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School nurse shortage condemned

A shortage of nurses in schools means that another Baby P tragedy may happen because they do not have the time to implement child protection measures, a nursing leader has claimed.

Dr Peter Carter has said that as nurses come under increasing pressure, they are not in a position to give children the care they deserve.

He blames the fact that because there are too few nurses - some are looking after 2,500 schoolchildren across 26 schools - they are struggling to cope.

He says: "Let's get upstream, let's get nurses into the schools because logic suggests there's other Baby Ps out there, that a lot of children are suffering, but it's not being recognised."

Dr Carter said there was evidence that a number of schools do not implement requirements, and there is extra pressure on nurses in the wake of major reports into child protection issues.

According to the Royal College of Nursing (RCN), the number of school nurses in England working the equivalent of full-time needs to more than double, from 2,634 (2008 figures) to 6,000.

Copyright © Press Association 2009

Royal College of Nursing

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"Shirley is so right and these issues must be addressed before any real improvement can happen but school nurses should be valued and supported and as mentioned by Cath, sexual health is a key deliverable for them." - Name and address supplied

"I was a school nurse for 7 years and a school nurse manager for 9 years, a job which I loved and committed to 100%. I have recently left the school nursing service to work in safeguarding children. My main reason for leaving school nursing was because I was dissatisfied with the lack of value placed on the school nursing service from a senior management perspective within the organisation and the lack of recognition of the role in its entirety. Whilst I appreciate that an academic qualification provides the theoretical underpinning for school nurses to carry out their role, I also believe that experience counts for a lot too. The places for entry onto the degree programme are limited and there are numerous experienced staff within school nursing who are not receiving the financial recompense for doing a worthy job. The pay and conditions for school nurses is inconsistent across the country, and there is much disparity between Health Visting services and School Nursing services with school nursing always appearing as the 'poor relation'. This does nothing for the confidence and the integrity of the staff who work in this service. The government's agenda for reform and review of children's services cannot be put into place and maintained without the support and input from this service, nation wide, and it is vital that the public health role is continued in order to improve the health of our Children & Young People, our future society.
My firm belief is that there should be a pre-requisite degree to become a school nurse as with Health Visiting and this is an issue that needs to be addressed from within central government and by professional bodies. Until some of these issues are addressed and a clear pay/career structure is advocated nationally,  the service will continue to falter in respect of recruitment and retention and it is inevitable that the outcomes for Children & Young people will suffer as a result.
I remain passionate about school nursing, but feel that the profession needs a great boost in terms of recognition, investment and are voice from within central government." - Shirley Archibald, Staffs

"I totally agree with Dr Carter about the value of school nursing – upstream working is what it's about. There are numerous ways in which school nurses support young people and families.  However, deciding between various worthwhile interventions can be difficult, as discussed in a recent paper: Gleeson C. (2009). School nurses' workloads: how should they be prioritised? Community Practitioner 82(1):23-6. The National Healthy Schools Programme provides an ideal framework for
running services such as drop-in clinics which are used by young people for all kinds of issues, including sexual health, acne, mental health or weight problems. Pupils invariably like these clinics which unfortunately tend to be unreliable due to a lack of strategic commitment by PCTs. In their defence, however, PCTs have to comply with government targets for so many things that little time is left to plan strategic health improvement schemes. The Darzi review with its focus on quality improvement offers an opportunity for school nurses to continue to press for an increase in their workforce to improve the current patchy provision." - Cath Gleeson, Yorkshire

"School nurses are actually better paid than well-qualified practice nurses!! I took a drop in salary from being a school nurse to being a practice nurse and would say that my job is much busier and more demanding than school nursing. There is often a lot of time wasted in school nursing, little regulation of what nurses are actually doing and although population per nurse sounds great, most are able and well pupils." - Name and address supplied

"Of course baby Peter was not in school and health visitors are needed in the early years" - Kathy French, Bromley

"I believe that there would be more school nurses if the salary was equivalent to working in a hospital setting. It is highly impossible to make it in 2009 on a 30,000 a year salary." - Camille Dyer, New York