For the past 28 years, Toni McCallum has provided health services to students in Vacaville Unified School District. Her strong leadership advocacy has fostered growth and appreciation of nursing services within the district. Starting as a district school nurse, Toni developed and maintained a broad program of health education and services designed to protect, maintain, and enhance the health of students.
She strengthened and facilitated the educational process by identifying and remediating health related barriers that impede the learning process. She built relationships and earned the trust of her educational colleagues who witnessed her dedication to children’s health and well-being
Toni was instrumental in all facets of implementing a comprehensive health services. She employed the nursing process on an organizational level and planned, organized, monitored and directed the Health Services program for the district. Additionally she assessed program effectiveness and compliance with all relevant laws, ensure effective and efficient program functioning.
In July of 2015, Toni became a Nationally Certified School nurse. Her other accomplishments include Citizen Award of Merit, Participation in the Child Obesity Study with UC Davis, and Certificate of Appreciation from the Solano Asthma Coalition. Congratulation Toni
Excellence in School Nursing Award
Belinda Brager has served as the credentialed school nurse for Calaveras Unified School District for the past seven years. She has been instrumental in implementing health services, supporting special education and working with the community to enhance health services. Belinda provides direct health care services to students, parents and staff, as well as supporting optimal educational outcomes for special educations students Belinda has holds a Master’s Degree in Nursing and a Public Health Nurse certificate with the State of California. Recently, Belinda completed an Administrative Credentialing program through the Teachers College of San Joaquin.
Belinda is currently the Northern Section Treasurer but has also served as the publications chair for Northern Section. Belinda has been instrumental in working on the vision screening training video and helped with the medication administration training video.
Recently, Belinda has been charged with and has successfully facilitated IEP meetings for her special education students. Leading these meetings through a nursing lens has allowed the best educational placement for students with health care and academic needs. As shared by Belinda, when considering multi-tiered systems of support, nurses understand the tiered model and then can effectively provide support to the student to ensure success. Congratulations Belinda
ENA Foundation Scholarship Allows Member to Complete Doctoral Project By Alexandra Pecci, Special to ENA Connection
Official Magazine of the Emergency Nurses Association | November 2015
If you could have peeked into Mariann Cosby’s life in mid-October 2015, you might have been astonished by what you saw. Her latest degree — Doctor of Nursing Practice — was officially conferred, she signed on to teach graduate students in the school nurse credential program at the California State University, Sacramento School of Nursing, and was chosen to serve as one of two senior coeditors for the upcoming fourth edition of the American Association of Legal Nurse Consultants Principles and Practice. Perhaps it’s all in a day’s work for Cosby, DNP, MPA, RN, PHN, CEN, NE-BC, LNCC, and president of MFC Consulting, but she is never content to rest on her many laurels. And she says she will never stop learning and growing her nursing practice.
"I guess it’s my curious mind," she says. "I find it stimulating. There’s always something to know. There’s so much I don’t know." Cosby, an ENA lifetime member, was awarded a 2014 ENA Foundation Doctoral Scholarship, which helped her complete her doctoral program project, School Nursing Simulation: An Evidence-Based Practice Intervention for Improved Confidence in Health-Related School Emergency First-Responder Role. Through the project’s aims, improved outcomes for school children included those with severe allergies and allergic reactions.
Cosby’s nursing and professional accomplishments are many and wide-ranging. During her more than 30-year nursing career, she has been a staff nurse and nurse manager; nursing instructor and college faculty member; independent legal nurse consultant and expert witness; public health consultant; author; and school nurse, among other roles. She’s a certified lifecare planner, as well as a dedicated volunteer, lending her time and expertise to a host of committees and boards, including her local chapter of the American Association of Legal Nurse Consultants, the California Geriatric Education Center Advisory Committee, and many others.
Much of Cosby’s experience and expertise has culminated in better educating and empowering school nurses. Cosby is president of the Northern Section of the California School Nurses Organization, and will continue her dedication to the field in her new role at the California State University, Sacramento School of Nursing. Many possible emergency scenarios can happen to a school nurse, yet school nurses often don’t have the same kind of day-to-day experience in emergency nursing that a staff nurse in a hospital would. In addition, school nurses are often the only medical professionals on campus. As an educator, Cosby has developed scenarios that are school nursing specific, and part of an all-day simulation program, that give school nurses a chance to brush up on their emergency skills by practicing and learning in a safe, supportive environment.
"It’s so important in school nursing to have this," she says. "Not all nurses have that experience when they come into school nursing." Cosby has taught classes like these before, and has received feedback from participants about the real, tangible difference the classes have made in their lives, and in the lives of their students. One nurse told Cosby how she was able to apply what she learned when one of her students was having a possible anaphylactic reaction at school.
"It’s great to hear those kinds of stories and hear it is making a difference in that nurse’s practice," Cosby says. It’s just one of many examples of the ways emergency nurses can have an impact in many different arenas, not just within a hospital, Cosby says. She adds the nursing voice is an important one for a wide range of issues, and she hopes to continue to provide that voice in the future.
"Anything where nursing has an impact or should have an impact," is a place where she hopes to make a difference, whether in the legal sphere, public health sphere, school nursing sphere, or beyond. "I think in terms of community value it’s a profession that can be infused in so many aspects of our world and our community." she says. "There is no end to the opportunities." There seems to be no end to Cosby’s insatiable hunger for knowledge and commitment to improving nursing’s impact on quality care and education.
NVUSD improves vision testing of students
Napa Valley Register, October 16, 2015
It used to take school nurse Debbie O’Haire more than a week to test the vision all of the students at a single school in the Napa Valley Unified School District. Now, she can do it in one day, with reliable and accurate results. The Lions Club of American Canyon made it possible by making available to NVUSD schools new technology that quickly and easily tests a person’s eyesight. Using a special camera called the Welch Allyn Vision Screener, O’Haire and the school district’s five other credentialed nurses are able to test 8,000 students a year in far less time than it took using eye charts hung on walls and other basic tools. “When we screen, it needs to be done efficiently and accurately,” said O’Haire, who handles all of the nursing duties for two middle schools (Harvest and River) and four elementary schools (McPherson, Shearer, Browns Valley and Snow). “Otherwise, it isn’t worthwhile.” The switch to using the Vision Screener has dramatically reduced the time it takes O’Haire and her five colleagues who have a multitude of other health duties to perform in addition to screening students for vision problems, which is mandated by the state for children in grades kindergarten, third, fifth, eighth and eleventh. Testing for near-sightedness and far-sightedness for an entire elementary school could sometimes last six days, according to O’Haire, due in part to working with young children who sometimes are easily distracted from reading an eye chart. “Kindergartners like to look at butterflies, they like to do other things” than take an eye exam, she said, chuckling. There have been other important improvements from using the camera, said school nurse Kate Scudero, who covers American Canyon High School and American Canyon Middle School, as well as Napa Junction and Canyon Oaks elementary schools. “What we’re finding with this program is we can detect astigmatism at much earlier age,” said Scudero. In fact, figuring out if a student had astigmatism wasn’t really possible under the old methods, added O’Haire. “So this camera is picking up previously what we could not pick up.” The cameras also make it possible for the nurses to test students who couldn’t be examined before, either because of their age or disabilities. “This camera will screen preschoolers, it will screen children with autism, it can screen non-verbal children,” O’Haire said. Ben Anderson, a former mayor of American Canyon and a Lions Club member, said the cameras can be used on people ranging from six months of age to 100 years old. All a child or adult has to do is sit and stare for about 30 seconds into the camera’s lens, which emits soft colorful lights to capture their attention. A built-in speaker produces sounds like “little tweety birds,” said Anderson, making it easier to test young children. Like all Lions Clubs, the American Canyon chapter is dedicated to helping people overcome vision troubles. “If you can catch a kid before he reaches age 10, there’s the possibility you can correct many of the deficiencies they may have,” said Anderson. The Lions Club district to which the American Canyon chapter belongs bought seven cameras, each costing $7,700. The equipment is shared among multiple chapters, which meant only one camera was available for all NVUSD schools to share. Soon, however, the district will get its own camera. O’Haire was so impressed with the Vision Screener that she contacted the nonprofit Community Projects, Inc. in Napa and persuaded them to purchase a camera specifically for the school district. The district is happy with how the vision program has evolved with the help of local philanthropy and collaboration. “We’re thrilled,” said Elizabeth Emmett, NVUSD’s director of communications and community engagement. “Community partnerships are really an important part of supporting all the schools.” “The community belongs in our schools, and this is a great example,“ Emmett said.
Davis School nurses stretched thin
Appeared in The Davis Enterprise October 2, 2014, by Jeff Hudson
Davis school nurses are stretched thin Davis High School nurse Rhonda Youtsey checks junior Kathy Islas' blood pressure on Thursday. Coping with paperwork load and more than 2,700 students per nurse, the Davis school district is finding it hard to retain skilled nurses. Fred Gladdis/Enterprise photo
Like many California school districts, the Davis school district has trouble retaining school nurses.
And the turnover is fueled by several factors, including school district salaries that are lower than nurses can receive in the private sector (and elsewhere), as well as a heavy load of paperwork, and the large number of students that school nurses are expected to monitor.
The Davis district currently staffs the equivalent of only 3.2 full-time nurses to cover a district enrollment of some 8,600 students — a ratio of one nurse for every 2,700 students. This translates to about a half-day per week of school nurse time at each elementary school, one to 1 1/2 days of school nurse time at each junior high campus, and three or four days of school nurse time per week at Davis High School.
Because school nurses have been stretched thin for decades, office staff as school sites has long been called on to handle basic first aid — Band-aids for skinned knees and Kleenex for bloody noses. School nurses are involved primarily with more specialized tasks.
School districts have seen a rise in the number of medically fragile students — including those with physical disabilities, severe allergies and chronic medical conditions.
“There are many more students now using EpiPens and other autoinjectors,” said Rhona Youtsey, who has been a school nurse with the Davis district for 28 years. “Back when I started, there were maybe one or two students per school (using autoinjectors), but now some schools have 20 or more.”
Local special education students, who might in decades past have attended a program at Greengate School in Woodland, have in many cases been mainstreamed into classrooms in Davis in recent years, and that has added to the duties of school nurses as well.
School nurses also often get involved in screening students for hearing problems, vision problems and scoliosis (sideways curvature of the spine).
Private-sector opportunities for nurses generally pay higher salaries than school nurses receive. As a result, the Davis district has lost four school nurses in the past four years — and the lack of continuity brought on by that turnover has further compounded the problem to a degree.
Carla Levin worked as a school nurse in the Davis district for a number of years, but left in 2010, and now works as a nurse practitioner — at a much higher salary than a school nurse receives.
“School nurses are spread very, very thin,” Levin said. “And often, school nurses end up primarily doing required paperwork. I think school nurses could really make a difference in the health and wellness of students (to a greater degree than they currently do), but they are not able to because they are spread so thin.
“And school nurses are not well paid — I think that is a problem.”
Levin also suggested that the Davis district could do a better job managing the nurses that it has.
Now that the Davis school district’s budget is starting to recover from the cutbacks brought on by the state budget crisis between 2008 and 2013, the district is planning to increase staffing for school nurses to the equivalent of four full-time positions. But that will only lower the ratio of students per full-time nurse from 2,700-to-one to 2,150-to-one.
The school district also is increasing training of unlicensed non-medical school staff, such as support staff and paraeducators, to administer medication to students in certain cases.
Davis school board trustee Sheila Allen offered a pithy summary during the Sept. 4 school board meeting of the challenge that the district faces in retaining school nurses: “It’s hard work, the ratio is terrible and we don’t pay very well.”
Allen has a Ph.D. in nursing, and has taught community health and public health at Sacramento State University. In a phone conversation with The Enterprise, she expanded on her remarks at meeting, saying, “Our pay (for school nurses) is not very good (compared to the private sector). And we likely cannot make up that difference.”
But Allen added that since school nurses tend to have the summer off, school districts might benefit by focusing on prospective hires who want to have time during the summer to look after their own sons and daughters.
As compared to decades past, school nurses function “more like case managers, assuring we’re compliant with state regulations,” Allen said. “For kids with chronic diseases, the nurses follow up with the doctor’s office. They monitor medications and procedures that have to be taken care of at school. They make sure everyone has health insurance, and if someone has no insurance, they do follow-up to see if a referral should be made. ”
— Reach Jeff Hudson at email@example.com or 530-747-8055.
Gardner's Efforts Recognized
Beckman Shines with Brilliance at the GEM Awards
Donna Beckman, BSN, RN, Northern Section CSNO Technology and CSNO State Membership Chair, captured the Western Regional Finals for Nurse.com GEM (Giving Excellence Meaning) Awards in the Home, Community and Ambulatory Care category. Beckman, along with 29 other finalists were honored on June 27th at the glamorous Universal City Hilton located in the Los Angeles area. Beckman admits, prior to the announcement, she leaned over to her husband Kyle, who accompanied her and whispered, “You know I won’t win.” Much to Beckman’s surprise they, announced her as the Region winner.
Says Beckman, “I thought getting the State CSNO School Nurse of the Year was big, I was overwhelmed when they announced my name.” In essence, Beckman touts that it’s “Kind of a big deal to be recognized among your peers and by the nursing profession. We work so hard and often underestimate all that we do.” Beckman shared the entire experience was stellar which included photo shoots, magazine coverage and national recognition. “I just wish to thank Cathy Owens, the CSNO State Public Relations Chair for nominating me.” Said Beckman.
According to Nurse.com, recognition of nursing excellence has been an important part of the company mission for nearly 30 years. Nurse.com has a national program to honor nurses and the extraordinary contributions they make to patients, the nursing profession and the healthcare system. The GEM (Giving Excellence Meaning) Awards program is unique in that all of the nurses that are recognize each year are nominated, selected and honored by nurses. The Home, Community and Ambulatory Care celebrates an RN who exemplifies outstanding clinical knowledge and nursing expertise in caring for patients in settings outside the hospital in professional home care nursing, home hospice, sub-acute and intermediate, or in other ambulatory community, industrial, or school nurse roles.
Donna is currently the Special Education School Nurse Coordinator at the San Joaquin County Office of Education. Donna graduated from Cal State University, Bakersfield in 1983 with her Bachelor of Science in Nursing. She obtained her Health Services Credential from CSU Bakersfield in 2004. She has over 20 years of hospital experience in Med-Surg, Oncology, Orthopedics and Home Health. She has held all positions from staff nurse to supervisor to Director. She has been a school nurse since 2000; worked on a Community Challenge Grant and a Cal-Safe Grant.
State Orders Rocklin Unified to Rehire Four Nurses.
firstname.lastname@example.org Published: Saturday, Jun. 21, 2014 - 10:42 pm Last Modified: Sunday, Jun. 22, 2014 - 9:10 am Rocklin Unified School District must rehire four nurses it laid off in 2010 and pay them four years of back wages with interest, the California Public Employment Relations Board ruled last week.
Board members upheld a judge’s 2012 decision that determined nurses Jennifer Hammond, Genevieve Sherman, Susan Firchau and Jennifer Bradley had been wrongfully fired in retaliation for expressing concerns about staffing, workload and safety, which is protected by the Education Employment Relations Act. The four women were the district’s entire nursing staff.
“We have received the PERB ruling, are reviewing it and discussing it with the board,” said Roger Stock, superintendent of the 11,000-student district. The agenda for Tuesday night’s board meeting includes a discussion of the decision with legal counsel in closed session.
The district can decide to accept the ruling or reject it and file a petition with the 3rd District Court of Appeal, according to the PERB website.
“I believe the district will do what’s ordered and offer to reinstate their jobs,” said Barbara Scott, president of the Rocklin Teachers Professional Association, which filed the complaint against the district.
Hammond said all four nurses are planning to return to their jobs at the district. “I want to go back because I have a vested interest in this,” Hammond said. “I live in the community, and I’m happy to go back.”
The complaint paints a picture of a tumultuous relationship between the nurses and administrators. Problems started in 2008 when the nurses asked for office space and enlisted the union to help them. The schism grew after Hammond, the lead nurse, refused a district official’s request to teach a bus driver to suction a student’s trachea tube, saying it was unsafe.
The district and its nurses were at loggerheads over training scheduled for days that the nurses – who did not all work full-time – were not working or when they had other work-related obligations, the complaint said. District officials told them to rearrange their work days. The nurses refused and were told “to be careful” and “to watch out,” according to the complaint.
The “beginning of the end” came when the nurses refused to train students from the Regional Occupation Program to perform emergency medical procedures, Hammond said. Only doctors are authorized to supervise and train medical assistants, she said.
“We were being asked to do things that were really unsafe and outside our scope of practice,” Hammond said in an interview. “We did offer some alternate suggestions. But (district officials) absolutely made our lives miserable and then laid us off.”
On Friday, Stock said the district is constantly reviewing its medical and health safety practices to ensure they comply with appropriate regulations. “Sometimes it’s a matter of a difference of opinion that we are fully compliant.”
Bradley’s performance evaluation reflected the tense relationship between district officials and the nurses. In the review, Director of Special Education Betty Di Regolo wrote that communication between the district and the nurses had been challenging during the 2008-09 school year. She warned Bradley that it was going to get worse, according to the complaint.
The situation deteriorated to the point that a meeting between Hammond and an administrator “ended with him literally screaming in my face,” she recounted Friday. Hammond asked for union representation and left the meeting. She received a letter of reprimand.
The nurses received preliminary pink slips in March 2010 along with staff in 78 full-time positions. Union concessions allowed the district to retain 71 full-time jobs. The four nurses’ jobs were not saved. District officials said the layoffs were financial and that the timing had nothing to do with the nurses’ engagement in protected activity. The union complained that the district was retaliating against the women.
The two sides met in a settlement hearing that ended with no resolution before the case moved on to a formal hearing in 2012. A judge agreed with the union and the nurses. But the judge rejected a union claim that the district had transferred the nurses’ work to an outside unit without giving the union a chance to bargain.
Rocklin Unified paid about $37,000 in attorney’s fees out of its unrestricted general fund, Stock said.
“The union was delighted to be vindicated by PERB, and it’s a long time coming,” said CTA attorney Laura Juran. “Again, we think it’s unfortunate instead of making things right they continued to incur legal fees.”
The case is likely to cost the district hundreds of thousands of dollars, because it includes salary raises and interest, Juran said.
Hammond, who said she’s working at another school district, isn’t expecting a big payout. While PERB’s decision awards lost wages, that amount is reduced if the nurses earned income in other jobs. It remains unclear how much the district has to pay.
“It’s not five years’ pay,” she said Friday. “There were probably two months I didn’t receive a paycheck.”
She said most of the other nurses found jobs as well. Only one couldn’t find a job close enough to home. “It was never about the money,” Hammond said. “It was always about the safety of the kids.”
The district now is being served by a health team that includes a registered nurse, licensed vocational nurses and health aides, Stock said. The women who were laid off are all registered nurses, said Scott, the Rocklin teachers’ union leader.
Hammond is “very concerned” about how she will be received when she returns to Rocklin Unified but said she will approach the situation professionally.
Stock, who has been superintendent since the beginning of last school year, said the district has a strong working relationship with all its employees. “We always want to make sure all employees are treated professionally,” he said.
Scott is hopeful that the old wounds can be healed. “I think with new leadership there is always a time for rebirth and to grow again and to make new relationships. I think we have kind of been working on that.”
School Nurses Save Money: Study
By Genevra Pittman
May 20, 2014
NEW YORK (Reuters Health) - A Massachusetts program that put full-time registered nurses in schools more than paid for itself by averting medical costs and lost work for parents and teachers, according to a new study.
Many school districts have cut or reduced the hours of school nurses in recent years, and nationwide less than half of public schools have a full-time nurse, the authors of the report note.
They say their results warrant "careful consideration" from districts that are thinking of making such cuts in an effort to save money.
"The findings of this study suggest that from a societal perspective, the benefits of school nursing services may well exceed the cost for those services," Li Yan Wang told Reuters Health.
She led the research at the Centers for Disease Control and Prevention's Division of Adolescent and School Health in Atlanta, Georgia.
To assess the Massachusetts program, the researchers compared money spent putting full-time nurses in schools with money the program saved by reducing doctors' visits and keeping parents at work and teachers in front of the classroom.
For the 22 types of procedures school nurses performed during the study, from testing blood sugar to administering physical therapy, the researchers calculated how much it would cost to go to a clinic or hospital for the same care.
To measure lost wages for parents, they determined the time parents would have to take off work if children were dismissed early, as well as how often they would have to come to school to help kids take their prescription medications if no nurse was on site.
Finally, to assess teacher productivity, they referred to an earlier study that found teachers spent 20 fewer minutes per day dealing with student health issues once a nurse was assigned to their school.
Massachusetts records showed that during the 2009-2010 school year, about 477,000 students at 933 schools covered by the program received school health services. Paying nurses to provide those services cost $79 million.
The same care provided outside of school would have cost $20 million. In addition, with no school nurses parent productivity losses would have totaled $28.1 million and teacher productivity losses, $129.1 million.
Wang and her colleagues calculated that every dollar invested in the school nurse program saved $2.20 overall, according to the findings published May 19 in JAMA Pediatrics.
Anne Sheetz said those savings are just a start.
"We haven't looked at the number of emergency room visits saved, we have not looked at the number of hospitalizations saved . . . we have yet to look at the big savings," she told Reuters Health. "This is just a drop in the bucket."
Sheetz, the study's senior author, retired last year as the Director of School Health Services at the Massachusetts Department of Public Health.
When she started the position, she said, "I could not believe the amount of health care that was being done in schools and the critical nature of it."
School nurses, Sheetz said, see 60 to 70 kids each day. They have to be ready to provide emergency care and mental health services and help manage chronic conditions like diabetes. Nurses are also charged with teaching other members of the school community about issues such as life-threatening food allergies.
"The role of the school nurse has really expanded," said Martha Keehner Engelke, who has studied that topic at East Carolina University in Greenville, North Carolina but wasn't involved in the new report.
"People think of it as doing vision screening and putting on Band-Aids," Engelke told Reuters Health. "Those things are there, but that's a really small part of what school nurses do."
Two local doctors who have worked with the Massachusetts school health services program, pediatric allergist Dr. Michael Pistiner of Harvard Vanguard Medical Associates and endocrinologist Dr. Maryanne Quinn of Boston Children's Hospital, agreed that it has had a considerable impact on kids' health in both of their specialties.
"Cost has been a very real barrier," Pistiner said.
The new study, he added, "may change these conversations. It may put getting a full-time school nurse back on the priority list."