California falls significantly short of a new recommendation by an influential group of pediatricians calling for every school in the United States to have at least one聽nurse on site.
Fifty-seven percent of California鈥檚 public school districts, with 1.2 million students, do not employ nurses, according to research from Sacramento State University鈥檚 School of Nursing.
The call for a nurse in every school appeared this week in a policy statement by the Illinois-based . The group鈥檚 replaces its previous one, which recommended that school districts have one nurse for every 750 healthy students, and one for every 225 students who need daily assistance.
The academy said the use of a numerical ratio was 鈥渋nadequate to fill the increasingly complex health needs of students.鈥�
Even when measured against that old yardstick, California鈥檚 schools are woefully deficient. Statewide, there is one nurse for every 2,784 students, according to 2014 numbers from , a program of the Lucile Packard Foundation for Children鈥檚 Health. That鈥檚 nearly four times more students per nurse than the academy had recommended.
And in some regions it is far worse than that. In Santa Cruz County, for example, there were 13,432 students for every nurse in 2014.
California鈥檚 school nursing shortage is troublesome, experts say, because nurses provide much more than basic health services to students. They help manage chronic diseases, assist with obesity prevention, and participate in emergency preparedness and behavioral assessment, among other things.
鈥淪chool nursing is one of the most effective ways to keep children healthy and in school and to prevent chronic absenteeism,鈥� said Breena Welch Holmes, lead author of the academy鈥檚 policy statement and chairwoman of its Council on School Health.
Kathy Ryan, a nurse in the San Diego Unified school district and president of the , said the academy鈥檚 new guideline, which also calls for access to a physician in every school district, underscores the vital need to upgrade health services in the state鈥檚 schools.
She noted that the new recommendation is stronger than the previous ratio-based guideline for whole school districts. Having a nurse across town, even if it means a school district is meeting a numerical target, is not as effective as having a full-time nurse on site every day, she explained.
Ryan noted that when children聽are absent, schools loses money. So when school nurses help reduce absenteeism, they could eventually pay for themselves, she said.
California鈥檚 school nurse deficiency is due in large part to the fact that schools are not legally obliged to hire nurses, and employing them competes with other priorities for scarce funding, said Linda Davis-Alldritt, ex-president of the and a former nursing consultant to the state鈥檚 Department of Education.
鈥淒istricts are stretched for money, and school nurses aren鈥檛 required, so they don鈥檛 see the need,鈥� she said.
For California to attain the academy鈥檚 goal of a nurse in every school, the state legislature would need to make it a requirement, Davis-Alldritt said.
Barbara Feder Ostrov contributed to this report.
This story was produced by , which publishes , a service of the .