Union files state complaint over Philly nursing cuts

About 30 nurses, teachers and supporters showed up last month to protest in front of the School District of Philadelphia. (Michael Bryant / Staff Photographer)

In an attempt to halt the practice of having principals, secretaries, gym teachers and other non-medical personnel administer medication to city school children, the Philadelphia Federation of Teachers has filed a formal complaint with the state health department, officials announced today.

The complaint charges that the Philadelphia School District is “endangering the lives of the school children it is required to protect.”

Faced with a budget shortfall of over $700 million, the district laid off 47 school nurses effective Dec. 31.  Most schools are now without full-time nursing care, though the district says that it has stitched together a system where all “medically fragile” students have nursing services.

PFT President Jerry Jordan said that’s not good enough.

“This is a terrible accident waiting to happen,” Jordan said.  “I understand the budget crisis, but what is the price of making sure that kids are safe?  God forbid that there is an accident in the distribution of medication.”

In the complaint, union attorneys cited “wholesale violations” of provisions of the the Department of Health’s Guidelines for Pennsylvania Schools for Administration of Medications and Emergency Care.

Specifically, the district has violated the state’s rules by directing non-medical professionals to administer medications and by requiring school nurses to train other staffers in how to give medications, the union said.

Many schools have long gone without full-time nursing care, but the most recent cuts have forced a dire situation, Jordan said.  He said he raised the issue of non-medical staff giving medications with district last year but was brushed off.

“They said, ‘Well, those are just guidelines, and we don’t have to follow them,” Jordan said.  

Jordan said he checked with state officials, who told him the rules were more than suggestions and must be followed.

When certified school nurses aren’t available, medication is given out by principals, gym teachers, counselors, community liasons, secretaries and even aides who normally monitor the playground, the PFT found.

One veteran school nurse now works at three schools, including one busy school with over 1,000 elementary school children.  The school used to have two nurses.

“When I’m there by myself, I see over 30 kids for illnesses and injuries, and 20 more for their meds,” said the nurse, who asked that her name be withheld.  “I have diabetics — some who are non-compliant — a tube feed, many special ed students.”

Just covering the students’ basic needs means things the state mandates nurses do — vision screenings, immunizations checks, height and weight checks — must wait.

And the school has a sizable English language learner population, many of whom have no other medical care.

The one day a week she’s at one of her other schools is the only day that school, which has about 500 students, has nursing care.  When the nurse isn’t there, a secretary is the nurse designee.

The secretary is great — conscientious and kind, the nurse said.  But she’s not a medical professional, and that’s a problem, she said.

“Other people aren’t listening for lung sounds. They can’t make medical assessments,” the nurse said.

Robert McGrogan, head of the district's principals' union, worries about the implications for kids.  He also worries about the implications for his members, who must step out of parent meetings, classroom walkthroughs, or other important work to hand out medication.

"This is a dire financial situation," McGrogan said.  "I appreciate that.  But it doesn't mean that we can just arbitrarily and capriciously put people in situations they're not certified to handle."

Lauren Perez has two boys in public school, including one who’s a Type I diabetic and receives regular insulin injections.

“My son, who is very healthy otherwise, could simply go into a low blood sugar coma and die,” Perez said.  “The only person who can give him a life-saving shot is a nurse.”

Her younger son, the diabetic, is covered by a nurse.  But her older boy is in kindergarten at Dobson Elementary, which goes without nursing services most days.

“There’s another diabetic child at Dobson, but no full-time nurse.  How safe is that?” Perez asked. “As a parent, you send your child to school for six hours and you believe that they’re cared for medically.  But that’s not necessarily the case, and it shouldn’t be.  What’s going to happen in an emergency?”

For the fifth week in a row, dozens of school nurses and their supporters gathered on the steps of the district's North Broad Street headquarters today to call attention to the cuts.  The group has said they will continue to protest until their concerns are answered.