Nurse Dorothy Elaine Whitehead walks into the classroom. She makes her way past students in wheelchairs and special medical seats, toward Shawn Coleman, 18, who lies on his right side, waiting for his lunch.
Coleman was severely brain-damaged when hit by a car 13 years ago.
Whitehead's presence makes him smile. She reaches under Coleman's shirt, finds his feeding tube and connects it to the intravenous bag holding his high-calorie formula.
Whitehead is a school nurse whose job is in jeopardy because of state budget cuts. She performs intravenous feedings for two students a day. For others at the 110-student Claremont School, she may administer anti-seizure medication, change colostomy bags or fix catheters.
Whitehead is among 57 school nurses and 50 support personnel in the city whose jobs are on the chopping block because of state budget cuts. The cuts are part of a larger $6 million reduction in state aid to the city Health Department, which are part of an overall $21 million cut in state aid to Baltimore.
While the nurses provide vital services at Claremont and other schools for emotionally disturbed and mentally handicapped students, their contributions are less dramatic -- but still important -- elsewhere in the city school system.
School nurses are a vital source of medical care for many students in the city. They are the ones who spot early hearing or vision problems, or provide birth control, pregnancy or venereal-disease counseling. In all, the small group of nurses visits students in 123 of the city's more than 180 public schools.
"Most of the children we serve don't have another source of medical care," a Health Department spokeswoman said. "As a result, there is a lot of work going on to find other sources of funding for them. But, if nothing changes, Nov. 30 will be the last day for them."
Mayor Kurt L. Schmoke has instructed acting Health Commissioner Elias Dorsey to make school nurses a top priority in drafting his plan for dealing with the cuts, said Clinton R. Coleman, the mayor's press secretary. By Monday, the plan is scheduled to be given to Schmoke, who will make the final budget decisions.
The threat of removing the school nurse is already taking its toll at Claremont. Nancy Malone, a teacher at the school and a board member of the Baltimore Teachers Union, says it is stressful. She says it seems like she spends as much time fighting for resources as she does doing her job.
"Every time you turn around, we're in danger of losing something," she says. "I've been to Annapolis twice. I marched in D.C. And I'm supposed to be teaching students every day. We have to run, run, run all the time."
Malone says that if Claremont loses its nurse, teachers will be hard-pressed to fill the gap. "These are very difficult tasks for the staff and students to handle," she says.
Whitehead worries about losing her job. She also fears that the health needs of Claremont's students -- some of whom live in pediatric hospitals -- will go unattended while they are at school.
"If they go through with the cuts, they may hire agency nurses on contract," she says. "But then, there is someone new here almost every day."
As a result, she said, the nurse won't know the students well and won't be in the best position to spot previously undetected medical problems in students.
When asked about the prospect of Claremont's nurse being let go, Brandon, a 13-year-old student simply replies: "What about the children who need the food and stuff?"