A new business line: School nurse assistants

Program helps schools deal with tight budgets

Remember the good old days when you felt sick at school or fell on the playground? The school nurse was right there to hold your hand and wipe away your tears until your parents were by your side. Today, that heartwarming picture is truly a long trip down memory lane, with one-nurse-one-school staffing often a casualty of school budget constraints. In Ohio, for example, individual school nurses now often cover several schools, and school administrators may find themselves subbing in times of illness and pain.

Reacting to the lost services and with grant funding in hand, in 1997, the Springfield City (Clark County, OH) Board of Education issued a communitywide request for proposal (RFP) for a school nurse assistant program. The winner was Mercy Home Care, based in Urbana, OH. "We addressed everything they asked for [in the RFP] and structured a new position rather than using [home health] aides," says Patricia Haley, MSA, manager of personal care services. The program started as a pilot in five schools — four elementary and one junior high — and has expanded to 14 others this year, according to Haley.

Under the program, Mercy school nurse assistants perform basic first aid and preliminary health screenings such as vision and hearing tests and head lice checks. The Ohio Nurse Practice Act also allows the assistants to administer medications at school; they are always on-site for children in need. "They are basically the eyes and ears of the [school] nurses, [who] are available at all times by beeper," she notes.

Although she encouraged home health aides already employed by Mercy Home Care to apply for school nurse assistant positions, the program draws an entirely different type of worker, according to Haley. Applicants are predominantly parents already involved in the school who want to work but only when their children are in school. Five home health aides have been cross-trained to cover school nurse assistant absences, she adds. The two positions pay equally, starting at $7 per hour.

Mercy conducts criminal background checks and requires that applicants pass basic skills tests such as alphabetizing a list of names. Applicants must also have a high school diploma or GED, Ohio driver’s license, and car insurance. (Infrequently, assistants travel between schools.)

School nurses participate in applicant interviews, at Mercy’s request. "[They] had people they really wanted [in the positions], and this helped them see another person was better qualified," Haley explains.

Those hired go through a four-day training program, conducted by Mercy, that covers CPR, basic first aid, body substance isolation and infection control, communications, signs and symptoms of abuse, gang awareness, and both school and Mercy policies. Haley developed the training in collaboration with a school nurse.

Although the Urbana school district initiated the program, getting school nurse buy-in is critical, Haley reports. "You have to work closely with [them]. They feel threatened. [Many think] I’ve been doing this for years. I don’t need help,’" she explains.

School nurses also have input into the school nurse assistants’ performance evaluations. The Mercy private duty nursing supervisor manages the school nurse assistants, but she "seeks active collaboration with school nurses on any areas of retraining," Haley says.

Mercy has a year-to-year contract with the school district. It covers the agency’s recruitment, training, and supervision costs and gross profit goals, according to Haley. Although the positions drew many applicants, staffing has, at times, been challenging because of guaranteed coverage for some schools and unexpected departures of certain school nurse assistants, she explains.

The school district, school nurses, parents, and Mercy all give the program high marks, according to Haley. It allows the school district to fill a service gap at a lower cost than if it developed the program itself, and it frees school nurses to be more proactive, providing additional health education and visiting the homes of at-risk children, she explains.

"It’s a great program. It’s a chance for a private duty agency to be active in the community in a whole different way," she says.


• Patricia Haley, MSA, Manager of Personal Care Services, Mercy Home Care, Mercy Memorial Hospital, 904 Scioto Street, Urbana, OH 43078. Telephone: (937) 653-3447.