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.”
Board Of Education
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.”
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.
The Kittredge school nurse has been there since 2007. They have had at least one diabetic student there for years. Its 2015, so since the rule has been in effect for 8 years, why did they implement this midyear with no advance notice and so reactive like they did?
I don’t know of any nurse ever coming to Kittredge to support the diabetic child. Since she’s been in her role for 8 years, why didn’t she spend that time developing the existing people in the school with the skills needed instead of the one week change they implemented this time?
The child is in 6th grade at Kittredge, he has 24 weeks left of school, and now Kittredge has a nurse. What if Vanderlyn gets a diabetic child next year, are you going to change them again? why can’t DeKalb get every nurse clinic partner up to speed to meet the requirements so they don’t have to change every year based not on the changing needs of the schools. If they don’t have a long term plan to address this it will be too disruptive to the schools to move nurses around wily Nelly without a long term plan.
I haven’t heard anything about middle school needing nurses? The child in question is per all policies a 6th grader in middle school. if middle school doesn’t have nurses then why did they make this change now.