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System considers changes in school nurses

By Greg Gelpi

A proposal would reduce the required training of school nurses in Clayton County, while placing nurses in all of the county's schools.

The Clayton County school system has registered nurses at all elementary schools, one middle school and one high school. The proposal puts licensed practical nurses in all of the system's schools.

"What (Chief Financial Officer Lee Davis) and I are trying to do in the long run is save money and protect children," Superintendent Barbara Pulliam said at a recent meeting of the Clayton County Board of Education.

Having LPNs at all schools would provide a "more equitable distribution" of nurses, Pulliam said.

The proposal would replace RNs with LPNs as they leave the system, said Charles White, a spokesman for the school system. The school system is not looking to get rid of any nurses already on staff.

"I just don't want to alarm the folks who are RNs in our schools," White said.

The proposed changes would "maximize resources," while addressing the issue of "next to no coverage" in middle and high schools, he said. The system wants to "provide the broadest amount of healthcare to as many students as possible."

The proposal would be phased in during a three-year period and would place an RN over a group of LPNs.

"There are going to be places where the coordinator of nursing is going to be allowed to exercise her discretion," White said.

The system will place nurses appropriately where they best meet the medical needs of a particular student body, he said.

It's important to have a health professional at every school, said Sid Chapman, the president of the Clayton County Education Association, an association that includes school nurses.

"I think it would be better to have LPNs at every school, rather than no nurses at all," Chapman said. "I think it would be even better to have RNs at every school."

RNs could be cost prohibitive, though, he said. He expressed concern for the school system's nurses and for the schools that have no nurses.

"I would hope that they wouldn't dismiss any RNs," Chapman said. "I always felt too that secretaries divvying out medication is risky. I always thought it would be better to have a trained professional."

A teacher as well, he said that he has encountered seizures, "weird" reactions to medication and students passing out.

"The healthcare person they have there should be the highest trained person they can afford to have," said Dr. Deborah J. Clark, the associate dean of nursing at Clayton College & State University.

Clark explained that both RNs and LPNs are licensed healthcare workers, but that LPNs receive 18 months of training, while RNs receive two to four years of training. LPNs have technical degrees, while RNs have training, which provides them with a "high level of critical skills and problem solving."

"(The LPNs) do not have the depth of training," she said, adding that schools present a myriad of health issues. "You have all the normal childhood diseases passed around the school. They also have the complex family problems."

According to licensing, LPNs must be supervised by RNs, but the system is not sure how the supervision will be structured or how it will operate.

The school board adopted the current structure a few years ago. The proposed restructuring has not been brought before the board as of yet and has not been finalized.