July 17, 2014

Merced Union schools need another registered nurse to handle students’ medical emergencies

Diabetes, asthma, seizures and heart conditions affect high school pupils

More students are showing up at area high school campuses with serious medical issues such as asthma, seizures, diabetes or heart conditions.

They are categorized as medically fragile.

The Merced Union High School District, with campuses in Merced, Atwater and Livingston, needs to hire a third registered nurse to handle a growing number of health emergencies. Interviews were being conducted this week, but school nurse candidates are difficult to attract.

The numbers of medically fragile students seems to be growing, according to Darren Sylvia, director of student support services.

“It’s not unreasonable to assume health and medical issues would manifest themselves on school sites,” Sylvia said. “Last year, kids showed up with more medical needs than in years past.

“Several decades ago these students were in specialized schools or stayed at home. Medical advancements have allowed longer longevity, but that presents tough challenges for schools to provide health support for those students (who are) medically fragile,” Sylvia said.

When students can have stability in their educational plans, then they can learn, Sylvia said. But if they are not in school, they can’t learn, and if they aren’t feeling well, their minds aren’t focused on learning.

“We are not going to fix their problem, but we can help them deal with medical needs and become productive citizens,” Sylvia said.

The district has two registered nurses to cover six campuses and is trying to hire a third. Sylvia expects revised state legislation requiring campuses to have a licensed vocational nurse to pass next year after it failed the first time last year.

Last year, there were three medical emergencies in one week at Golden Valley High School. It usually averages one or two medical emergencies districtwide in a month, according to Sylvia.

Ter Yang, a registered nurse who supervises nursing activities at all schools, said more and more students are experiencing medical issues. She said she’s on the go all the time and never knows what to expect. She covers Merced, Atwater and El Capitan high schools.

“Every day we average 25 to 30 students come through the health office at one school,” Yang said. She is hoping another nurse can be hired. She previously worked in acute care at a hospital but prefers the flexibility of school nursing, which doesn’t involve working weekends and holidays.

The state recommends a ratio of one nurse to 750 students; the MUHSD ratio is one nurse to more than 5,000 students.

Along with the two registered nurses, the district has two LVNs and seven health aides, who are not allowed to give medication to students. Health aides document students’ conditions, keep medical records and do vision, dental and hearing screening.

A report prepared by Sylvia shows the number of students with medical issues. They include asthma, 910; attention deficit disorder, 317; diabetes, 35; life-threatening allergy reactions, 53; heart conditions, 48; compromised immunity, 22; seizures, 77; pregnancy, 35; food allergies, 250; mental health, 90; and needing medication, 41.

A severely disabled student at one of Merced’s schools has been having seizures daily that can last from 4 to 8 minutes. This requires a medication that must be given by a nurse.

Kabao Vang is a registered nurse who divides her time among Golden Valley, Livingston, El Capitan and Buhach Colony high schools. She said the most common conditions she encounters are diabetes and seizures.

You never know when and where students will experience seizures, Vang said. She said a medical emergency takes place at least once a month and her job entails considerable travel among the campuses.

Some students don’t know they have diabetes until it’s identified, Vang said. She said school nursing is a different environment than other health venues, but she wouldn’t trade it for anything else.

Brian Mimura, Fresno-based program manager for The California Endowment, lauded the district for trying to boost its nursing staff.

Mimura said students need to be healthy so they can be successful in school. He said some schools, including a couple in Clovis, have integrated comprehensive services with school-based health centers. There are none in Merced County, though, he said.

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