Eileen Gomez, nursing coordinator for Albemarle County Schools, gives a Hollymead Elementary School student his daily medication. Credit: Credit: Josh Mandell, Collectbritain

Until recently, children who came to Albemarle County elementary schools with a fever or who sprained an ankle at afternoon recess couldn’t see a nurse right away.

Before the 2015-16 school year, all but one of Albemarle’s elementary schools kept a nurse on duty for just six hours of each school day. These hours did not include bus arrival and departure times. Only the nurse at Hollymead Elementary, who also serves as the division’s school nurse coordinator, worked extra hours.

Albemarle County Public Schools is now working to have nurses stationed at elementary schools for the entire day to treat students in those situations— and in life-threatening emergencies.

This year, 11 of 16 elementary schools in the county employ full-time nurses who work 7.25 hours each day. These schools enrolled about 84 percent of the division’s elementary school students in 2015-16.

All of Albemarle’s middle schools and high schools have full-time nurses. Employing a nurse full-time at a much smaller elementary school represents a greater per-student cost. But leaders of the division say this saves valuable time for principals, teachers and staff, who have to deal with student health issues when no nurse is present.

“It’s a better use of resources than having principals bandaging knees,” said school board chair Kate Acuff. “I think it was a good investment, and I am hopeful that we can continue it.”

Acuff, who has a Ph.D. in public health, said having a nurse on duty at the start of the day can help prevent infectious diseases from spreading in a school.

In 2015-16, Albemarle County Public Schools spent $82,500 on additional nursing hours at the five largest elementary schools. This year, the same expanded hours went into effect at five more elementary schools, adding another $90,928 to the division’s budget.

Superintendent Pam Moran hopes to include the remaining five elementary schools— Broadus Wood, V.L. Murray, Red Hill, Scottsville and Yancey— in her budget request for the 2017-18 school year.

“There are two principal reasons why it is important to expand our use of full-time school nurses—to meet an important health and safety need… and to be proactive in making sure we are able to support our students and staff in an emergency, regardless of their school location,” Moran said.

“Once we have more timely information on projected revenues for next year and on our overall needs, we’ll have a better idea on what we will be able to afford.”

The division’s Health Advisory Board, which includes medical professionals, parents and school staff, has recommended that all schools be supported by a full-time nurse.

“Obviously, it’s an expense for the county,” said Lori Balaban, a pediatrician on the advisory board. “But having something bad happen could be costly in a lot of ways.”

Albemarle County school nurses summoned rescue squads 35 times and treated 75 major injuries during the 2014-2015 school year.

“…If you’re leaving part of the day uncovered, you’re just gambling that nothing is going to happen at that hour,” Balaban said. “It’s nice to have someone with medical training there, because scary stuff can happen sometimes.”

Eileen Gomez, the division’s school nurse coordinator, said young students with severe allergies and chronic conditions like asthma, epilepsy and diabetes have the most need for medical supervision.

“It’s really helpful if a school nurse is there when a student first gets diagnosed [with a health condition],” Gomez said. “They can help them continue to safely attend school.”

Health clinics at the largest elementary schools sometimes get more than 50 visits in a day.

“Those offices are pretty busy places,” Gomez said. “They need to keep the nurses in. It would be overwhelming without them.”

Gomez said school nurses function as a primary medical caregiver for many low-income students, and are often the first to identify students with mental health issues.

According to the National Association of School Nurses, less than half of America’s public schools employ a full-time nurse.

“Schools can’t do everything, and can’t fund everything,” Balaban said. “But helping kids be healthy is going to help them learn, graduate, and be productive members of society… Anything we can do to support that is good for them, and good for the community.”

Josh Mandell graduated from Yale in 2016 and has been recognized by the Virginia Press Association with five awards for education writing, health, science and environmental writing and multimedia reporting.