Consultant: Schools Short On Nurses

By MARILYN BROWN The Tampa Tribune

Published: Sep 17, 2007

TAMPA - The Hillsborough County School District is facing a serious nursing shortage that Superintendent MaryEllen Elia should do more to address, a former top administrator says.

Mary Ellen Gillette, the district's former student services director who retired in 2002, said the shortage - and Elia's dismissive response to complaints by nurses - pose a hazard to the district's 192,000 students.

"Our community will soon recognize that Supt. Elia's actions are detrimental to the health and well-being of our children," Gillette wrote to The Tampa Tribune. "This is truly an unfortunate development."

Gillette, who worked in the district for 27 years, knows what she's talking about, said Sandy Gallogly, the district's supervisor of school health services, one of Gillette's former jobs.

"She is the personification of school health services throughout Florida," Gallogly said. "She is an icon."

In all, 68 nurses and health assistants have quit since August 2006, leaving 248 to cover 222 public schools.

Elia said Friday that there is no shortage, and that complaints from nurses are overblown. She said she has authorized the addition of six licensed practical nurses and will fill the positions of two registered nurses who recently quit.

"I have committed to making sure that we have one health professional at every site," Elia said, noting some school districts don't have that.

Frustrated by a hiring freeze that depleted the number of nurses and health assistants, nurses met with Elia three weeks ago to express concerns. They said it's not safe for students in public schools who need medical attention.

Elia responded with a letter published Sept. 6 in the Tribune that took issue with the complaints, saying the staffing levels were adequate. She suggested some of the duties handled by nurses such as student height and weight measurements could be handled in the classroom or by hiring retired part-time nurses.

"Our medically fragile children will get the medical supervision they need," Elia wrote. "Other children will have a health care provider available for minor medical issues in case of an emergency."

Nurses Outraged

The letter outraged many of the nurses.

"I think we were all upset with her response," said Linda Edinger, a registered nurse for 37 years, nine in Hillsborough schools. "The fragility comes in with the student who walks in with an issue you know nothing about. You can't plan for that."

In addition to dealing with more students with seizures, diabetes, asthma and allergies, nurses recount helping students who had miscarriages in bathrooms, were victims of sexual abuse or had undiagnosed health needs because the family had no doctor or insurance.

Edinger supervises a health assistant at each of four elementary schools - Collins, Ruskin, Cypress Creek and Summerfield - and a licensed practical nurse at Sessums Elementary. She also splits her time with another nurse at Cimino Elementary.

Edinger said the district's recent claim that there is a nurse or health assistant at every school isn't true. The health assistant assigned to Collins has to work at Sessums two days a week, she said, because there are so many students at Sessums with special needs.

Elia's written response in the newspaper also pushed Gillette to speak out about the loss of two programs she helped develop.

One program made sure there was at least one health care professional in each school under supervision of a registered nurse. The other was the Healthy Student program in high schools and middle schools that allowed parents to sign up to have the district dispense over-the-counter drugs such as Tylenol or Motrin when needed. It ended this school year. Students now need a prescription or physician's note to have over-the-counter drugs dispensed.

"Both programs have been unsystematically dismantled by Supt. Elia," Gillette wrote. "Her actions have resulted in resignations, alienation and fear on the parts of those who work to provide student health programs."

The district also is ignoring the Nurse Practice Act, which requires licensed practical nurses and health assistants be trained and supervised by a registered nurse, nurse practitioner or physician, Gillette said.

Three registered nurses have resigned in the past couple of weeks, although one, Karen Tanski, agreed to stay when offered a reassignment to a high school rather than overseeing three elementaries plus a middle school.

District Can Hire 6 LPNs

Elia approved hiring six additional licensed practical nurses at a cost of $195,000 for the remainder of the school year, said Nelson Luis, who oversees student health services. He said he requested eight but is happy to have six and be able to replace the two registered nurses who left.

As of Friday, the district was updating assignments based on those additions, Luis said.

Gallogly said a few registered nurses will be assigned to just one school, but some will oversee more schools than they do now. She credited Gillette with helping secure the additional licensed practical nurse positions after she volunteered to review the district's current plan in August.

Gillette has been hired as a district consultant several times since her retirement, but she did the recent review at no charge after hearing from nurses in the field.

Her detailed assessment and possible solutions for the district's shrinking health care services were delivered Sept. 4 to Gallogly, Luis and their boss, Gwen Luney, Gillette said. Her report included ways to tap other community and district resources for funding as well as savings from shortening the annual calendar of some nurses during summer months.

"I've heard nothing," Gillette said late Friday.

Elia said Friday that she knew Gillette had a plan, but she had not seen it.

Luis said the district plans to adopt some of Gillette's suggestions, such as looking for additional funding sources in the community.

Registered nurse Carol Butts said this is the first year she has had to care for the 2,130 students at Riverview High with no assistance. Some 27 students may have seizures at any time. Several require daily procedures such as catheterization, and up to 10 students at a time line up in the portable classroom clinic.

Because she can't leave students alone, Butts said she is being moved near the main office so an adult is nearby to stay with students when she is needed elsewhere.

"In two weeks I'm being taken out of my wonderful portable with four cots and a 10-by-10 privacy square to move to a tiny office in student affairs with two beds and no cabinets," Butts said. "I can't do it like this - I can't do it by myself."

"We've got to figure out a way for this to work," Butts said. "I just want it to be OK for the kids."

Reporter Marilyn Brown can be reached at (813) 259-8069 or mbrown@tampatrib.com.