Westbrook’s new District Nurse Sudeshna Bandyopadhyay in her office, which is located in the Sacarappa School. Courtesy photo

WESTBROOK — Maine’s low unemployment rate — 2.9% as of September — may be good news for workers, but it’s a problem for employers that need skilled workers. That includes local school districts who need nurses.

School nurses are on the front lines for students with chronic health issues that can require daily, in-school attention, according to Westbrook’s new district nurse, Sudeshna Bandyopadhyay.

Yet, school nurses are already stretched thin. The average school nurse in Maine is responsible for 602 students, according to the National Education Association.

The American Academy of Pediatrics recommends at least one full-time registered nurse in each school building.

Some schools use temp agencies to fill in when regular school nurses are absent, while others have a pool of substitute nurses they call on. But even those solutions seem to be lacking lately, as so-called “gig jobs” are not as popular during a good economy, according to Westbrook Superintendent Peter Lancia.

“We’ve had to use a temp agency for nursing substitutes (at least weekly) and even then they don’t have enough people sometimes. We need our schools covered by nurses every day and covering that isn’t always easy,” Lancia said.

Portland Public Schools has a pool of about a dozen substitute nurses to call upon.

It sounds like a lot — but most of our subs work other jobs and have limited availability to sub for us,” said Tina Veilleux, school nurse coordinator for Portland.

“If there is not a sub available, there are some options, Veilleux said. “Most school office staff are trained to give medications and handle minor injuries and illness. They can call a nearby nurse for consultation. Nurses can also cross-cover when needed. This means a nurse may go to a couple of schools in a day, to limit the time a school is without a nurse.”

Traveling between schools

As Westbrook’s district nurse, Bandyopadhyay oversees the district’s staffing of nurses and other administrative duties while also acting as a regular school nurse herself. She was hired about a month ago from a temp agency. She had been a frequent substitute nurse in Westbrook schools.

Substitute nurses are able to go school to school, but that is not an “ideal situation” and can make it hard for nurses to treat a student and get them back into class quickly, Bandyopadhyay said.

“You want to be able to work in the same building each time, with the same kids, so you get to learn them. You learn their specific needs, allergens, health issues,” Bandyopadhyay said.

As a district nurse who works out of Saccarappa School, Bandyopadhyay travels between Westbrook campuses frequently, and that means she has to rely on different substitute nurses to cover Saccarappa.

She also may spend time being a substitute nurse herself at another school, dealing first hand with the difficulty of inconsistent nurse subs.

“There is always a book to consult with each student’s needs, but that takes time and sometimes you have numerous kids in or serious things that need to be addressed right away. Each building really should have its own dedicated nurse and subs,” Bandyopadhyay said.

“Our district nurse hasn’t been on long, but she knows we will have to plan for when we cannot find substitute nurses. It’s been hard to fill that role,” said Saccarappa Principal Brian Mazjanis.

Even schools with less of a need for substitute nurses have difficulty replacing staff when needed.

“(The) district is fortunate to have a small pool of long-time, dedicated nurses willing to substitute,” Yarmouth Superintendent Andrew Dolloff said. ” But it’s definitely a challenge to find adequate coverage for school nurses.”

Playing into that difficulty is that school nurses are paid less than nurses at hospitals or private clinics,  Bandyopadhyay said.

Nurse substitute make between $95 and $195 a day, higher than the typical substitute teaching position but less than half what nurses in a hospital may make per day.

“A lot of nurses at the temp agency’s goal was to work their way into an intensive care unit or hospital, they make far more money, I have friends making up to $90,000 per year doing that. I am not making that, though I have more predictable hours and a healthier work life,” Bandyopadhyay said.

Westbrook nurse substitutes make between $95 and $195 a day, with subs covering longer-term assignments making more per day. Portland schools pay $125 per day;  Gorham, about $195, Yarmouth, between $92 and $112; and South Portland, $30 an hour or $195 for a 6.5 hour day.

RSU 5, which includes Freeport, Pownal and Durham, pays their nursing subs $140 a day, Superintendent Becky Foley said. In the Lake Region School District, subs who are registered nurses make $160 a day and licensed practical nurses make $140.

In Portland and Westbrook, the substitute nurse budget is allocated into their substitute teacher budget, while Brunswick Schools allocate roughly $8,500 specifically for substitute nurses. In the Windham and Raymond district, $415,000 is allocated to substitutes a year in general, with no specific allocation for nurses.

‘Our literal crisis’

The lack of substitute nurses is indicative of an overall nursing shortage, according to Brenda Petersen, associate dean for the University of Southern Maine’s School of Nursing.

“It is really all related to our literal crisis looming with not enough nurses to meet the needs across the country and in the state,” Petersen said.

New nurses often take hospital jobs without ever considering a career path in the school system, meaning that schools receive the brunt of the shortage.

Bandyopadhyay agreed.

“For me, being in schools was what I really wanted to do, but that is not as common,” she said.

At the University of Southern Maine, the nursing school hopes to build partnerships in the coming years with the schools to address their needs for a workforce.

Having those opportunities would allow us to introduce working within schools to our students, but also, I think having our students doing training at schools would help schools meet their needs with not enough nurses,” Petersen said.

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