A need for nurses: Douglas ESD expands crucial service
Shortly before last Thanksgiving, Superintendent Michael Lasher got some news that didn’t seem to inspire much holiday gratitude. Douglas County government planned to cancel the contract between the county’s public health department and Douglas Education Service District, a contract that had been providing limited nursing services to county schools.
The move was consistent with steps taken by the cash-strapped county to privatize many of its public health services. That was little consolation for Douglas ESD administrators, who were aware of the gaping need for school nursing services. But potential adversity soon turned to opportunity.
“It seemed like a good time for us to finally take the plunge and directly hire some nurses,” Lasher said. “School nursing is something for which districts have repeatedly asked, and I’m happy we have the funds to get this off the ground.”
Starting Jan. 4, Barb Hofford and Ashley Pittam came on board with Douglas ESD, prepared to visit each of our school districts to assess their needs. Both are registered nurses who formerly worked for Douglas County Public Health. Hofford, in fact, was the public health nurse who had been working part-time for ESD under its contract with the county.
Hofford said the part-time contract limited her duties to working mostly with medically fragile students – helping children with seizures or diabetes, for example, or who required feeding tubes. Now Hofford and Pittam are able to travel to the 13 school districts served by Douglas ESD and to assess what each school needs. What they are finding is that many schools have been left to their own devices in dealing with medical challenges.
As a result, some school districts were not furnished with doctors’ orders for operating medical equipment. Others were keeping detailed medication records, but lacked a system for complying with patient privacy laws.
Hofford and Pittam said their first goals in this assessment phase as district nurses are to provide continuity and confidentiality. Also high on their list is to offer resources and referrals so that parents, students and schools can get the help they need, whether for mental health assistance or frontline training.
“We want to standardize health practices, be an advocate and help families and schools connect with services and practitioners,” Hofford said. “We want our students to be healthy and successful in school and in life.”
Writing protocols, drawing up action plans and determining what medical duties can be delegated to school staff after training are also on Douglas ESD nurses’ to-do list. They also are on a team that draws up 504 plans (medical accommodations for students with health needs or disabilities) and Individualized Education Plans.
Both Hofford and Pittam have backgrounds that serve as sturdy bridges to district needs, according to Douglas ESD Special Education Director and Assistant Superintendent Pat Sublette. Hofford has a wealth of experience in mental health, and Pittam has specialized in prenatal care and pregnancy.
The scope and breadth of Hofford’s and Pittam’s duties may come as a surprise, especially to baby boomers who recall school nurses who dispensed bandages and took temperatures from one central office. Douglas ESD nurses may not wield immunization needles, but they have plenty to keep them occupied tending to a student population of 13,000 spread from Elkton to Glendale.
Oregon law encourages school districts to provide one registered or school nurse for every 3,500 students by July 1, 2016. Our two nurses are much closer to that number than before Jan. 4. By billing Medicaid and exploring grants and potential partnership opportunities, Douglas ESD has been able to take a big step in the right direction.
“Part of our mission is to support children in Douglas County through school districts, and this is an ideal opportunity to expand our services,” Sublette said. “We’re thrilled to be able to do it.”