How Philly School Nurses Are Standing Up for Students & Families
Last Thursday school nurses testified at the school board against these policies that put our students, families, and profession at risk.
Philadelphia’s school nurses work hard every day to provide the best care for our students, and we have been increasingly concerned about the school district policies that harm students, and disrespect families and nurses. Here’s why:
(School Nurses at the 11/21 School Board Meeting)
The School District of Philadelphia has not been following state law for immunization compliance.
All public schools in the Commonwealth of Pennsylvania are required to enforce immunization requirements, which includes excluding students from school if they do not have the necessary vaccinations. These vaccinations are important both for our students’ health, and the health of the entire school community. Before this crisis began, immunizations were effectively managed by school nurses. School nurses know our students and families best, and we are best placed to help them navigate the healthcare system, so that very few students actually need to be excluded in practice.
However, three years ago the School District decided to stop excluding students for missing immunizations. This decision created the crisis we have today, leading to an unprecedented increase in unvaccinated students. Following the mumps outbreak at Temple University in the spring of last year, school nurses needed to share our growing concerns. School nurses testified multiple times in front of the Board of Education, and following their efforts we were informed in May that the process of excluding students would be reinstated, beginning in the 2019-20 school year.
Decisions are being made without respect for school nurses or families.
At the beginning of the school year, all nurses were informed by the district that the deadline for immunization compliance was October 3, and following this date students would be excluded from school. School nurses spent countless hours communicating with families and healthcare providers in order to make sure students got the immunizations they needed, so that they would not miss any school.
Unfortunately, the District’s actions quickly undermined our hard work. The deadline for exclusion was pushed back at the last minute, and communication with nurses and families was frequently confusing and contained inaccurate information. Non-nurses were put in charge of calling families, but we discovered that many of the students whose families were being called already had all the required vaccines documented in their records. Parents had to miss work or pay for appointments based on these calls, only to find out that their children already had all the needed vaccinations. On top of this, postcards with private vaccination information were mailed home, violating students’ medical privacy.
Student records are being changed without medical documentation.
Prior to the most recent exclusion date of November 4th, we received an email from the Office of Specialized Services stating that students over 14 years old would be taken to City Health Centers by the district on “field trips” during school, in order to receive their missing immunizations. There is no plan for when these trips will occur or how they will be organized. We have contacted colleagues who work at these health centers, who told us they were not aware of this plan, and are reluctant to administer vaccinations to children without their parents present.
All of these students’ health records were then changed by district staff from non-complaint to provisionally complaint, on the basis of these field trips. “Provisionally compliant” is used when a student has proof of an upcoming appointment. In this case there has been no appointment scheduled, just a plan for these future “field trips”.
Nurses’ licenses have been put at risk by mismanagement.
Equally troubling is the district’s handling of the departure of our former school district physician. As nurses, we can’t legally administer medications without an order from a provider. Most of the medications we administer have orders from students’ private providers, but school nurses in Philadelphia have always had standing orders from the district physician to administer certain medications such as Tylenol. We were not formally informed of Dr. Mathurin’s resignation, and continued to administer these medications for weeks even though the standing order was no longer valid, putting our licenses at risk. It was only when nurses called the Department of Health to confirm the illegality of this practice, and brought it to the district’s attention, that we finally received notice to stop administering pain medication.
It’s time to trust the experts: the school nurses who spend every day working with students and families.
School Nurses are the experts on the health needs of our students and families. As healthcare professionals, we keep up to date on national and state mandates for student health, vaccination policies, disease prevention, health and wellness promotion, and more. When the district takes steps like these, it puts students at risk, harms families, and ties the hands of the exact professionals who have been hired to keep our students safe and healthy.
We will continue to take action to defend the health of our students, families, and profession! We hope you will join us.
Click here to watch the testimony of all the school nurses who testified at the school board meeting on Thursday. The nurse testimony begins at 2 hours and 8 minutes.