Healthy Prescription for Learning : Hospital-Based Teachers Bring Classroom to the Student

During the opening week of school, most teachers devote some time to memorizing names on the seating charts and reviewing forgotten facts with students.

Teacher Patti Kelly has a much different agenda. She spends considerable time just locating her students, as she can’t expect them to seek her out. And she also must remember to get school supplies sterilized and double-wrapped before she begins teaching.

Kelly is a hospital-based teacher, helping to fill the education gap when a child is too ill to go to a conventional school but well enough to learn. For the past 15 years, Kelly, 55, of Hollywood, has taught at Childrens Hospital of Los Angeles as an employee of the Berenece Carlson Home/Hospital School of the Los Angeles Unified School District.

She may teach at bedside or in a hospital classroom, depending on how ill her student is. Or she may scrub and don sterile garb if her student is in a positive pressure room, an environment designed to minimize the chance of infection.

Besides having a working knowledge of a wide array of subjects, Kelly must also know enough about each student’s ailment to recognize when symptoms are interfering with learning. And she must often help her students overcome the inconveniences of illness to get on with the business of learning. “Invariably,” Kelly noted, “the intravenous (line) is placed in the writing hand.”

Although hospital and home teaching programs for temporarily disabled students have existed for several years and are required by state law, school administrators and teachers say the public remains largely unaware of the services. “I meet parents (of hospitalized children) who say, ‘You mean there’s school here, and it’s free?’ ” said Ilia Sebastien, 30, of Long Beach, another teacher at Childrens Hospital.

The most recent law governing home and hospital instruction was signed by Gov. George Deukmejian in May and clarifies two important points, according to Delbert Royer, consultant for the Los Angeles County Office of Education in Downey. It spells out eligibility for home and hospital instruction by defining a temporary disability as “a physical, mental, or emotional disability” incurred while a pupil was enrolled in regular day classes or an alternate program.

The new law also states that a district is responsible for providing instruction for students in hospitals within that district--even if the student attends school elsewhere. The law originated partly in response to disagreements between districts over responsibility for providing instruction to children hospitalized outside their home school district.

School districts must notify parents of students’ rights to home and hospital instruction and parents, in turn, are responsible for notifying the district when their child needs the services. “Instruction must begin no later than five days after parent notification if the child can benefit then from instruction,” said Royer.

Teachers may be stationed at a single hospital if there are many students there, or may travel between hospitals or homes. Many classroom teachers also put in extra hours to teach temporarily disabled students. The Los Angeles Unified School District has 25 home teachers, 45 hospital teachers and about 100 extended home teachers who, after their regular classroom duties, tutor students at home.

Classrooms in the Hospital

The curriculum of hospital and home instruction varies. Students who are well enough may go to a hospital classroom; others receive bedside instruction. At-home instruction can only take place if a responsible adult is present. One hour of home or hospital instruction counts as a day of attendance.

Because of the limited instruction time, hospital and home teachers share a universal goal, according to Jerry Weyer, principal of the Berenece Carlson Home/Hospital School. “We try to keep the kids caught up so when they do go back to school, they won’t be too far behind.”

Parents are especially appreciative of the instruction program, said Weyer. “I haven’t gotten a bad report from a parent yet,” he said. “Most are grateful that someone is getting their kids’ minds off their medical problems.”

In Southern California, the demand for hospital and home programs has risen steadily in recent years, Weyer noted. “Last year, we served 3,000 students,” he reported. In 1984, 2,600 students received hospital and home instruction through the Los Angeles Unified School District alone; in 1983, the number was 1,800. Other districts with smaller programs also report similar increases.

Substance Abuse Problems

Partly responsible for the increase, Weyer believes, are the growing problems of drug abuse and eating disorders among teens and pre-teens. Of the 3,000 students serviced by the LAUSD program last year, Weyer estimates that 70% were temporarily disabled by emotional problems or substance abuse.

“We see some increase (in the need for home or hospital instruction) for emotional problems--which might include drug abuse,” said Carolyn Thurber, spokesperson for the Bellflower Unified School District.

An increase in the number of accident victims and cancer patients has expanded the need for home and hospital instruction in the Long Beach Unified School District, said Sandy Sanders, the district’s program specialist in nursing services for the Child Life Department.

Hospital and home teachers are a “special breed” of instructors, say school administrators who work with them. Most quickly acquire a working knowledge of medical terms and say they don’t worry about catching their students’ illnesses. Teaching of contagious students isn’t required.

Even so, working with seriously ill children can take an emotional toll, especially when a student dies.

“Sometimes I become very upset and depressed,” Patti Kelly admitted. “But the children themselves bring you out of it. Last Friday a student died but I couldn’t grieve too much because another child was waiting.”

“They’re usually motivated children,” said Mitzi Kushida, 46, of Northridge, who taught last summer at Childrens Hospital and remembers one little girl who asked for an assignment to take home while on a pass.

“The real payoff,” Sebastien said, “is that many kids don’t fall behind in their studies, and they continue in the proper grade when the sickness is over.”