School nurses provide health care for chronic acute illness, give medication and are first responders for in-school injuries. Student Health Services provided this staffing report on DeKalb Schools’ Nurses And Healthcare Workers (2/2/2015) for its elementary schools.
Currently, DeKalb Schools only funds healthcare employees in elementary schools. The board (with Marshall Orson leading the charge) and superintendent are looking into staffing the middle and high schools with nurses and healthcare workers. Across the metro Atlanta area, the following models are currently used to provide healthcare services:
Atlanta Public Schools (47,000 students)- 2 lead nurses, 19 district consulting nurses, and licensed nurses serving all schools. These nurses share schools and respond based on need.
Cobb County Schools (111,000 students)- 1 lead nurse, 5 district consulting nurses and licensed nurses in local schools.
Clayton County Schools (50,000 students)- 6 supervising nurses with CNA’s (Certified Nursing Assistants) and CMA’s (Certified Medical Assistants) serving local schools. Supervising nurses oversee the services of the CNA’s and CMA’s in the schools.
DeKalb County Schools (100,000 students)- 1 lead nurse, 3 consulting nurses and licensed nurses and clinic assistants supporting the elementary schools. Consulting nurses may assist in the middle school and high school setting, if needed.
Fulton County Schools (94,000 students)- 1 medical doctor, 1 lead nurse, 14 district cluster nurses and unlicensed clinic assistants in the local schools. Cluster nurses support the unlicensed persons in the schools.
Henry County Schools (40,000 students)- 1 lead nurse, licensed nurses and clinic assistants serving the all schools. Personnel assigned to multiple sites. Assignments are made by cluster.
Gwinnett County Schools (161,000 students)- 1 lead nurse, 10 cluster nurses, and registered nurses and clinic assistants in local schools.
Through analysis, the following trends were found:
- A few districts only hire licensed nurses. (APS, Cobb).
- Many districts utilize a cluster assignment format and assign personnel to multiple sites. (Gwinnett, Fulton, APS, Henry, Clayton)
- Many districts employ a lead nurse and supervising nurses to support the personnel in the local schools. (APS, Gwinnett, Henry, Cobb, Clayton, DeKalb and Fulton)
OPTIONS
Based on this analysis and considering the increased health needs of students in the district, the following three options are being presented to the DeKalb Board of Education for consideration:
Option 1: Hire 24 licensed nurses to support middle and high schools and keep current structure (55 licensed nurses and 21 unlicensed persons in the elementary schools) to support elementary schools in the district. Persons would work in feeder pattern. This would be an expansion of the current model in DeKalb and is similar to the model in Gwinnett County Schools.
Option 2: Hire 24 CNA’s (Certified Nursing Assistants) to work in the middle and high schools and reassign current licensed nurses (55) to work in clusters/regions to support the unlicensed persons and CNA’s throughout the district. This model is similar to the service delivery in Clayton County Schools.
Option 3: Reassign currently employed 55 licensed nurses that work in the elementary schools to support all schools throughout the district. The nurses would be assigned by clusters/ regions and would be assigned to schools based on acuity of need. This model is similar to the service delivery in Atlanta Public Schools and would save the district money, as new hires would not be needed.
Timeline
2014-15 Placement of Health Personnel (approximately $400,000)
March, 2015 – The Student Support Department will work with Human Resources to post positions on PATS. Advertisements will be placed in local trade publication and at local schools with students graduating with appropriate credential.
April, 2015 – Interviewing and Hiring process will be coordinated with Human Resources.
2015-16 Placement of Health Personnel (approximately $880,000)
June/July, 2015- The Student Support Department will work with Human Resources to post positions on PATS. Advertisements will be placed in local trade publication and at local schools with students graduating with appropriate credential.
July/August, 2015- Interviewing and Hiring process will be coordinated with Human Resources
Additional Considerations
To help retain nurses that serve our students, consideration should be given to reclassifying the workday for nurses from 6 hours to 8 hours. This increase in salary would help to make hiring competitive with other markets that might pull from qualified candidates. Additionally, the classification should be the same among regular education nurses and special education nurses. Currently, there is a major difference in the salaries and regular education nurses leave to work for the special education program because of salary.
To provide support to all schools, consideration should be given to increasing the number of district consulting nurses from 3 to 6 to better support the persons serving the local schools.
“Extremism in defense of liberty is no vice. Moderation in pursuit of justice is no virtue.”