study by the association found that the nurse-to-student ratio is 1: 2,030.
"We have a lot of people practicing nursing at schools that are not nurses," National-Louis' Gibbons said. "Medication errors in this country are at an all-time high. Research tells us that when non-nurses and aides (are dispensing medication) the rate of error is much higher."
Recent legislation, introduced in June by U.S. Rep. Carolyn McCarthy of New York, would provide grants to states through the Centers of Disease Control and Prevention to improve the nurse-to-student ratio.
That legislation was referred to the House Committee on Energy and Commerce.
In the meantime, the Illinois Association of School Nurses is advocating to have a representative on the State Board of Education.
"As we get more children with medical needs, the need for school nurses is greater," Wolff said.
"Would a state law help? Absolutely."