Monthly Archives: October 2015

Licensed Nurses & the Care of Diabetic Students

Posted on October 26, 2015 by | 2 comments

Regarding the “School Health Care Realignment of Services”, Dr. Green said, “The practice as implemented in 2004 was to ensure that every student with diabetes was supported by a licensed nurse during the entire instructional day.”


Stan Jester
Board Of Education
District 1

A few weeks ago the school district exercised a School Health Care Realignment of Services. Superintendent Stephen Green explained the guidance the district used to make these recent school nurse reassignment decisions.
Dr. Vasanne Tinsley is currently the Director of Support Services and has been with the school district since 2007. The following are Dr. Tinsley’s answers to some follow up questions I had regarding practice, board policy and state mandated care of diabetic students.
SBOE Rule 160-4-8-.18, O.C.G.A. § 20-2-779, and DeKalb Schools Policy JGC-R(1) all say the same thing regarding schools with diabetic students, “The school nurse or at least one trained diabetes personnel shall be on site at each school and available during regular school hours to provide care to each student with a diabetes medical management plan being implemented by the school.”

Vasanne Tinsley

Question: Before the recent nurse shuffle in October, did all elementary schools with diabetic students have a school nurse or at least one trained diabetes personnel on site during the entire school day?
Dr. Vasanne Tinsley: Yes. Each elementary schools had either had a nurse or a clinic assistant. Clinic assistants had basic training to monitor students, but are unable to administer insulin. School nurses are able to monitor and give insulin injections as needed.
Question: Since the October nurse shuffle, do all elementary schools with diabetic students have a school nurse or at least one trained diabetes personnel on site throughout the regular school day?
Dr. Vasanne Tinsley: Yes. Based on current enrollment data, schools with diabetic students are supported by a licensed nurse. Licensed nurses are able to monitor students and administer insulin injections as needed.
Question: Does it comply with state law § 20-2-779 to not have a school nurse or at least one trained diabetes personnel on site during the entire school day at elementary schools with diabetic students?
Michael Walker (DCSD Interim Chief Legal Officer) : [The analysis provided to this question] is a privileged and confidential communication.
Note: Regarding the “School Health Care Realignment of Services”, Dr. Green said, “The practice as implemented in 2004 was to ensure that every student with diabetes was supported by a licensed nurse during the entire instructional day.”
Question: What is a licensed nurse?
Dr. Vasanne Tinsley: A licensed nurse is either a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). The licensed nurse credential requires completion of a nursing program of study (LPN- 18 months, RN- 2 -4 year program) and successful passing of the state license board examination. Licensed practical nurses must be supervised by a registered nurse. In our district, the lead nurse and consulting nurses provide this supervision.
Question: Can you elaborate on the practice that was implemented in 2004.
Dr. Vasanne Tinsley: Because of the diversity of the population of the school district and the shift in medical concerns noticed in students, it was recommended that the Student Health program only hire individuals with a higher level of training and more skill. The Board of Education and Superintendent Johnny Brown supported this recommendation and approved to cease hiring clinic assistants (unlicensed personnel) to support elementary clinics throughout the district.
Question: For at least the last few years there have been diabetic students at DeKalb elementary schools without a licensed nurse. When did said practice stop being implemented with fidelity?
Dr. Vasanne Tinsley: In the initial plan created many years ago, diabetic students in schools without a licensed nurse were supported by travel nurses from neighboring schools. Typical support was offered during the middle point of the day, when insulin most injections take place. The licensed nurse was required to travel daily to another site to support the monitoring of blood sugar, injection of insulin, and after meal monitoring. The travel nurses were often away from their base locations for up to 2 hours, leaving the base population without health support. This practice has been consistent and has not been implemented without fidelity.
Question: Dr. Green also mentioned, “The District went further to develop a collaboration with DeKalb High School of Technology South to develop the training for current non-licensed staff”. What is the status of that? How do current DCSD employees who are non-licensed school nurses become licensed nurses?
Dr. Vasanne Tinsley: The district has been in communication with the Principal and the teacher of the Certified Nursing Assistant (CNA) program at DeKalb High School of Technology-South to begin the development of this professional learning program for clinic assistants to become Certified Nursing Assistants/with the passing of the exam. We are hopeful that this program will be available for enrollment during the 2016-17 school year. Offering this opportunity would show our commitment towards retention of the clinic assistants, who have basic training in first aid, CPR and procedures of the school district. This may also offer possible employment to students who graduate from the district with the CNA credential through our Career Tech program. Clinic assistants would not be licensed nurses upon completion of this program brief training program. The licensed nurse credential requires completion of a nursing program of study (LPN- 18 months, RN- 2 -4 year program) and successful passing of the state license board examination.

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Posted in Healthcare, Human Resources

Over-Crowded Buses

Posted on October 19, 2015 by | 5 comments

13 percent of the total 1,485 school bus runs at DeKalb Schools are over-crowded.


Stan Jester
Board Of Education
District 1

The DeKalb County School District’s (DCSD) Transportation Department transports approximately 60,000 students daily. As of October 11, 2015, the department has a bus driver allotment of 878 drivers of which 822 positions are “actively” engaged in providing daily bus transportation support for 803 routes. The District has a total school bus fleet of 1,009 school buses with an average age of 10.1 years. The District maintains a minimum of 950 schools buses, to include 100 spares, to ensure bus availability to support the District’s daily transportation operations. The DeKalb County School District follows the industry standard of three students per seat for grades K-5 and two students per seat for grades 6-12.
At the Board of Education meeting this month, many bus drivers showed up for public comments to explain some concerns they have. As reported by Marlon A. Walker in the AJC, “Sometimes, bus driver Kim Davis says, the school buses in DeKalb County are so full of students that some are forced to stand the whole way to school.”
Cathy Douglas, president of the Bus Advisory Council, said she believed the district was down about 70 bus drivers and did not have the buses needed to handle every route. “Children are late every day because of no drivers,” she said. “On some buses, there are as many as 80 students on 64-passenger buses. If a bus breaks down, we’re in trouble.”
The school district’s analysis and response last week to over-crowded buses:
STRATEGIC OVERVIEW TO ADDRESS OVER-CROWDED BUSES

Subject: Strategic Overview to Address Over-Crowded Buses
By: Superintendent Stephen Green

Analysis/ Findings
The Transportation Department conducted a capacity/utilization analysis of all bus routes and identified bus runs over capacity by one or more students. Based upon this internal analysis, approximately 13 percent of the total 1,485 school bus runs are over-crowded at this time. As of October 11, 2015, there are 196 bus runs identified as being over-crowded. However, this does not imply that all over-crowded school bus runs have students standing while the bus is in motion. The following prioritization strategy is being utilized to address these issues in the short-term:

  • Priority #1: More than 16 students over bus capacity
  • Priority #2: Between 6 and 15 students over bus capacity
  • Priority #3: Less than 6 students over bus capacity

Short-Term Strategy
The District’s short-term strategy focuses on resolving all over-crowded runs no later than October 23, 2015. The following key actions will be taken over the next several days:

  • Continue to validate ridership in collaboration with schools and Transportation staff
  • Balance loads and reassign students to new bus runs as appropriate
  • Where load balancing is not feasible, additional drivers and/or double runs will be utilized
  • Partner with school bus transportation service vendors as a supplemental resource to address overcrowding
  • Effectively communicate student route changes to all impacted stakeholders prior to implementation

Long-Term Strategy
The District will continue to further develop a comprehensive long term strategy (3 to 5 years) to balance student ridership across the District. This long term strategy will consider the following key areas as we seek to build additional capacity to ensure scalability and accommodate future growth:

  • Conduct a thorough analysis of the Transportation management structure and operations to enhance the District’s school bus service delivery
  • Significantly reduce the annual employee turnover rate by hiring and retaining a larger pool of highly qualified school bus drivers and monitors
  • Improve internal and external communications with all stakeholders
  • Purchase additional buses in accordance with the District’s school bus replacement cycle
  • Determine annual funding requirements for long term sustainability

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Posted in Buses, Stephen Green