With the start of classes last week, nurses in Denver Public Schools felt a more pronounced sting than normal since they’re spread as thin as ever, district officials and employees said.
The district’s shortage of nurses is about 60% worse than it would be in pre-pandemic years, officials said. Most nurses in the district have to cover multiple schools, some as many as five. And most Denver schools are served only by part-time nurses.
It’s all part of a larger national shortage during the COVID-19 pandemic not only in schools but across the entire nursing industry.
Robin Greene, director of the district’s nursing services, said students aren’t at risk with the shortage and she’s hopeful the district will be able to hire more nurses in the near future, lightening the load for the others.
Still, the shortage does lead to concerns about whether students have enough access to medical care in case of emergencies, said Rob Gould, president of the Denver Classroom Teachers Association. And some school nurses are suffering from exhaustion and burnout.
So far, Rebecca Sposato, a DPS nurse who’s covering four schools on two campuses, said she’s managed. The pandemic did force new responsibilities onto her plate, but it took others away as well. Some of her colleagues are indeed tired, but she’s hopeful this year will be better than the last.
“The first week or two of school is always heavier,” Sposato said. “You don’t have a nice rhythm or groove established yet. You have a huge pile of paperwork.”
Denver Public Schools, the state’s largest school district, currently has 135 nurses on staff to cover 223 schools that educate about 90,000 students, Greene said. Ideally, the district would have 160 nurses, she said.
A large part of the problem is that as the pandemic worsened, nurses across the health care industry burned out or left their jobs entirely, forcing school districts to compete even more with the higher-paying private sector for prospective hires, Greene said.
Even at the ideal staffing level, most nurses would still have to cover at least two schools, and as things are now, some of them are responsible for up to five, Greene said.
Sposato said she maintains a “hopelessly optimistic” attitude. Working in a hospital during the pandemic would have been more difficult and stressful, she said, adding that she can handle the multitasking and whatever else comes her way.
“I took care of Marines with combat injuries,” Sposato said. “I haven’t seen anybody (in schools) with a hole in their body.”
She added that she doesn’t know if the district has ever reached adequate staffing levels for nurses.
Schools should have one nurse for every 750 students, according to the Centers for Disease Control and Prevention. Denver’s public schools do currently meet that mark, but in 2016 the American Academy of Pediatrics called that standard inadequate, instead recommending a full-time nurse in every school.
Gould said the teachers union wants the district to meet the newer standard but doesn’t see it happening any time soon.
“It’s bad,” Gould said.
But the district is moving in the right direction.
As of March 2020, only about a tenth of Denver’s public schools had a dedicated full-time nurse, Chalkbeat reported. And now, almost a quarter of the district’s schools have a full-time nurse, according to Kathrine Hale, the district’s manager of nursing and student health services.
In that same time span, school nurses have had to adopt an entirely new set of responsibilities. Marnie McKercher, the lead school nurse consultant for Aurora Public Schools, told The Denver Post late last year that COVID-19 disease education and mitigation accounted for about 95% of the job.
“It’s harder on our existing nurses and we need our existing nurses,” Greene said.
But Sposato said with online and hybrid learning, some of her other responsibilities “evaporated,” balancing out the workload a bit more.
“I’ve been doing more contract tracing, more phone calls to students about calling in sick but less first aid, less medications in the cabinet,” she said.
School nurses can also delegate some of their less-specialized responsibilities to other staff members, Greene said. But that can only cover so much.
That’s where concerns arise, Gould said. Should a nurse covering multiple schools face several medical emergencies at once, the students could be at risk. He said a special education teacher called him last week worried that she wasn’t properly trained to care for one of her students prone to seizures.
“They don’t have a school nurse and she didn’t feel like she had any training on it,” Gould said.
Union representatives expressed those concerns to the district and Gould said he was optimistic they would handle the situation appropriately, but there are many more scenarios like that and the schools are limited. They can only handle so many of those scenarios with the number of nurses they have, he said.
Greene said she’s working to keep an open line of communication with nurses to avoid burnout and make sure their work is covered. And she’s actively trying to hire more nurses to lighten the burden.
The district can’t compete with private-sector jobs that sometimes offer signing bonuses of up to $50,000, Greene said. Nurses working for the district make an average salary of $75,000, she said.
Instead, Green said the district can cast a wider net to try and catch nurses that were previously overlooked.
Before, the district only looked for nurses with pediatric experience, but now they’re accepting those with adult experience, too. And they’re working with the University of Colorado system to catch more fresh graduates. But it will be some time before the district sees whether the new approaches work, she said.
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