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New school nurse plan concerns some

Staff cuts lead to nurse-sharing between schools

Posted: September 9, 2012 - 12:09am
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Registered nurse Laura Vivian administers to seventh-grader Ella Rohweder, 12, at Dzantik'i Heeni Middle School on Friday. Vivian works mornings at Floyd Dryden Middle School and afternoons at Dzantik'i Heeni leaving the schools without a nurse for half their day.  Michael Penn / Juneau Empire
Michael Penn / Juneau Empire
Registered nurse Laura Vivian administers to seventh-grader Ella Rohweder, 12, at Dzantik'i Heeni Middle School on Friday. Vivian works mornings at Floyd Dryden Middle School and afternoons at Dzantik'i Heeni leaving the schools without a nurse for half their day.

In its effort to dig out of a budget crisis, the Juneau School District this year reduced the number of school nurses it employs from ten to eight.

That means Laura Vivian spends the first part of her day at Floyd Dryden Middle School, and midway through it, she gets in her car and drives to Dzantik’i Heeni Middle School, where she works in the afternoon.

Vivian is concerned about students at the four schools that lost their full-time nurses this year, she said.

“What’s going on is I’m so busy at both schools … and I’m a very hard worker, so I’m trying to work through as much as I can … but I’m so overwhelmed with other stuff that I feel like I can’t do my job fully for these kids,” said Vivian.

Riverbend Elementary School and Thunder Mountain High School are also sharing a nurse under the new school nurse plan, which just took effect for the 2012-13 school year.

JSD spokeswoman Kristin Bartlett explained the plan’s genesis.

“The four schools were chosen as a result of an analysis of student needs, input from our school nurses and the physical proximity of schools,” Bartlett wrote in an email. “A new nursing plan was developed with input from school nurses and participation from a local nurse consultant.”

According to student services director Brad Hoyt, nurses have generally been “positive” toward the plan they helped develop earlier this year.

“They’re initially the ones that came up with the proposal of ‘let’s team a number of schools together,’” said Hoyt. He added, “I think the nurses have done a very good job at those four sites.”

But Hoyt’s optimism about the nurse-sharing plan is not shared by Vivian — and she is not the only one.

“It’s been an overwhelming workload for those of us who now have more than 1,000 students on a caseload, and nothing has been taken off our plate,” said Maureen Hall, Vivian’s counterpart at Riverbend and Thunder Mountain.

“There’s some parents that are a little upset, and they’re asking, you know, why there’s not a nurse for their child. And I 100 percent agree with that,” Vivian said.

“We had a situation come up where Ella had missed her dose of morning medication. It happened a couple of times last year, and I would just call the nurse and have her give it to her there at school,” recounted Brooke Rohweder, a Dzantik’i Heeni parent whose daughter must take two daily doses of medication. When the same thing happened this year and she was told the nurse was not available in the morning, she said, “My jaw kind of dropped.”

Already this school year, Vivian said Thursday, she has been asked to deal with a student needing attention at one middle school while she was at the other.

“They wanted me to go drive over … two times to one school in a day, like an hour apart, and I ended up saying no and we had to have the vice principal take over,” Vivian said.

Hoyt said he is unaware of that specific incident, though he noted a number of staff members at schools have been trained or are being trained as UAPs — “unlicensed assistive personnel” not certified as nurses, but able to administer medication, first aid and EpiPen auto-injections, among other needs.

“We felt it was important to have someone trained on each campus who was able to support the kids’ needs,” said Hoyt.

Despite the UAP training, Vivian said, she still fields phone calls “several times a week” asking her to help with a need that arises at the other middle school.

“I just try to work it out over the phone when I can,” Vivian said.

Dzantik’i Heeni’s assistant principal, Dale Staley, said staff may not be equipped for all eventualities.

“For certain things, we may not know what to do, and we just have to dial 911 and rely on the professionals to get here as soon as they can,” Staley said.

Hall said that whatever remains to be done of the UAP training is actually a burden right now.

“We’re still in the process of training the unlicensed assistive personnel … but they have their full work schedules, and we have ours, and trying to fit in time to check them off on their skills and make sure they’ve completed their modules, you know, that’s an added duty,” said Hall.

Meanwhile, both nurses said, they are falling behind on what they have to get done.

“I have a stack of student health histories from the registration days that I haven’t even had an opportunity to begin to look through,” Hall said.

“Usually in November, the State of Alaska will be sending us an immunization requirement … and I haven’t even been able to start that or even look at that,” said Vivian, echoing Hall.

Another parent, Teresa Kesey, who has a daughter with a peanut allergy at Dzantik’i Heeni, said in an email that while she believes the middle school “is doing the best they can under the circumstances,” she is concerned about her daughter’s health and safety.

“I have always felt my kids were safe at school knowing the nurse knew them by name and face, knows their history and I felt confident in their ability to treat an anaphylactic reaction or asthma attack,” Kesey wrote. “I no longer feel that way about the middle school which my daughter attends.”

“I just know from personal experience that no school should be without a nurse,” said Rohweder matter-of-factly. “In my opinion, it’s not acceptable for the health of our kids to be on the line, so to speak, because of budget cuts.”

Staley was cautious in his assessment of the plan.

“It seems to be a little awkward, but we’re used to having a full-time nurse in all our buildings, I think,” Staley said.

“Change is always difficult, and I think … kind of just the newness of it is probably the biggest challenge,” Hoyt agreed, noting that many schools elsewhere in the country do not have their own full-time nurses. Juneau Community Charter School, Montessori Borealis and Yaakoosge Daakahidi Alternate High School are among them.

Staley did express some concern about more chronic cases.

“You never know when something may happen with a kid,” said Staley. “Some students are what they call medically fragile or frail, and that can be a physical condition, a medical condition, I guess even an emotional condition. I guess we’re hoping the district will have something in place that will meet those students’ needs, and soon.”

LuAnn Powers, Auke Bay Elementary School’s nurse and the unofficial lead nurse for the district, said she has heard “horror stories” from Hall about the new system. She also worries that UAP training could lead to more cuts in the school nurse plan next year, she said.

“We just feel like our voices haven’t been heard,” Powers said.

The JSD currently has no funding to refill the two nurse positions eliminated during budget cuts, Hoyt said, though he sounded as though the district administration would like more nurses, not fewer, under ideal conditions.

“It would require additional funding from the state to be able to refill those nurses,” said Hoyt. “That would be optimum. That would be the best-case scenario.”

• Contact reporter Mark D. Miller at 523-2279 or at mark.d.miller@juneauempire.com.

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