Florida has a school nurse shortage. Is poor pay the reason?

Pinellas County public schools are struggling to meet their goal of at least one nurse per campus.

As of March 21, the district had 32 of 123 positions open. And with demand for nurses outstripping supply across Florida, some fear the number of vacancies will only grow as other nurses leave for more lucrative positions outside the schools.

Hoping to stem the tide, some of the Pinellas nurses who remain have launched a campaign to pressure the district to boost their salaries in the next round of contract negotiations.

“If you want to hire professionals, you have to pay professional wages,” said Jennifer Reznick, a nurse at Cypress Woods Elementary in Palm Harbor. This month, she added a second school to her assignment.

To Reznick, the need is clear.

The Florida Hospital Association projects a statewide deficit of 21,700 licensed professional nurses, or LPNs, and 37,400 registered nurses by 2035. To recruit and retain nurses in that market, she contends the district needs more competitive pay. She’s been saying so for nearly three years.

“Eventually, they’re going to find they can’t hire any nurses,” Reznick said. “I stay because, who else is staying? I’m here to fight the good fight.”

After receiving a 4.5% raise last year, Pinellas school district LPNs make an average hourly salary of $20.29. For a full-time 10-month contract, that comes out to $30,730 a year.

By comparison, the average hourly wage for LPNs in the Tampa Bay region three years ago was $23.02, according to the Florida Center For Nursing’s most recent report on the state’s nursing workforce.

Stephanie Long, the district’s chief student support officer, suggested it’s the shortfall — not the money — that’s the root cause of the problem.

She noted the number of openings in the district decreased from 16 to seven after the county commission targeted the need in 2017 by raising the local health department property tax by 2 cents per $1,000 of assessed value. It hovered around six open slots until the pandemic.

The vacancies grew to the current 32 despite the pay rate being at its highest point.

Average pay for school LPNs has steadily risen from $21,467 in 2017-18 to the current $30,730, according to district data. And Pinellas has the highest average hourly wage for its LPNs of any other school district in the region, Long added, with Hillsborough paying $18.28 and Pasco paying $17.60.

Hillsborough and Pasco have different structures for the way they assign nurses to schools. Each also faces a shortfall, though, and they are advertising to fill multiple nursing jobs.

Hillsborough had 158 open licensed professional and registered nurse positions as of Monday. To cover the work, the district had 143 nurses from a staffing agency, with the 15 remaining slots handled internally by employees who float between schools, spokesperson Tanya Arja said.

In Pinellas, Long contended a mix of market forces — particularly the shortage of nurses in all sectors — is driving the district’s low numbers. That doesn’t mean it has given up on recruiting or on looking to boost pay.

“We’re trying. We want to do whatever we possibly can,” she said, pointing out that the district gave the nurses a $1,000 bonus last year on top of raises, and it pays for their continuing education credits and license fees.

But it’s going to take a concerted effort to draw people into the profession if the schools and other health service providers are to overcome the growing nurse deficit, she contended.

In the meantime, she said, the district reviews situations daily to ensure that students get the best possible medical services. Each school has at least three staff members besides the nurse who get training on how to handle medical situations when the nurse is not present, Long explained, and district-level staff nurses are on call to provide support.

Parent Lynne Waters worries that isn’t enough.

Her son, David, is a Type 1 diabetic who has depended on school nurses for his insulin shots daily, until recently getting a pump that still requires monitoring.

“Up until this year, where there aren’t enough nurses to go around, there’s been a nurse in the school every day,” said Waters, whose son attends Palm Harbor Middle School.

Now, she said, her son often turns to a “fantastic” school secretary for help with medical issues. “But that’s not her job.”

If needed, Waters or her husband leaves work to go to the school to handle problems that arise — including one just days ago.

“Unless your kid is sick, maybe you don’t think about it,” Waters said, stressing the importance of having nurses available full time at all schools.

Nurse Brandi Hartung started splitting her time between two Pinellas schools this academic year. When she took the job in 2017, she said, she considered it the perfect fit — she could do the work she loved at one elementary school, on a schedule that matched her children’s days.

These days, Hartung said, the demands on her time have grown along with the number of students she serves — nearly 1,600 between the two campuses. In addition to handling the known needs of children, she said, she deals with splinters in fingers, injuries from home, parents who request help with things like their children’s eyedrops and even staff members with health issues.

That’s on top of emergencies. And, she pointed out, unlike hospitals, schools don’t have multiple medical professionals to consult with one another and make decisions. Leaving school without taking home paperwork has become nearly impossible, she said.

“Most people think we sit here, eat bonbons and give ice packs and Band-Aids out,” Hartung said. “I don’t think they realize all we do.”

Last year, the top five services the nurses provided were administration of medicines, first aid, health records review, complex procedures and parent and staff consultation.

She called the pay an insult, contending it’s a key factor in the departure of other nurses to higher-paying positions. Last year, she said, her take-home wage was just over $21,000. She had to take her adult children off her health insurance plan because of the cost.

Her second job, as a part-time nurse for the Department of Health, pays better. Her daughter earns more as a hairdresser, she added. She expressed gratitude that her husband makes enough to allow her to keep the job she wants to do.

“They need to bring us up to pay,” Hartung said. “It would make us feel like we’re appreciated for what we do.”

Nelly Henjes, president of the district’s support employees bargaining unit, said she’s presented the idea to district representatives several times.

“I think this year we’re going to have a bigger fight. We’re pushing on it,” Henjes said. “They’re playing with the health of children.”

School board chairperson Laura Hine said she’s aware of the situation. She said school and county officials have met to discuss the importance of having nurses in the schools, particularly given the county’s added tax rate for that purpose.

“We absolutely have to do better,” Hine said, adding that she would bring up the issue during budget talks. “We have to start looking at all the priorities.”