NCPA - National Center for Policy Analysis

Schools As Health-Care Providers

January 28, 1999

Not so many years ago, school nurses supplied Band-Aids, took temperatures and provided a place for a child who was not feeling well to lie down. Today, they are handing out drugs such as Ritalin -- the attention deficit disorder medication -- supplying asthma inhalers, tending to catheters and even tube feeding.

School officials across the country are trying to determine whether the nurses should be helped by hand-picked school teams or whether more nurses should be hired, as nurses themselves favor.

  • Over three million children in U.S. schools now take Ritalin -- more than double the 1990 figure.
  • Administering medication at schools for psychiatric and chronic illnesses is on the rise.
  • The nurses now often find themselves counseling students to quit smoking or practice celibacy.
  • Working parents often find it easier to send a child with a mild ailment to school and let the nurse take care of the problem.

"Many times parents depend on your assessment because of a lack of money and a lack of places for them to go," says a school nurse of 41 years.

Nurses point to policies of "inclusion" that have populated public schools with scatterings of chronically ill children who once would have gone to special institutions, but now can be medically managed in a more normal setting.

But the major challenge seems to be pill distribution. A survey of Boston's school system found that its 86 nurses -- who serve 64,000 pupils -- gave out about 200,000 doses of medication last year. School officials say that the survey may have been flawed and the total was probably higher.

Source: Carey Goldberg, "For School Nurses, More Than Tending the Sick," New York Times, January 28, 1999.


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