Playground scrapes, tummy aches, and terrorist attacks

AP logo February 21, 2005 -- Today the New York Times ran an AP story by Joe Milicia under the headline "School Nurses Want More Terror Preparation." The relatively brief piece does a good job of stressing the importance of school nurses as first responders to potential terrorist attacks in the post-9/11 era, even as many of the nurses now face serious short-staffing and a lack of resources. However, even though the piece actually mentions "lack of respect" as a barrier to school nurses getting training, a few of its elements may subtly reinforce regressive stereotypes about the nurses' work. In fact, school nurses provide vital preventative and other care, as students attend with more serious chronic conditions and less access to other care.

NYT logo The piece rightly explains that school nurses are "trying to work around tight school budgets and a lack of respect as front-line responders" to get the training they need to respond to terrorist attacks and other emergencies. It reports that nearly half the nurses responding to a recent National Association of School Nurses (NASN) survey listed emergency preparedness as their highest priority, but stresses that many schools today do not even have a full time nurse or health services. Ohio, for instance, is "one of several states that does not require a nurse in every school." The piece includes quotes from an Ohio school nurse and NASN executive director Wanda Miller, who notes that school nurses must be prepared for such emergencies because they are "really on the front line before even the EMT person gets there." The piece goes on to discuss the general needs of schools to get better training and more resources to respond to disasters, before returning to nurses at the end, noting that the 12,500-member NASN has trained over 2,000 school nurses in its disaster preparedness program.

Unfortunately, a few elements in the piece do little to address the "lack of respect" it identifies. The first paragraph establishes the seriousness of the subject by drawing a contrast between the nurses' need for emergency training and the fact that they have been "[l]ong associated with treating playground scrapes and tummy aches." Indeed they have, but saying that and no more gives the impression that the increased need for disaster preparedness is the only thing that separates school nurses from this stereotype. It is not. Modern school nurses care for students with a wide range of serious chronic conditions, such as asthma, provide critical preventative care and teaching, and are a vital part of the community health system. The piece concludes by noting that Ohio nurses at a disaster preparedness session "responded with a collective sigh" when shown pictures of a baby with anthrax, after which the trainer assured them that they did not need to know how to treat victims of biological weapons, just how to identify early symptoms. This suggests that school nurses are just marginally trained workers who serve as part of the early warning system but can't be expected to play any great role in dealing with serious illness. However, school nurses typically have at least bachelor's degrees in nursing, and they are capable of taking an important role in such care, though presumably emergency departments--including ED nurses--would have a greater overall responsibility for dealing with deadly biological agents.

See the AP article by Joe Milicia "School Nurses Want More Terror Preparation" in the February 21, 2004 edition of the New York Times.