Thanks to everyone who responded to the recent Pay Equity Survey. The preliminary data from the survey, combined with data from the Massachusetts Teachers Association (MTA), indicate that the districts listed below currently have pay equity (defined as nurses employed full-time by a school district having the same salary schedule as the teachers and other professional support personnel in that specific district).

Please review this list. If you think that any of the data is incorrect or if you have additional districts to add, please contact Barbara Connolly at connolly@msno.org. We received some conflicting data. Pay equity committee members may be contacting you to verify information. The data collection and analysis continue and complete results will be available later in the year.

Dear Colleagues,

I wrote 'Nurses in the Educational Setting' two years ago when nurses in my school system were in negotiations. We kept hearing "Nurses are not educators" ( This is no longer an issue because we are included in MGLChapter 71, Section 41.), "Nurses don't correct papers", "Nurses don't have to keep records on their class", etc. 'Nurses in the Educational Setting' shows what nurses and educators have in common. I want to share this with those of you who are going into negotiations! Just one more piece of information! Please adapt them for your use.
Kathy Hassey

NURSES IN THE EDUCATIONAL SETTING

1.  TEACHERS are DOE Licensed.
NURSES are BORN (Board of Registration in Nursing) Licensed, DOE Licensed, CPR/AED & First Aid certified.

2.  TEACHERS use "Assessment" to evaluate how a student is progressing. (Correcting papers, standardized tests, etc.)
NURSES use "Assessment" to evaluate a student's health. (Assessing for fever, blood pressure, blood sugar, vision, hearing, emergencies, injury, mental health, medication reaction***, etc.)

3.  TEACHERS communicate with parents regarding students.
NURSES communicate with parents, teachers, doctors, agencies and specialists.

4.   TEACHERS keep records on the students in their classes.
NURSES keep records on all students including all State Mandated Screenings. (200 - 1100 students per building... plus staff)

5.   TEACHERS write lesson plans for students.
NURSES write Individualized Health Care Plans (IHP) for students with medical/health conditions and monthly reports for Department of Public Health.

6.   TEACHERS attend TEAM, 504 and pupil study meetings regarding students progress.
NURSES attend TEAM, 504 and pupil study meetings to assist teachers with medical knowledge regarding their students.

7.   TEACHERS need PDPs for continuing education.
NURSES need PDPs (Educator) as well as CEUs (Nursing Licensure) for continuing education.

8    TEACHERS use every possible "teachable moment" to educate students.
Every interaction between the NURSE and student/staff member includes "teaching/education" regarding health, illness, wellness, firstaid, etc.

*** NURSES ARE LICENSED TO ADMINISTER MEDICATIONS

Dottie says she composed this one Friday at the end of a typically busy week looking over a weekly staff memo including the essay "What Teachers Make". With Dottie's permission, we now share her perspective. This essay can be another tool in negotiations.

"What School Nurses Make" Dot Warner, Editor, NCSN Newsletter NECSN Newsletter Spring 2007, p. 6

“The dinner guests were sitting around the table discussing life…” So the story goes, in a warm-hearted piece entitled “What Teachers Make” [author unknown], frequently circulated among educators. An arrogant CEO puts a teacher on the spot with the condescending question “what do you make?.” implying, of course, that her low salary signifies a lack of status. The teacher responds with a litany of what she makes: “I make kids wonder…I make them question…I make them read…” And finally, she zings him with the clincher, “I make a difference. What do you make?”

School nurses constantly grapple with this issue, ironically striving to be paid as well as our teaching colleagues. I wish, just once, certain people would ask me this thought-provoking little question: “You’re a school nurse—be honest. What do you make?”

You want to know what I make? I make kids with asthma understand what’s actually going on in their lungs. I make them demonstrate how to use their inhaled medications effectively. I make them measure their own peak expiratory flow and interpret the numbers to determine how well their asthma is controlled, and what they should do about it. It’s hard to learn when there’s not enough oxygen getting to your brain.

I make kids with diabetes visualize what’s happening to their metabolism at the cellular level. I make them count carbohydrate grams by reading nutrient labels, and calculate their own insulin dose. I make them recognize, and verbalize, the symptoms and treatment of hypo- and hyperglycemia. It’s hard to learn when your body shuts down for lack of glucose.

I make kids with twisted ankles and strained muscles understand how to cope with minor injuries and recognize serious ones. I make them repeat back to me the acronym RICE, standard self-care for most sports-related aches and pains. I make them feel good about their efforts to stay fit and healthy. It’s hard to learn when you are in pain.

I make kids who are truly ill with infections feel better by soothing their sore throats and reducing their fevers. I also make kids aware, often for the very first time, that sometimes it’s really OK to stay at school when you don’t feel perfect. It’s hard to learn when you’re really sick, but also when you are just pouting.

I make kids hurting from grief and fear believe there are adults at school who care about them. It’s hard to learn when you are scared. I make mental health my business, and I intervene with mental health issues more often than you would ever believe. I make a link between school and psychiatrists, counselors, and physicians. I make hard choices as I weigh the needs of the individual against the safety of my school community. It’s hard to learn when your thoughts are disordered.

I make kids feel informed and confident in dealing with their changing bodies. I make my office a safe haven for girls with menstrual issues, complete with not just pads and unsoiled clothing, but straight answers to their questions. I make eye contact as I address kids’ underlying fears related to sexual activities. It’s hard to learn when you’re devastated with worry and embarrassment.

I make middle schoolers feel competent and comfortable in handling broken braces on their teeth, torn contact lenses in their eyes, and infected jewelry in their body piercings. It’s hard to learn when your teeth throb, your eyes burn, or your belly button is draining pus.

I make sure my students can see and hear, by routinely evaluating their vision and hearing. It’s really hard to learn if you can’t see the board or hear the teacher.

I make referrals, I make phone calls, I make connections to people and agencies that provide healthcare, glasses, and dental care to families in need. It’s hard to be a good parent when you feel hopeless.

I make assessments every time a child walks through my door. Simple, or serious? I make the call—is this headache an emerging sign of deadly meningitis, miserable chronic migraines, or simply algebra-avoidance? Chronic disease, or adolescent drama? I make dozens of decisions every day, and I make them alone, without another healthcare professional to back me up. I make them knowing that no one in my school really understands the complexity of my nursing assessment, the hundred observations and clinical judgments that are taking place each time I care for an ill or injured child.

I make teachers and administrators feel at ease, because I’m here to deal with the daily blood and guts, as well as the occasional life-threatening emergency. I make the effort to educate educators about our students’ health problems and medications, and what they can—and can’t—do to help.

I make contact with counselors throughout the school day. I make professional collaboration a reality, not just wishful thinking, because we can do more for kids together than either of us can accomplish alone.

I make phone calls to more parents in a single day than many teachers make in a week. I make an impression of this district with every call. I make a few of them unhappy, because they really don’t want to be bothered. But most of the time, I make things right, because most parents are grateful for the professional care I give.

I make do with limited supplies, crowded space, and a lack of privacy. I make the best of a computer system that does not work right for healthcare. I make peace with compromising my professional standards regarding the confidentiality and legality of my documentation. I make the best of things, because I really want to be here.

I make time for professional development and continuing education, even though the district doesn’t recognize this, or adequately reimburse me for my time and expenses.

I make my school, my students, and my colleagues safer, healthier, and more comfortable than they would be without a school nurse. I make it easier for teachers to teach, counselors to counsel, and administrators to lead our school. I make it possible for kids to learn.

And for this, in public education, a world run by educators who continually bemoan the lack of respect their low salaries reflect in the eyes of our society, I am paid far less than what my nursing skills, experience, and education are worth in any other practice setting. My worth to this district, with my BSN and 20+ years of nursing experience, is 68% of the salary of an entry-level teacher, fresh out of college. What I’m paid, is embarrassing to admit.

But, you want to know what I make? I make a conscious decision to practice nursing in a school setting. I know I make a difference, too.

A book published in 1989 entitled Just a Nurse stated that "the public wants a nurse to be a warm, caring human being. The intellectual acumen needed to practice professional nursing is rarely understood." This statement applies to school superintendents and school committees who rarely seem to recognize the role of school nurses and certainly do not seem to understand the "intellectual acumen" required of these nurses.

The practice of professional nursing by school nurses occurs within the complex and unpredictable setting of the educational institution, not in a medical facility. A school nurse usually functions as a sole practitioner in her school. The Comprehensive School Health Manual, published by the Massachusetts Department of Public Health in 1995, reminds us that the comprehensive and expanding public health nature of school nursing practice demands an educational and skill level that enables the school nurse to meet the current health needs of the students and staff. Why then, do the majority of school districts in the Commonwealth continue to devalue the nursing profession by refusing to pay nurses on the same salary scale as teachers and other non-classroom based educational support staff?

It is the Massachusetts School Nurse Organization's contention that the practice of salary inequities ultimately impacts the quality of health care delivered to students, since it is difficult to attract and retain school nurses with expertise in critical thinking, decision making, program management, health education and counseling, program planning, and community outreach, when competitive salaries are not offered.

It appears that school districts which deny school nurses pay equity are violating the Education Reform Act's statement of nondiscrimination. A summary of the issues in the lawsuit are as follows:

1. under the Education Reform Act school nurses are required to be certified like all other educational professionals and to have a bachelor's degree as a prerequisite to certification...
   
2. school nurses are professional educators, as are all other non-classroom based educational support staff...
   
3. under Education Reform school nurses are the legal equal of other certified educators...
   
4. in spite of having to meet the same requirements as classroom teachers pay equity and professional standing are denied the school nurses...
   
5. salary schedules for school nurses are much lower than all other educational professionals...

Also, the Education Reform Act states (Section 99 of Statutes of 1993, Chapter 71):

"All programs and actions undertaken under the provisions of this act shall be conducted in a manner reflecting and encouraging a policy of nondiscrimination and equal opportunity for members of minority groups and women. All officials...of any school department...shall take affirmative steps to ensure equality of opportunity in the internal affairs of such departments...Each school district department...shall adopt measures to ensure equal opportunity in the areas of hiring, promotion,...rates of compensation and in-service training programs..."



The MSNO Board of Directors has voted to support this legal action to achieve pay equity for school nurses. More information will be forthcoming to every school nurse in the State regarding how they can lend their encouragement and financial support to this undertaking.

The Boston Globe: "School Nurses Seek Pay Parity" by Anne Barnard
Thursday, August 3, 2000
Metro/Region Section B Page 4

The Boston Globe: "School Nurses Demand More Pay" by Alexander Reid
Sunday, October 8, 2000
Metro/Region South Edition Page 1

You may read these articles by visiting The Boston Globe. Click on archives section and type in search category the word school nurse.