Health and Student Services ESP —  Building a Quality Workforce

Building a quality workforce requires attention and focus by employers and employees alike. The Health & Student Services Quality Workforce that exists in our public schools has not happened by accident. It comes together when Health & Student Services Education Support Professionals are recognized and included as part of the school district's basic mission — enhancing student achievement.

This effort must include results-oriented job descriptions and evaluations, new employee orientation programs, ongoing in-service training programs, relevant and current skill set training, and career-enhancing professional development programs.

On this site we highlight some of the challenges Health & Student Services ESP encounter as they endeavor to build a Health & Student Services Quality Workforce.

Our Job Descriptions — Who We Really Are and What We Really Do

"Kids who couldn't leave the hospital when I got out of nursing school in the '70s are now living at home and getting on a school bus every day!" said Martha Bergen, Nursing Instructor at the University of Minnesota. "Back then, all you needed was first aid and some office nursing skills to be a school nurse. Today we have nurses and health care professionals in the public schools who have come right out of years in Intensive Care Units, and within a month doing public school health care, they are burned-out and exhausted! It's a really tough job!"
   The Trenton Times, April 30, 2001

There are a wide variety of titles in the Health & Student Services ESP job group, including registered nurse, licensed practical nurse, nurses' aide, health or therapist aide/technician, medical technician, family and parent services aide, community welfare services worker, and non-managerial supervisor.

Health & Student Services ESP are vital to nearly every aspect of student health and welfare within a public school. Members of this job group enable many students with special health needs to succeed in the academic arena. The occupational, speech and language, and physical therapy assistants work with individuals to help them surmount physical obstacles to their learning. Nurses, nurses' aides, and licensed practical nurses help keep students healthy, and by providing students with health education, teach them to maintain their health independently. The tasks performed and the skills required to address the complex challenges of student health and welfare are varied, difficult, and often dangerous.

Those who are responsible for identifying and describing who Health & Student Services ESP are and what they really do are often woefully misinformed or even totally uninformed. Some Health & Student Services ESP have no job description at all! Others have a job description that bears no genuine resemblance to the diverse and essential work they do.

Here are examples of situations a Health & Student Services ESP might encounter during a typical day:

• In an Alabama school district, the school nurse drives a "Health Bus" from school to school to administer health care to students. She prepares the "Health Bus" for her daily rounds the night before. The nurse had to learn to drive the bus herself and obtain a CDL license at her own expense, since a school bus driver was not provided.
  
  Her day begins by dealing with students who are on sick call in the morning. Those who have a temperature of 102º or greater might go home, but most remain in the "Health Bus" with the nurse for the day because there's no one to take care of them at home. The nurse calls 911 for any emergency or serious problems, and notifies home, doctors, guardians, etc.

• Health & Student Services ESP's days often begin with calls from bus drivers reporting sick or injured students from their morning routes. They frequently must address a child abuse issue or problem reported by the driver.

• Staff refer all health and welfare issues to the Health & Student Services ESP. Teachers call the nurse for medical referrals, cafeteria employees call for eating disorder issues, secretaries refer injury and violence problems, and custodians deliver students who have been fighting. Coaches refer sports injuries to the health professional at all hours of the day — coinciding not only with phys-ed classes, but also with sports practices and events.

• A school district in Kentucky has a Family Resource Center where the Health & Student Services ESP is responsible for the care and welfare of families as well as students. In this capacity, the school nurse must make home visits regarding child abuse, neglect, and/or violence at home. The home visits take place in the afternoon after school, and often last until 6 or 7 p.m. Home visits often involve bringing the sheriff, and never occur without the presence of at least an aide.

• An assistant nurse in Las Vegas must file "Random Moment Forms." These forms describe a service provided at any given moment during the day in order to prove that the service was performed and to get funding reimbursement.

• Teachers planning field trips notify the ESP health provider of the trip schedule approximately one week in advance. The ESP must prepare many forms and equipment to enable the teacher to administer necessary medications or treatments to the students. When medications are administered, the teacher records the amount and time, and signs the record. The ESP health provider is then responsible for the accuracy of those records.

• Health & Student Services ESP are responsible for a staggering amount of paperwork. Health insurance is a huge problem for many families in many school districts. Completing the "random moment forms" and the "bubble sheets" are essential to getting funding from Medicaid and CHIPS, or other programs and agencies that may provide monies.

• Many Health & Student Services ESP begin their day with snail mail, e-mail and voice mail. They move on to cope with "lice patrol" screenings, medical referrals, daily records and health logs for each student, injuries, bleeding, infections, dehydrated athletes, medical procedures such as catheters and tube feedings, ordering supplies, distributing daily medications, bandaids and cotton balls, nutrition issues, 911 calls and follow-up, drug and substance abuse issues, dental emergencies, pregnancy problems and birth control issues, bacterial or viral outbreaks, public health notifications and information, court and law enforcement consultation , and "piercing" issues, just to name a few.

• Grief counseling was once an aspect of life that was never addressed in school, but educators and parents now recognize that children need help and professional guidance in order to cope with serious stress from the grieving process. The nurse or health professional is always part of the counseling "team." However, meaningful training and planning are often overlooked and the health services ESP often is left to improvise in very difficult situations.

This list could go on forever. Health & Student Services ESP meet these challenges with competence, personal attention and often a great deal of courage. They interact closely with parents, students, other staff, the community, and quite often law enforcement and the courts, on a daily basis. Their jobs are usually performed in situations of stress, conflict, crisis or emergency.

It is vitally important to identify and accurately define — and then describe comprehensively — what Health & Student Services ESP really do on a daily basis. In a recent survey, 64% of Health & Student Services respondents believe their job descriptions do not accurately describe the amount or type of work they really do. More disturbing was the discovery that 39% have no input at all in updating or changing their job descriptions. Most members understand that this is unacceptable.

Your job description matters a great deal! It should be an accurate, results-oriented, current description of who you really are and what you really do in a public school district and as part of the Health & Student Services Quality Workforce.

To Section 2: Federal and State Statutes