The most recent data on health care in Orange County schools shows that school nurses continue to be in short supply, with some districts better off than others.

And the size and wealth of a school district don’t necessarily correspond to more nurses, according to the Orange County Department of Education’s 2009-10 Health Services Year End Report, which is the most recent available.

For example, eight school nurses work for the Capistrano Unified School District, which has some 52,000 students, while the equivalent of 19.6 are employed in the similarly sized Santa Ana Unified School District, according to the report.

There is one credentialed school nurse for every 16,263 students in Saddleback Valley Unified School District, which has the worst nurse-to-student ratio in the county, according to the report.

Pamela Kahn, coordinator of health and wellness at the Department of Education, said her ideal would be a nurse at every school. At present, however, most of the health care at schools is performed by health clerks under the supervision of the nurses, she said.

“In an emergency, there’s no guarantee a nurse will be on-site,” said Kahn. She worries that a dangerous health incident could result from stretched resources. “My fear is that’s what it would take [to raise awareness] — an incident. If someone is not trained well, people slip through the cracks.”

School nurses perform a wide range of health services. They make vision and hearing assessments, write care plans for students with chronic conditions like diabetes and asthma, make physician referrals and assess special-education students.

They also train health aides to handle health situations that arise during the school day, such as asthma attacks and fevers.

Kahn said it’s difficult to say why some school districts employ so few nurses while others — for example, Huntington Beach Union High School District — have a full-time nurse and health clerk at every school.

“It’s a matter of administrative priorities and funding,” she said. She predicts that the current budget-cutting climate will lead to even higher nurse-to-student ratios in the near future.


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