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Schools still need nurses

By Ashlee Murray As a pediatric emergency-medicine physician in Philadelphia, I am often asked for advice on when children should return to school during or after an illness. Until recently, I have always encouraged parents to send their children back to school as quickly as possible, because school is an essential part of every child's life.

Laporshia Massey , 12, died after suffering an asthma attack at West Philadelphia's Bryant Elementary School on a day when no nurse was on duty last fall.
Laporshia Massey , 12, died after suffering an asthma attack at West Philadelphia's Bryant Elementary School on a day when no nurse was on duty last fall.Read more

By Ashlee Murray

As a pediatric emergency-medicine physician in Philadelphia, I am often asked for advice on when children should return to school during or after an illness. Until recently, I have always encouraged parents to send their children back to school as quickly as possible, because school is an essential part of every child's life.

However, in the wake of significant School District budget cuts, layoffs affecting many of Philadelphia's school nurses, and two student deaths due to illness at city schools, my advice has changed dramatically.

When I was growing up, I had to be very ill before my mother would keep me home from school. She knew that if something serious happened, the school nurse would know what to do. If my asthma was acting up, my mom could send me to school with my inhaler and the nurse would make sure I used it when I needed it. If I had a bloody nose, the nurse would know how to stop it. And if I was really sick, the nurse would call my mother and tell her to pick me up.

Now, from my experience as a pediatrician, I understand that most children are healthy and don't tend to fall gravely ill in classrooms and school hallways. But on the rare occasions when that does happen, shouldn't someone at the school know what to do? Shouldn't children be able to receive necessary care and medications during the school day? And shouldn't parents be able to feel secure about their children's physical well-being when they send them off to school?

We'll never know whether a school nurse could have saved either of the two children who died at Philadelphia schools in the past year. But we do know a school nurse would have been better prepared to help than most of those present.

A school nurse likely would have recognized that the child who died at Bryant Elementary School last fall, was having an asthma attack and needed emergency medical care. Likewise, a school nurse probably would have been more equipped to treat the child who died at Jackson Elementary School in May. But neither school had a nurse on duty on the day in question.

My colleagues and I have often debated the impact of school budget cuts on the well-being of the city's children. We will never be able to bring back the children who died. But as a society, we can recognize the need to prevent future deaths.

Only by restoring school nurses in every Philadelphia school, on every day of the week, can we be certain that someone will be present and able to quickly recognize a child's needs in case of an emergency at school. There will be someone there who knows how to use an EpiPen for a severe allergic reaction, who can administer an inhaler if a child's asthma acts up, who recognizes a traumatic eye injury in need of immediate medical attention, and who is trained to perform CPR or use a defibrillator in the case of a heart attack.

We can do more than just hope that these situations don't come up again. We need to be prepared. Bringing nurses back to Philadelphia schools is the first step.