The "Does Your School Have A School Nurse?" Story

It was an ordinary day.  Reading a few of my favorite sites online when I came across a story that seemed as if it might have been written yesterday.  But, the article was dated 1918...more than 100 years ago.  Story about schools employing school nurses and how school funding cuts have threatened school nurses, while a deadly pandemic proves they could be among the most important figures in education.  Seems that the current push for schools across the country to return to in-person learning isn't something new.  It also happened over 100 years ago.  In part, it read..."When I look at opening schools, and I've been very entrenched in it both at the state level and at the local level, it feels to me like we're doing the biggest social experiment ever without an institutional review board.  We are going to have kids and staff that are sick and, God forbid, die."  And, another post I recently read told about the pandemic of 1918.  It read:  In 1918, the flu would kill more than twice that number — and perhaps five times as many — in just 15 months. Though mostly forgotten, it has been called “the greatest medical holocaust in history.” Experts believe between 50 and 100 million people were killed. More than two-thirds of them died in a single 10-week period in the autumn of 1918. Sound familiar?  A woman by the name of Robin Cogan, a nationally certified school nurse from New Jersey, writes a blog known as "Relentless School Nurse" where she's been sharing useful information as well as stories from school  nurses around the country.  Her recent posts to her blog have been centered around a central theme: It has taken a Pandemic to Understand the Importance of School Nurses.  One such post from 1918, that appeared in The Charlotte News read, "There can be little doubt, that as the work of the nurse becomes better understood, there will be a greater demand all over the world for her services in the school, for wherever she has made her entry, her value has been recognized."  

The School Nurse showing a student how to brush his teeth.

But, in recent decades, school nurses have been eliminated from many schools across the country.  Less than 40% of public schools now employ school nurses.  In the western part of our country, that number has dropped to under 10%.  So, when you read about schools starting soon, it's difficult to imagine a responsible plan for returning to school without  an on-site medical professional.  But, for many of America's strapped school systems, that's what's probably going to happen.  And...how is that going to work out?  School nursing began as sort of an experiment when cities were becoming crowded with unsanitary slums and public school that were faced with influenza, tuberculosis and skin conditions like eczema and scabies.  Do you remember back to your youth and attending school?  Was there a school nurse you could be sent to if you became ill in the classroom.  I was very luck evidently, since in the school district where I went to school, as well as returned to and taught for 33 years, there was a school nurse, and still is, in every school in the district.  In the upper grades there were usually two or more school nurses.  Back in 1902, The Henry Street Settlement, which was founded and led by nurse Lillian Wald, who pioneered a program to place one school nurse in four city schools, with at least 10,000 students, for a month.  That nurse was Lina Rogers, and her undertaking was a significant one.  She was to perform her duties at each school in a makeshift nurses' office, sometimes being the janitorial closet.  

The school nurse is needed in all schools.  Click to enlarge.

Eventually students realized she was available at certain times and used her as there "go-to" medical care, being treated as if she were the family doctor.  At the end of the experiment, Rogers was appointed to lead a team of school nurses in the city.  When her program began once again, the district found that the 10,000 absences a month they had experienced the year before dropped to about 1,000 a month.  Rogers became an advocate for school nursing and cities across the United States realized the success of the Henry Street Settlement's success.  Roger's ended up writing a textbook detailing her work and giving guidance to the nation's women who were setting out to become school nurses.  She then began to visit student's homes and found that things other than illness was keeping them from school. Things such as lack of babysitters, housework, street crime and neglect were keeping them from going to school.  Social problems were facing absenteeism as much as health problems.  Throughout the postwar years and the Great Society programs of the 1960's, school health programs expanded to address drug abuse, students with disabilities and mental health.  Seems that school nurses became iconic fixtures in the public school, but after the recession of 2008, school funding took a big hit once again.  School funding was reduced in most states and with that was the loss of many school nurses.  The School Nurse still finds themselves advocating for public health reforms, but it is a never-ending battle.  Now, during the COVID-19 pandemic, nurses could be once again the most important figure in the school.  When schools don't have public health professionals in their schools, they face infection control expertise and mismanaging of proper procedures needed to help stop the spread of the virus.  The Federal Government has been asked to supply 208 billion dollars to help support school nursing.  How's that going to work out?  Your guess is as good as mine, but without the school nurse in each and every school in the country, this pandemic is going to spread like wildfire in the schools.   We need those school nurses to help keep our children safe the best they can.  Let's hope it can be done.  It was another extraordinary day in the life of an ordinary guy.