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School nurse shortages are not a new problem; the pandemic amplified the need

Even when districts are fully staffed, most school nurses are assigned to multiple buildings during the year.

COLORADO, USA — When a student needs to take a trip to the school nurse's office, in many schools, there's not always a nurse to greet them. 

This isn't a new issue, but like many things, it was made worse because of the pandemic. Several districts across Colorado have to share nurses across different buildings. 

In a letter to the Denver Board of Education, the Denver School Leaders Association (DSLA) expressed their concerns about the nurse shortages facing the district. 

In their letter, DSLA said in part "The 2020 Bond and Mill Levy that was passed by DPS voters earmarked a four million dollar investment to support an increase in full-time nurses in schools." 

The letter goes on to say, "Yet we find ourselves in the position of having 61 of our schools without a school nurse assigned to their building."

According to a Denver Public Schools (DPS) spokesperson, there are now 44 schools within the district without a permanent school nurse assigned to the building. 

DPS has 19 open positions for nurses. Around this time last year, they had 15 school nurse openings.

"I will say every year we do have a shortage, but this year it’s exponentially a little bit larger," said Kathrine Hale, Manager of Nursing and Student Services for DPS. "We’re continuing to work with staffing agencies and bring on new staff. We have also requested health techs from different agencies to help us support schools in another way while we’re navigating some of the challenges."

Hale said it is not uncommon for nurses to be assigned to more than one building and share assignments. She said while nurse shortages are not a new issue for the district, the pandemic certainly changed things. 

"Our nurses have been supporting after hours, if there’s a COVID case, they’re reporting after hours," she said. "The beginning of the year is always challenging, but I still think there’s some sort of residual burnout from the last school year."

RELATED: Overworked and underpaid: Colorado educator shortage exacerbated during the pandemic

To help address these shortages, DPS is offering a $2,000 sign on bonus and expanding their applicant pool. Generally, school nursing positions are only open to those with a bachelor's degree, but Hale said they are now accepting applicants with associate degrees who are pursuing an undergraduate degree. 

"Within the last week hired about five more DPS school nurses, which is phenomenal," Hale said. "But they’re going through the HR process and that can sometimes take a couple of weeks to get everybody through." 

At Jeffco Public Schools, a district spokesperson said they are short six nurses, but the bigger challenge has been the fluctuation of nurses coming and going. For example, the district will hire two, but one will resign. 

The district said the shortage fluctuates almost daily. 

"They are leaving for external organizations (hospitals mainly) because they offer substantial sign-on bonuses and stipends we cannot compete with," a district spokesperson said. 

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Douglas County Schools recently filled their last nursing position. When fully staffed, they have 47 school nurses, but do not have a nurse for every school.

"For example, a nurse may cover a high school," a district spokesperson said. "Another nurse may cover a high school and a program (such as Bridge). A nurse may cover a middle school and a program. A nurse may cover a middle school and an elementary school. Or a nurse may cover two elementary schools."

"We truly want nothing more than our students to be safe and supported," Hale said. "There’s just this unfortunate shortage across the board." 

Full letter from Denver School Leaders Association to the DPS Board Members: 

Dear Dr. Marrero and DPS Board of Education,

The DSLA board is reaching out on behalf of our membership to voice our concerns regarding the shortfall in staffing of school nurses. The 2020 Bond and Mill Levy that was passed by DPS voters earmarked a four million dollar investment to support an increase in full-time nurses in schools.

In response to this additional funding, all school leaders increased their nursing time by at least a day or more. Many leaders cut their health tech para staff to respond to the call to have a full-time nurse. Yet we find ourselves in the position of having 61 of our schools without a school nurse assigned to their building.

Schools that do not have a nurse assigned are faced with the following urgent safety issues to address:

The additional demand on front office staff as they negotiate the huge workload they already have during the first weeks of school.

The concern that the temporary plan to provide one day of nursing per week to each school means that the nurse would only have time to do paperwork and not have time to work directly with students.

The urgent need to make sure school staff have received the required delegation training to support students on the first day of school (which has already passed).

The professional liability for school leaders if a child’s health plan is not followed because there is no nurse to train and inform school staff.

Incomplete or inaccurate health conditions/allergy lists that have yet to be shared with staff; and school has already started on 8/23/21.

The additional job duties and responsibilities that are needed to ensure that we have all our COVIDClarity on the steps that are being taken to recruit candidates for the open positions protocols in place and a licensed professional heading up our COVID Coordinator team.

Addressing parent concerns regarding the Mill Levy monies that they approved but have not actualized into additional nursing time in schools.

While we appreciate your attempt to create a temporary solution by sending a memo to schools that have a nurse assigned to their building to inform them that they will need to share their nurse with schools who have not yet had a nurse assigned, sending this message out on the Friday before school starts is far too late to address the needs we all faced on the first day of school. In addition, the email sent on Friday, August 20th at 12:44 PM did not provide school leaders with a timeline by which the changes to staffing would occur.

The DSLA board is asking for the following next steps to support school leaders as they negotiate the lack of nursing services with our students, staff, and family members:

A clear timeline for when we will have a temporary nurse assigned to each building that is without coverage

Clarity on the steps that are being taken to recruit candidates for the open positions

A clear timeline for when we will have our permanent nurse assigned to each building that is without coverage

Nursing services to explore the option of training candidates in the qualifications they might need to be qualified to be hired as an HTP

Communication from the district to the community regarding the shortfall and how it is being addressed, so this does not fall onto school leaders to navigate.

Sincerely,

The DSLA Executive Board
The DSLA Representative Board

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