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Upper-Intermediate Instant Lesson™

Nurses Save Money

Pre-Reading Activities

A: Discussion
Answer these questions in pairs.
1. Do you/did you have a nurse at your high school?
2. What do school nurses usually do?
3. How often do most students see a nurse at school?
4. Discuss this question: What would be the advantages and disadvantages of cutting the hours of nurses in high schools or replacing them with an alternative system? (For example, a phone line and easy access to a nearby medical center.)

Reading Activities

A: Completing A Summary
Use today's article to complete this summary of information.

A study in Pediatrics reports that a program employing full-time in schools has paid for itself by saving and teachers time in productivity and expenses. While many schools no longer have school nurses full-time, the researchers say the results of their study funding for full-time nurses.

School nurses save money: study

Mon May 19, NEW YORK (Reuters Health) - A Massachusetts program that put full-time registered nurses in schools more than paid for itself by averting medical costs and lost work for parents and teachers, according to a new study.

Many school districts have cut or reduced the hours of school nurses in recent years, and nationwide less than half of public schools have a full-time nurse, the authors of the report note.

They say their results warrant “careful consideration” from districts that are thinking of making such cuts in an effort to save money.

“The findings of this study suggest that from a societal perspective, the benefits of school nursing services may well exceed the cost for those services,” Li Yan Wang told Reuters Health.

She led the research at the Centers for Disease Control and Prevention’s Division of Adolescent and School Health in Atlanta, Georgia.

To assess the Massachusetts program, the researchers compared money spent putting full-time nurses in schools with money the program saved by reducing doctors’ visits and keeping parents at work and teachers in front of the classroom.  

For the 22 types of procedures school nurses performed during the study, from testing blood sugar to administering physical therapy, the researchers calculated how much it would cost to go to a clinic or hospital for the same care.

To measure lost wages for parents, they determined the time parents would have to take off work if children were dismissed early, as well as how often they would have to come to school to help kids take their prescription medications if no nurse was on site.

Finally, to assess teacher productivity, they referred to an earlier study that found teachers spent 20 fewer minutes per day dealing with student health issues once a nurse was assigned to their school.

Massachusetts records showed that during the 2009-2010 school year, about 477,000 students at 933 schools covered by the program received school health services. Paying nurses to provide those services cost $79 million.

The same care provided outside of school would have cost $20 million. In addition, with no school nurses parent productivity losses would have totaled $28.1 million and teacher productivity losses, $129.1 million.

Wang and her colleagues calculated that every dollar invested in the school nurse program saved $2.20 overall, according to the findings published Monday in JAMA Pediatrics.

Anne Sheetz said those savings are just a start. “We haven’t looked at the number of emergency room visits saved, we have not looked at the number of hospitalizations saved . . . we have yet to look at the big savings,” she told Reuters Health. “This is just a drop in the bucket.”

Sheetz, the study’s senior author, retired last year as the Director of School Health Services at the Massachusetts Department of Public Health.

When she started the position, she said, “I could not believe the amount of health care that was being done in schools and the critical nature of it.”

School nurses, Sheetz said, see 60 to 70 kids each day. They have to be ready to provide emergency care and mental health services and help manage chronic conditions like diabetes. Nurses are also charged with teaching other members of the school community about issues such as life-threatening food allergies.

“The role of the school nurse has really expanded,” said Martha Keehner Engelke, who has studied that topic at East Carolina University in Greenville, North Carolina but wasn’t involved in the new report.

“People think of it as doing vision screening and putting on Band-Aids,” Engelke told Reuters Health. “Those things are there, but that’s a really small part of what school nurses do.”

Two local doctors who have worked with the Massachusetts school health services program, pediatric allergist Dr. Michael Pistiner of Harvard Vanguard Medical Associates and endocrinologist Dr. Maryanne Quinn of Boston Children’s Hospital, agreed that it has had a considerable impact on kids’ health in both of their specialties. “Cost has been a very real barrier,” Pistiner said.

The new study, he added, “may change these conversations. It may put getting a full-time school nurse back on the priority list.”

The new study, he added, "may change these conversations. It may put getting a full-time school nurse back on the priority list."

SOURCE:  JAMA Pediatrics, online May 19, 2014.

Article © 2014 Thomson Reuters Limited. Lesson © 2014 www.english-to-go.com


B: Finding Information
Complete the gaps in this table of information using today's article.
Name Position  Why they are mentioned in today's article
____________________ Head researcher, Centers for Disease Control and Prevention's Division of Adolescent and School Health, Atlanta Discovered that a Massachusetts program with full time school nurses saved money.
Anne Sheetz Senior Author of Massachusetts study and Director of School Health Services, Massachusetts Department of Public Health __________________________________________________________
____________________ ____________________________________ Believes nurses offer a wide range of services.
____________________ ____________________________________ Believes that the school nurse program has had positive benefits  in allergy pediatrics.


C: True or False
Decide whether these statements are true (T) or false (F) according to today's article.
1. A large number of schools in the United States are trying to save money by employing nurses part-time rather than full-time.

2. A previous research project demonstrated that having a school nurse made teachers healthier.
3. Wang's team of researchers calculated the amount of money saved by avoiding hospital stays for students.
4. Through her work with the Massachusetts study Engelke showed that school nurses now do an increased number of different tasks.
5. The Massachusetts study showed that the school nurses program provided savings of more than 100%.


D: Reading Carefully
Answer this question using today's article.
How did researchers calculate the amount of money that they think is saved by funding school nurses?


E: Reading For Detail
Here is a short imaginary interview with a school nurse. Complete the gaps in the interview with information from the article.

What does a school nurse do?
My work varies greatly. Of course there are the standard things like cleaning kids up and putting _________ on their wounds when they've got a cut and doing _________  screening.  But as well this, I have to be ready to provide emergency care and make sure that children with chronic conditions like _________ are managing their conditions effectively. I also have to provide _________  services for students experiencing depression and of course be ready to recommend that they see the right health professional if they need further care. 
Has your job changed?
I'd say that my work has _________. People have a view of what the school nurse does but nowadays as well as providing medical care at school for students, I spend a lot of time educating _________ about different medical concerns like _________. A lot of students are quite unaware that they could endanger someone else's life by eating something like a peanut butter and jelly sandwich at school.  
How many students do you help?
In a normal day I would probably see around _________ students. I am checking on students for various things, doing some First Aid and if there's an accident, I have to assess whether someone needs hospital care. 


Post-Reading Activities
You may do one or more of these.

A: Giving Your Opinion
Write a short discursive essay on this topic: School nurses save schools money.

B: Language Focus
To describe your present routine or habits you can use the present simple tense and a frequency adverb.
- I always do my paperwork before school.
- I usually see around 60 kids a day.
- I never leave work before 6 pm.

Use the interview from Reading Activity E to describe the daily routine of a school nurse.
Remember to use the present simple tense and a frequency verb to describe the different actions of the nurse's routine.


C: Completing An Interview
Work in pairs. Extend the interview from Reading Activity E and Post-Reading Activity B with your own ideas. Add questions and answers and then conduct the interview. 
What does a school nurse do?
My work varies greatly. Of course there are the standard things like cleaning kids up and putting Band-Aids on their wounds when they've got a cut and doing vision screening. But as well this, I have to be ready to provide emergency care and make sure that children with chronic conditions like diabetes are managing their conditions effectively. I also have to provide mental health services for students experiencing depression and of course be ready to recommend that they see the right health professional if they need further care. 
Has your job changed?
I'd say that my work has expanded. People have a view of what the school nurse does but nowadays as well as providing medical care at school for students, I spend a lot of time educating staff and students about different medical concerns like food allergies. A lot of students are quite unaware that they could endanger someone else's life by eating something like a peanut butter and jelly sandwich at school.  
How many students do you help?
In a normal day I would probably see around 60 to 70 students. I am checking on students for various things, doing some First Aid and if there's an accident, I have to assess whether someone needs hospital care.


TEACHERS' NOTES AND ANSWER KEY

Reading Activities

A: Completing A Summary - Sample Answer
A study in JAMA Pediatrics reports that a program employing nurses full-time in schools has paid for itself by saving parents and teachers time in productivity and medical expenses. While many schools no longer have school nurses full-time, the researchers say the results of their study support funding for full-time nurses.

B: Finding Information - Answers
Name Position  Why they are mentioned in today's article
Li Yan Wang Head researcher, Centers for Disease Control and Prevention's Division of Adolescent and School Health, Atlanta Discovered that a Massachusetts program with full time school nurses saved money.
Anne Sheetz
Senior Author of Massachusetts study and Director of School Health Services, Massachusetts Department of Public Health
Believes that having a school nurse program means money is saved by avoiding hospitalizations as well as providing health care that otherwise would have to take place out of school.
Martha Keehner Engelke Academic at East Carolina University, Greenville, North Carolina Believes nurses offer a wide range of services.
Michael Pistiner Pediatric allergist of Harvard Vanguard Medical Associates Believes that the school nurse program has had positive benefits in allergy pediatrics.

C: True or False - Answers
1. T.
2. F (It didn't make the teachers healthier, it decreased the amount of time they had to spend on student health issues.
3. F (The study didn't look at this.)
4. F (Engelke was not involved with the Massachusetts study but has studied this area.)
5. T (For every dollar spent they calculated that $2.20 was saved.)

D: Reading Carefully - Sample answer
Researchers estimated the cost of care at schools compared with the cost for hospital visits. They took into account how much money was lost when parents lost wages to leave work in order to take children to appointments or supervise children taking their medications.

E: Reading For Detail - Answers
What does a school nurse do?
My work varies greatly. Of course there are the standard things like cleaning kids up and putting Band-Aids on their wounds when they've got a cut and doing vision screening. But as well this, I have to be ready to provide emergency care and make sure that children with chronic conditions like diabetes are managing their conditions effectively. I also have to provide mental health services for students experiencing depression and of course be ready to recommend that they see the right health professional if they need further care. 
Has your job changed?
I'd say that my work has expanded. People have a view of what the school nurse does but nowadays as well as providing medical care at school for students, I spend a lot of time educating staff and students about different medical concerns like food allergies. A lot of students are quite unaware that they could endanger someone else's life by eating something like a peanut butter and jelly sandwich at school.  
How many students do you help?
In a normal day I would probably see around 60 to 70 students. I am checking on students for various things, doing some First Aid and if there's an accident, I have to assess whether someone needs hospital care.

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