$4.4M Contract to Help Baltimore School Nurse Shortage

• The city of Baltimore has contracted 3 universities to supply registered nurses to public schools, aiding in the critical shortage with only 56 RNS spread across 156 schools.
• This contract is part of Maryland’s statewide education reform plan which seeks to provide healthcare services to all students regardless of background. 
• Multiple states are dealing with a school nurse shortage, with over a third of schools not employing a full-time nurse at all, and attempting new solutions for their students.

Baltimore City Public Schools has contracted with the nursing departments at three Maryland universities for $4.4 million to address their school nurse shortage. The universities will provide five pediatric nurses to schools in Baltimore.

These contracts have been accepted by Morgan State University, Coppin State University, and Johns Hopkins University to staff a total of 15 schools within the city. Additionally, the universities have discussed expanding this relationship to provide up to 50 nursing students to work clinical rotations at Baltimore schools.

This article will detail the Baltimore school nurse shortage, the collaboration between the city and its universities, the education reform plan that prompted this investment, and other possible solutions to school nurse shortages.

Baltimore School Nurse Shortage

Currently, only 50 school nurses work spread across 156 school health suites. School nurses provide a variety of services, from immunization clinics to allergy management and more. These services are even more crucial for students who rely on school nurses as their only care providers.

Baltimore’s contracts with nursing schools will hopefully pull new talent directly to pediatric nursing in schools, a relatively unpopular route compared to the 83% of registered nurses working in hospitals, ambulatory health services, and residential care facilities.

Each university will provide 5 registered nurses with the potential to bring students into practice under them. The universities consider this a “win-win situation” for their students to gain practical experience and learn from nurses working in the field.

The chair of Morgan State University’s nursing program, Maija Anderson, says that this partnership will open up new opportunities for their students, “There’s not a lot of in-patient pediatric units in the state of Maryland, and that’s because kids don’t get [are] not typically hospitalized. The places where you see pediatric patients are in the community. And so, while we rotate our students through acute care and in-patient, we really want them to have experiences in the community setting.”

2021 Education Reform Plan

In 2021, Maryland turned its ambitious “Blueprint for Maryland’s Future” into law. This blueprint for educational reform works across 24 public school districts and several state departments to ensure every child, regardless of their background, will graduate high school ready to enter the workforce or attend university.

This blueprint is comprised of five pillars: early childhood education, high-quality and diverse teachers/leaders, college and career readiness, resources dedicated to student success, and governance and accountability. Each pillar is then split into 3 to 5 objectives for implementation.

Objective 5 of Pillar 4 is entirely dedicated to enhancing student health services. This includes access to a full-time health practitioner in the school and meeting students’ behavioral health needs.

As part of this plan, “Eligible schools shall provide full-time health care coverage by at least one licensed physician, physician’s assistant, or registered nurse during school hours, including any extended learning time.” This plan requires schools to employ registered nurses over licensed nurse practitioners due to their increased educational experience.

Maryland’s Blueprint also follows the recommendations from the American Academy of Pediatrics, the Center for Disease Control and Prevention, and the National Association of School Nurses by employing at least one registered nurse for every 750 students enrolled in a given school. With these new contracts, Baltimore’s schools plan to provide coverage at a 95% fulfillment rate.

The goal of this collaboration is to eventually expand the services provided at Baltimore schools and better serve students with disabilities or complex medical needs such as tube feedings, diabetes care, chronic disease management, and mental health first aid.

Alison Perkins-Cohen states that COVID-19 was a learning moment that helped prompt this reform plan. “We’re really committed to improving the health services that our young people receive in school. Health services in schools are really important and we all learned that in the pandemic. We’re trying to figure how to do that better.”

Other Solutions

Baltimore is far from the only city grappling with a school nurse shortage, with a 2021 study finding that more than a third of schools don’t employ a full-time school nurse. This shortage leads to poorer health outcomes for students and increased absences, hurting the student’s overall education.

However, not all schools share Baltimore’s approach to fixing this shortage. This year, D.C. proposed a new cluster model to combat their school nurse shortage. This method reduces the need for RNs and LPNs by bringing in health technicians to take on daily school responsibilities.

The Bottom Line

Baltimore’s contracts can last up to 2026, leaving ample time to see the long-term effects of their multi-million-dollar effort. As school nurses become more in demand, cities will continue exploring new solutions to draw in nurses. Perhaps they will look to Baltimore’s financial investment to prioritize pediatric nurses and encourage nurses to serve students who need them the most. 

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