The Relentless School Nurse: There Are 7 School Nurses for 8300 Students at 17 Locations in Moses Lake, WA

In this poignant blog post, Liz Pray, a dedicated school nurse in Washington State, reflects on a recent emergency involving a kindergarten student with epilepsy that underscores the critical importance of adequate nursing staff in schools. The “math is not mathing” in Moses Lake, Washington, where 7 school nurses care for 8300 students in 17 locations.

Liz raises essential questions about preparedness and resource allocation, emphasizing the need for advocacy in an underfunded environment. Her unwavering commitment to student safety shines through as she grapples with the implications of these staffing shortages on health outcomes. As the district seeks solutions to its financial woes, Liz’s reflections are a powerful reminder of these decisions’ real-world impact on student health and safety, renewing her resolve to amplify her voice for change.

Before her message, you’ll find a link to a newscast featuring insights from both Liz and the student’s mother. 

Moses Lake School District facing school nurse shortage

As a school nurse, whenever there is an incident involving 911, you replay it in your mind, wondering what could have been different. What could I have done to change the outcome? What could I have done to make sure the staff was better prepared?

On Tuesday of last week, there was an incident on the playground involving a kindergarten student with a known diagnosis of Epilepsy. The staff responded to the incident, called 911, and ensured that the student was safe. Where was the School Nurse? More than 12 minutes away at one of the other three buildings assigned to the caseload. The only thing that I could do was support the staff by phone and call parents from a number they did not recognize. This seizure was different, this event was described by staff, and the only thing that ran through my head was this is new. However, the staff did not know this. All the staff saw was this student was having her first seizure at school, and they needed help. What was described mimicked cluster seizures, and depending on physician orders, rescue medication could be administered. 

The Moses Lake School District has essentially come up against the perfect storm between a double levy failure and an approximately $11 million accounting error, both happening in the spring of 2024. The result of this has led to multiple staff non-renewals, schedule changes, and major cuts to spending overnight. The nursing department was cut by almost 40 percent when the district did not renew contracts for 4 out of the 11 School Nurses. 

In 21-22, the Washington State Legislature passed HB 1664, changing an antiquated Prototypical School Model and increasing the funding for School Nurses from 1:4600 students to approximately 1:673 students. After the September count and apportionment, the Moses Lake School District should be funded for almost 12 School Nurses. Yet, there are still 7 employed to care for the almost 8300 students in 17 locations. The reason given by the district, the positions may be funded, but they are not fully funded, and with the current financial state of the district, the positions cannot be filled at this time. 

The incident still plays in my mind. What could have been done to make sure that staff was better prepared? Should the seizure action plan have been questioned prior to the student starting school? Would you have questioned a physician and parent’s decision not to have rescue medications at school for a student who had been seizure-free for almost 5 months? Or is the longest seizure less than 3 minutes? How do you fight for the other 4 School Nurses who were not renewed from last year, plus the additional nurse we should have this year? What can I do to ensure that the other 1000+ students on my caseload are safe? 

When do you feel that the fight in you is gone? The only answer that I do have is to the very last question, the fight will never be gone if there are students that need a School Nurse. The will to fight is renewed after an incident as you replay over in your mind, wondering how will I best amplify my voice to make a change? 

Liz Pray MSN-Ed, RN, NCSN, SANE                                                                                School Nurse, Washington State