Parents worried about proposed nursing changes

By Greg Gelpi

A new school policy has Kim Spivey worried about the health and safety of her son.

Clayton County schools Superintendent Barbara Pulliam issued an administrative rule creating positions for licensed practicing nurses and consulting school nurses. The changes are part of the system's restructuring of the school-nursing program.

The Clayton County school system advertised vacancies for 18 LPNs.

The school system has RNs at all elementary schools, but Pulliam said at a meeting of the Clayton County Board of Education that she wanted to explore an option to place LPNs, who have less training than RNs, in all of the county's schools.

"I'm actually the mother of a diabetic child," Spivey said. "Of course, I am outraged."

Insulin must be administered to her son four times a day, including once at school, she said. An LPN, though, can't administer insulin shots without supervision of an RN.

The school system's restructuring plan would "more than likely" place an LPN in every county school, school system spokesman Charles White said. An RN would supervise a group of LPNs.

"LPNs under the Nurse Practice Act must practice under an RN," said Sabra Priester, the state director of the Georgia Association of School Nurses.

White said the starting salary for a school RN is $23,493 and the starting salary of a school LPN is $18,545.76. The funding comes from the state Tobacco Settlement Fund with additional funding coming from the school system's general fund.

"I don't know if it's as much saving money as it is spending the money we have to provide coverage for as many students as we can," White said.

The National Association of School Nurses recommends that there be one RN for every 750 students, Priester said. Her interpretation of the Nurse Practice Act is that an RN must be on the premises supervising an LPN, which would mean an RN for every LPN.

"That is my interpretation of the Nurse Practice Act and that is the interpretation given to me from many many workshops and seminars, and I go to just about every one of them," Priester said. "Cheaper is not always better. That is a poor reason to give less quality healthcare to our children. In the event of an emergency, the school nurse is the first person on the scene. Who would you want?"

She called LPNs "wonderful adjuncts to the healthcare profession," but said they lack the assessment ability that RNs are capable of.

Cassonya Brooks is also concerned. Her daughter, Nia, a kindergartner at River's Edge Elementary School had a tracheotomy before starting school, so she knows the importance of proper medical treatment.

Brooks said she is "totally opposed" to placing LPNs in schools, instead of having nurses on premises.

"It's not the best idea" for school nurses to be "less skilled medical professionals," she said.

The job description for a school system LPN requires applicants to have a diploma from an accredited LPN program, be licensed as an LPN by the state, have Cardiopulmonary Resuscitation Certification and have been an LPN for at least two years with experience in pediatric, adolescent or public health.

The school system is also advertising openings for two consulting school nurses. Applicants should have graduated from a state-approved professional nursing program with a bachelor's degree preferred and have Cardiopulmonary Resuscitation Certification. They must also be RNs and have two years of experience as school nurses. Experience teaching health topics is preferred.

According to the administrative rule that established the positions, the consulting school nurses will oversee the LPNs and visit them at least every other day.