A Full Time School Nurse in Every School! From the MASS PTA Newsletter, by Ellie Goldberg
At this year's 94th Annual Massachusetts PTA Convention in Plymouth, we first heard the story of Theresa Normile, President of the Burbank Elementary School PTA in Belmont.
Theresa led the campaign for full time nursing coverage and got it! She also organized Belmont's parents of food allergic children to work with the Belmont Schools to improve food allergy management guidelines. Now all kids are safer!
Theresa's son, Tyler, was diagnosed with severe food allergies to peanuts and tree nuts at the age of 1. He also has asthma. Having a child with asthma and food allergies heightened Theresa's awareness of the need for nursing coverage in the Belmont Public Schools.
Theresa soon learned that she was not alone.
She found the support and help from her PTA and other local PTA's working for more awareness of the needs of children with severe food allergies. First Theresa wrote a letter to the school nurses requesting help to form a support group for parents of children with food allergies. The nurses sent the request home and 40 families responded immediately.
The support group, co-founded with another mom, met in Theresa's living room to share ideas and concerns. They found out that two of the elementary schools in Belmont did not employ full time nurses. And, there was no consistent policy for managing food allergies or life-threatening reactions to food allergies. This group decided to start advocating to get full time nurses on staff at the elementary schools. They first went to the Superintendent and Assistant Superintendent and explained the need for full time nursing coverage. At first, the Superintendent's office suggested that a nurse could come to the school if a child was have a food allergy reaction.
Theresa's group responded with studies showing that there isn't time to respond to a life-threatening food allergy reaction (anaphylaxis). They also pointed out that asthma attacks often mimic anaphylaxis and that if a child is treated incorrectly, it could be fatal.
This got the attention of the Superintendent's office and funding was approved. However, at the very next budget meeting, the new nurses salary was the first items to get cut.
The parent's group next step was to call on the Massachusetts Department of Education, the Massachusetts Department of Public Health, the local Emergency Response Team, the Fire Department and local pediatricians.
They cited the recommendation from the Massachusetts Department of Public Health, the Massachusetts Department of Education, and the Asthma and Allergy Foundation of America that every school with a student at risk for anaphylaxis have a full-time school nurse.
They referenced studies that report there are 200 deaths per year in the U.S. from food allergies and that 1 in 5 children with food allergies will have a reaction while in school. Pediatricians presented the fact that anaphylaxis can mimic the signs of an asthma attack. Therefore only an RN can assess the child and determine the need for an injection of epinephrine.
The most convincing point was the statistic from the MA Department of Public Health that, out of 48 Epi-pens (epinephrine injections) administered while at school, 21% were given to children with no known allergy. State medical practice regulations dictate that "ONLY A LICENSED HEALTH CARE PROVIDER MAY ADMINISTER EPINEPHRINE TO A STUDENT WITH UNDIAGNOSED ALLERGIES!"
The School Committee responded. They recommended that the administration go back and find the money to fund these school nurse positions.
Full time nurses were employed that September. After this success, the parent group started working on developing a comprehensive policy for managing food allergies throughout the Belmont Public Schools.
Before the group's awareness campaign, there was an enormous amount of food being used in the classrooms. After working with the parents group, the school administration stopped the practice of celebrating birthdays with food. The Boston Globe did an article on "Food Allergies Changing Customs in Schools" in November. Belmont was highlighted.
The other big change was staff training about food allergies. Before the work done by the group, teachers for specials such as physical education and art were unaware of which children had food allergies. Now all staff who come in contact with the students with allergies are trained. While not all personnel are delegated the task of administering the epinephrine injection, all are aware of who the children are and how to access the emergency system. In classrooms, where the food allergy is severe, classmates are asked not to bring in food containing that allergen. Theresa stated that being the President of the PTA and being an RN opened doors and gained the respect of parents and community members. In addition, the Massachusetts Nurses Association asked Theresa to speak at the School Health Advocacy Day in May at the State House. Due to the high demand for her advice on coping with food allergies and how to mobilize communities to facilitate change, she founded Food Allergy Counseling and Teaching Services.
Congratulations to this team of advocates for showing how such active parent involvement can make a difference in our children's lives at school.
The world endures solely by virtue of the breath of school children. (Talmud)