school nurse helping boy put on face mask for coronavirusFor certain generations, there are memories of the school nurse who always seemed to be there to dispense medication, treat cuts and scrapes and ask questions.

Today, the school nurse shortage is so severe that the National Association of School Nurses calls it a national crisis.

According to their research, only 40% of schools budget for a part-time nurse and 25% have no nurse at all.

Nakia Best, PhD, RN an assistant professor at the UCI Sue & Bill Gross School of Nursing, wants to change that for the students of Orange County.

Why school nurses matter

The consequences are often harsh when a school lacks resources for a full-time nurse or has no nurse at all.

One case in point: Case management is an important function of the role. Best says students with chronic conditions get extra time with the nurse for additional support.

“They help the students manage their condition. They give them important guidance and information,” says Best.

As the incidence of childhood asthma and type 2 diabetes rises, the lack of a school nurse means those children are likely not getting that additional support and education. And that can have dire health effects later, she notes.

“You want to have a nurse who can ask why a student isn’t in school,” Best points out.

“When we have a nurse asking questions, they can get the student to where they don’t need their rescue inhaler as often. They know their triggers. They’re learning about their condition.”

Missing out on group work, instruction

Then, she says, they will be in school more often. Which leads to another consequence of the school nurse shortage: higher rates of absenteeism.

When that happens, Best says, children miss out on important instruction and group work that can’t be replicated at home.

Schools also take huge funding hits when students are absent.

According to the California Department of Education, schools statewide collectively lost $5.2 million because of absenteeism in 2019. Orange County schools lost $439,000 in the same time period.

Studying medical errors in schools

Another effect of the shortage, Best notes, is that others who may not be qualified are called upon to dispense medicine.

“When there’s not a nurse, I study who is giving medications. Often, it’s the health clerk, secretary, a teacher or the principal.”

Best isn’t trying to call anyone out; she simply wants to shed light on the issues.

“Everyone is doing what they have to, to keep kids safe and get their medicines.”

For her dissertation, Best worked with data on school nurses in North Carolina. She wound up developing good relationships with the nurses and the state’s school nurse consultant supervisor.

Telling the story with data

Best and the school nurse consultant supervisor were awarded a grant to study the impact of school nurse workforce, student, and school community characteristics on medication administration accuracy in North Carolina.

Now, Best is bringing that research to Orange County in an effort to effect change here.

Through her connection with a UCI Health pediatrician, she has been working with the person in charge of health and wellness for school nurses in Orange County, which she hopes broadens her reach.

She plans to use her expertise in informatics to show why this is such a critical issue.

“I want to go to the legislature. I want to tell a story. I can do that with data, analytics and visualization.”

Understanding what nurses do

The shortage of nurses in schools is especially timely right now as schools look at reopening amid the COVID-19 pandemic.

“People are trying to get school going, they’re realizing there’s no healthcare person to answer their questions,” Best says. “It’s bringing to light the shortage.”

Ultimately, she wants the decision makers to understand what these nurses do and the important role they play.

Best points out that social work and nursing positions are often eliminated when funding is short.

“Those services help students be healthy so they can stay in school and learn. I want to show that these are the good things that happen when there’s a nurse in every school.”