A nurse in every Delaware school
It was Becky Gravatt's first week as a school nurse, and as she stood watching one of her students get taken away in an ambulance, all she could think was "What have I gotten myself into?"
An even bigger question, perhaps?
What would have happened if Gravatt hadn't "gotten herself into" it?
A school without a dedicated nurse is something Gravatt doesn't even want to think about, she said Monday.
"It could absolutely be dangerous, and I can hardly think of a school that doesn't have children in it, that can't have a nurse in it," she said. "... If our state became a state like that, it would be absolutely awful."
Funding for school nurses proposed
Fortunately for Gravatt and other Delaware school nurses, a local legislator is working to make sure that doesn't happen.
Rep. Earl Jaques, D-Glasgow, recently introduced a bill he says would help ensure every school in Delaware has a school nurse by providing them additional state funding for the position. He said he also wants to make sure buildings don't have to share a nurse.
The bill would also allow districts to levy a "match tax" to help pay for the local share of a school nurse — currently, school districts have to cover the gap between the amount of funding they get from the state and the actual nurse's salary using their discretionary funds.
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"Several years ago a law was passed in Delaware requiring all (reorganized) public schools to have a school nurse on site," said Beth Mattey, lead school nurse at Brandywine School District and president of the National Association of School Nurses.
"... As I understand the law, this would require that charter schools follow the same requirements as public schools and provide a certified school nurse in the schools," she added. "Currently, 70 percent of the funding for school nurses comes from the state and 30 percent comes from local funds."
Much of the work school nurses do is planning for and preventing a potential health crisis, Mattey said. It's much more than caring for sick or injured children. School nurses promote health, model healthy behaviors and provide education to students on wellness.
"They may also be involved in 'garden to table' activities that promote healthy eating, sponsor health fairs to help educate the community on resources within the community, or sponsor activities to promote a healthy lifestyle," she said.
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Their very presence can help transform a school into a healthy community, Mattey believes.
"I believe all students should have a school nurse, all day every day," she said. "... If you think of the wide range of issues children bring to school, it is clear that a knowledgeable licensed professional school nurse must be available to care for the needs of our students. There are more students with chronic conditions such as asthma, life-threatening allergies or epilepsy. Nationally, school nurses report that they spend 32 percent of their time handling mental health issues of students. School nurses prevent emergencies daily by recognizing and seeking early intervention and treatment for potential health emergencies. "
No downtime for school nurses
Gravatt, lead nurse at Caesar Rodney School District, doesn't have a lot of free time.
"I'm sorry, just a second," she said Monday, setting down the phone for the third or fourth time that morning.
"Are you OK honey? Are you going to puke?" she asked a kindergartner at McIlvaine Early Childhood Center.
Just minutes before, Gravatt had administered medicine to another student.
"Here you go, open your mouth. That's right. Go back to class now."
On a typical day, between 80 to 100 kids may stream through her office, Gravatt said. Some have serious illnesses or medical conditions such as diabetes, asthma or cancer. Others just have tummy aches.
Gravatt, one of 16 nurses employed by the district, listens to each child's complaint carefully.
She knows the consequences of not doing could be incredibly severe. She's heard stories from other states that don't require each school to have a nurse on duty at all times and do not fund the positions even to the extent that Delaware does.
In 2014, a 7-year-old Philadelphia student died in a school with no on-duty nurse, and he was not the first one, it was soon revealed.
The absence of school nurses had become commonplace in a state where multiple districts had been subjected to withering budget cuts, and as a result had to reduce staff hours and positions.
“There is no net for the staff or the children,” Ann Smigiel, a part-time nurse at the school, told the Philadelphia "CityPaper" after the incident. “There’s no requirement to have any kind of medical team. It’s my job as the nurse to make sure there’s an emergency plan, and basically, it is 911… The equipment isn’t there, nothing is there for them.”
Smigiel was only on duty at the school on Thursday and every other Friday. The boy fell ill on a Wednesday.
Even when a school nurse is on duty, there's always a risk of something bad happening Gravatt said.
"Things that look so trivial can be so much more sometimes."
Someone has to be there to catch things and take life-saving measures when needed.
"Granted, every week isn't like that," Gravatt said. "But it could happen.
"I would be really dangerous having unlicensed professionals taking care of these students."
Contact Jessica Bies at (302) 324-2881 or jbies@delawareonline.com. Follow her on Twitter @jessicajbies.