Nurse-student ratio in isles among worst

Isle schools lacking sufficient nurses

>> Schools facing $9M in cuts

>> Big Isle hospital lays off 59

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Hawaii has 98 nurses who work with public school health aides, health officials say.

That comes out to one nurse for every 3,000 students, four times higher than the U.S. government's recommendation of one nurse per 750 students, according to the National Association of School Nurses.

Hawaii ranks among the five worst states in terms of public schools with the fewest nurses per student, according to a review that found most schools in the nation failing to meet a federal staffing ratio.

The national average is one nurse for every 1,151 students, said Amy Garcia, the nurse association's executive director.

The state Health and Education departments are working to improve the school health system, but Health Department spokeswoman Janice Okubo acknowledges that any changes would take a long time to occur.

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Hawaii ranks in the bottom five states for public schools with the least number of nurses per student, according to a review that found most schools in the nation failing to meet a federal staffing ratio.

Isle schools employ one nurse for every 3,000 students, a ratio four times higher than the government-recommended figure of one nurse per 750 students, according to the National Association of School Nurses.

Hawaii misses mark The National Association of School Nurses calculates the nurse-to-student ratio for each state. Federal guidelines recommend that schools employ one nurse for every 750 students, but the national average is one nurse for every 1,151 students. Hawaii has one nurse for every 3,000 students. 5 worst states States with ratios of 1 to 3,000 or more: Hawaii Michigan North Dakota Oklahoma Utah Source: National Association of School Nurses, Associated Press

The national average is one nurse for every 1,151 students, according to Amy Garcia, the nurse association's executive director. A quarter of schools in the nation have no school nurse, and medical duties have become a part of the job for educators across the country as schools cut their nursing staff or require nurses to work at multiple locations.

The change comes as more students are dealing with serious medical conditions, such as severe allergies, asthma and diabetes.

Hawaii Department of Health spokeswoman Janice Okubo said the state has 98 public health nurses who work as consultants to school health aides. Each school has one health aide trained in first aid and cardiopulmonary resuscitation, she said.

Okubo said her department is working with the state Department of Education to improve the school health system, which was established in 1969, but acknowledged that any changes would take a long time to occur.

"Now we have a lot more students who may be on medication, might have special health concerns," Okubo said, noting that in some schools, there are special-education teachers and other staff who are trained to provide medical services.

Although there are no historical data regarding the number of school nurses nationwide, members of the profession say there are fewer nurses doing more work, while teachers and other school workers pick up the slack. The average nurse splits her time between 2.2 schools, according to the school nurses association.

"Teachers deserve a school nurse because their time should be spent teaching," Garcia said.

Meanwhile, the workload of school nurses has increased since 1975, when the federal government mandated that schools accommodate disabled students, clearing the way for children with feeding tubes, catheters and other serious medical conditions to attend school. Today, 16 percent of students have a condition that requires regular attention from the school nurse, Garcia said.

Many parents and school administers don't realize that nurses are handling life-threatening conditions as well as performing vision, health and diabetes screenings, said Barbara Duddy, president of the Tennessee Association of School Nurses in Memphis.

"They think the school nurse is a nice little job where you take care of boo-boos," she said. "School nurses work very hard to make sure every child gets exactly what they need."

Garcia blamed shifting priorities, shrinking budgets and a misunderstanding of the school nurse's role for the loss of jobs.