20 city schools without nurses

Health Department cuts result of budget crunch

`Principals are crying for help'

System claims its officials had no say in reductions

September 26, 2004|By Laura Loh | Laura Loh,SUN STAFF

When students at Fairmount-Harford High School feel sick, principal Karen Lawrence is forced to tell them there is no nurse and send them home.

At Polytechnic Institute, a teenage diabetic waits for her mother to come twice a day to help her administer an insulin shot.

These are some of the problems that have resulted from budget cuts to a $10 million nursing program that is meant to place a nurse or health aide in every Baltimore school. The medical personnel are provided by the city Health Department, and the program is funded by the schools and the city.

This month, 20 of the city's 39 high schools learned they would be starting the academic year without any medical personnel on staff.

"It's a travesty," said Barney J. Wilson, Polytechnic Institute's new principal. "I understand budget crunches, but when it comes to having a healthy child in a classroom, it's important to have a nurse."

School officials said they were alarmed when the Health Department informed them of the staff cuts in June. Meetings scheduled between school and city health officials to discuss the matter were canceled for various reasons.

Gayle Amos, who oversees student support services for the system, said the Health Department pulled its personnel out of the high schools without consulting the administration.

"This has really been a surprise to us that they would take such a unilateral decision without talking to us," Amos said. "We, as a school system, are gravely concerned about the safety of our students, and we believe the Health Department should be, too."

Priority's shortfall

City Health Commissioner Dr. Peter L. Beilenson, who assigns the nurses and health aides to the schools, said he warned the system more than two months before the start of the school year so that it could prepare for the reduction in nursing staff.

"It certainly is a big priority of ours," Beilenson said about the city's school-based health program, which he describes as one of the nation's best.

The 20 schools lost their nurses because of a $1.5 million shortfall in the program's budget, about half of it caused by reductions in state medical and welfare funds that are funneled to the city, Beilenson said.

Another reason for the shortfall was that the city could not continue to cover what had become an annual $400,000 shortage in the system's portion of funding for the nursing program.

The city pays for slightly more than half of the $10.6 million nursing program, which staffs either a health suite or clinic in every school. The clinics, which provide sports physicals, family planning and mental health counseling, were not affected by the cuts.

The nursing program also became more expensive this year because nurses, who used to be paid $33,000 a year on average, received a 7 percent pay raise.

Cries for help

In past weeks, principals have flooded the central office with requests for help, some of them saying they have been forced to dispense medication to sick students - a violation of a state regulation that requires a registered nurse to oversee such medical care.

"I have a stack of e-mails ... where principals are crying for help, mothers are crying for help," said Louise Fink, the school system's director of interagency support.

One e-mail from a principal stated: "I am dispensing medication five different times each day to nine different students. I cannot continue to monitor medications, nose bleeds, etc. This is an assignment I cannot delegate. I [feel] there are serious [liability] issues here."

Emergency situations

In addition to students who require daily medication, schools also face the unpredictable.

On Friday, Poly's principal walked into the main office to find a student lying on a couch, complaining that she felt ill. Wilson said all he could do was check her forehead to see whether she had a fever, then call the girl's mother to arrange for the teenager to be picked up.

Poly's staff members have called 911 at least twice this year for medical emergencies, once when a student from neighboring Western High fainted from the heat at a joint assembly held to commemorate Sept. 11, 2001, and again when a Poly student had an anxiety attack during class.

Beilenson said he chose to make the staff cuts in high schools because older students are usually better able to care for themselves. Also, nurses are in greater demand in elementary and middle schools to test pupils' vision and hearing and check for scoliosis, an abnormal curving of the spine.

`A no-brainer'

Michael Hamilton, president of the Baltimore City Council of PTAs, faulted the school administration for not informing parents of the problem so that they could have lobbied elected officials to prevent it. Hamilton urged the mayor, health commissioner and school officials to quickly find a solution.

"This is a no-brainer," he said. "This is a component that is a must within our system."

School officials said they will continue to work with the city to restore the nurses.

For now, the central office is training school administrators in cardio-pulmonary resuscitation and first-aid procedures, said Amos, the school system official.

Wilson, Poly's principal, said he is already CPR-certified. "But I shouldn't have to do that," he said. "It's not my primary job."

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