Payzant Seeks Test on Use of Less-Specialized Nurses

San Diego schools Supt. Thomas Payzant on Tuesday proposed a six-month test for next school year to determine whether 50% of the district’s registered nurses should be replaced with lesser-trained nurses and aides to save money.

The test would reduce the number of registered nurses at a single high school and its surrounding feeder schools. Payzant said that the test would be accomplished by replacing retiring registered nurses.

A study by the accounting firm of Deloitte, Haskins and Sells recommended eliminating half of the 112 registered nurses in the district, and replacing them with licensed vocational nurses and aides. The move would save the district $900,000, according to the study.

But medical officials and nurses objected to the proposal, saying that the health of schoolchildren would suffer. Payzant said that because of the protests he is recommending that the board proceed cautiously, with a test case to determine the level of health care needed in the city’s public schools.

Payzant’s proposal for the pilot study, to be conducted by school nurses and health officials, will be considered by the district board next Tuesday. The board took no action Tuesday.

Opponents of the cutback expressed skepticism at the pilot study.

“The pilot study is a good way to go about it,” said Joe Tafoya, principal of Wilson Middle School. “But I would not like to be part of the pilot study. My kids need a professional nurse. My kids deserve a professional nurse.”

Dr. Philip R. Nader, professor of pediatrics at the UC San Diego Medical School and a district consultant, warned the board to proceed “very cautiously.”

“I believe that a decreasing level of quality would result,” Nader said.

Edward Fletcher, district director of health services, however, said after the meeting, “There may be varying viewpoints. But the study is worth a try if it can help us to provide services better or more reasonably. This particular study will not work everywhere. We will test it someplace and then test it again.”

He said he would choose a combination of schools for the pilot study based on the attrition of nurses and on the willingness of the schools to participate.