Danielle Tschebotarjew, a registered nurse with the Salem-Keizer School District, assists Emma Bangs, a health assistant at Whiteaker Middle School. (KEIZERTIMES/Derek Wiley)

Danielle Tschebotarjew, a registered nurse with the Salem-Keizer School District, assists Emma Bangs, a health assistant at Whiteaker Middle School. (KEIZERTIMES/Derek Wiley)

By DEREK WILEY
Of the Keizertimes

Nearly half of school nurse positions were cut in Oregon between 2010 and 2015, according to a report released in September by the Oregon School Employees Association (OSEA), Oregon School Nurses Association (OSNA), Oregon Nurses Association (ONA) and Upstream Public Health.

But Eric Richards, director of student services, said that’s not the case in Salem-Keizer.

“In our district, we have not had a trend in the number of nurse FTE (full-time employees) going down or even staying steady, it’s going up,” Richards said. “We’ve probably added two and a half to three positions over that time (2010-15).

Richards added the district also hasn’t had a difficult time finding qualified nurses.

“We had a full time position come open this year and we had four outstanding finalists, any of whom we would have been very happy with and we have a new person starting this year,” he said. “We had a great applicant pool. We were able to fill that. We haven’t felt the affects of any nursing shortage in our district, whatsoever.”

Lynn Lanham, a registered nurse in the Salem-Keizer school district for over 20 years, agreed with Richards.

“We have more help than we use to,” she said. “I think people are recognizing the level of care that the students need has certainly gone up. We’re better off than many other school districts in Oregon, for sure.”

But with a staff of 19 registered nurses for roughly 40,000 students, Salem-Keizer does still fall well short of the 1:750 ratio recommended by the state.

“I don’t know very many if any places that meet that standard,” Richards said. “It’s an optimal place that they’d like people to be but we certainly aren’t anywhere near that. Every discipline that works with kids in Oregon could probably use a little more help with case loads. If you look at OTs (occupational therapists) and PTs (physical therapists) or nurses or counselors and you look at their state or national standards on how many there should be for the numbers of kids, I don’t think it’s uncommon for most school districts to be at that level. The level that we have in all our disciplines, they do a very good job of making sure our kids are safe and get the services they are titled to under the law.”

According to the report, the state legislature would need to make an investment of $58 million per year in order to meet the 1:750 ratio and $78 million to guarantee every school building had a nurse.

The 18 registered nurses in Salem-Keizer are scattered over 65 schools.

Danielle Tschebotarjew splits her time between McNary High School and Claggett Creek and Whiteaker middle schools. She worked at a hospital in Texas and as a school nurse in New Jersey before coming to Salem-Keizer in March.

“I spend most of my time at McNary just because there’s more students and a little bit heavier case load,” Tschebotarjew said.

“Every day is completely different. You can try to start your day one way but it’s wherever the wind blows and takes you. It’s everything from seeing how the students are doing to finding out if the staff needs anything, contacting doctors because orders are being changed, just making sure my students are safe and getting their education, that’s how I spend my days.”

At each school, Tschebotarjew relies on a health assistant, who does most of the applying bandaids and ice packs.

“We work really close together, Tschebotarjew said. “Between them and whoever’s called into our help line and then whatever faxes are coming in, I have a check book that I do everyday to make sure I’m crossing my T’s and dotting my I’s. I feel that we’re being supported. Of course there’s nothing wrong with more  help but we’re doing the best that we can and so far it seems like everyone is doing well.”

All nurses take turns working the help line, open from 7:30 a.m. to 3:50 p.m. every school day, to answer any questions a health assistant or teacher may have about providing care.

With the growing population of diabetic children, most of the nurses spend the lunch hour at schools  injecting insulin.

“If you came here during our lunch hour, it’s tumbleweeds, it’s a ghost town, because we’re all at schools, going from one school to another, making sure all our diabetics are getting their medication before or after they eat,” Tschebotarjew said.

Last week, Tschebotarjew showed the staff at McNary how to administer tube feedings.

Through the Oregon Lions Club, every elementary student in Salem-Keizer gets an eye screening each school year.

“We get very good feedback from people who get services from our school nurses,” Richards said. “They do a terrific job. We don’t seem to have any problem attracting high quality registered nurses to come work on our health services team whenever we have openings. As the director of the department, it’s very rare that I get any calls of concern and on the contrary we hear a lot of positives about the help that our nurses give to our schools and the safety of our students.”