Iowa City schools are behind national standards for school nurses.

Though those standards call for each school to have a nurse, Iowa City school nurses are each responsible for four schools.

"The job of school nurses is to keep kids in school, healthy and ready to learn," said Linda Davis-Alldritt, the president of the National Association of School Nurses.

Her group recommends one nurse for every 750 healthy students. Iowa ranks 22nd nationwide in school-nurse numbers, with a ratio of one nurse for 819 students.

Iowa City is even further behind the guidelines.

Even though the School District has recently added a few positions, it has just one nurse for every 2,000 students.

School nurses will see an average of 10 to 35 students in the nurse’s office during a typical day at Iowa City schools. The district has six full-time nurses on staff — for the 25 district schools — who are assigned four schools to travel to each day.

Iowa City school nurse Jen BarbouRoske said traveling to four schools — City High, Hoover Elementary, Mann Elementary, and Twain Elementary — can be stressful.

"In order to do quality health care, you need to spend time with individual kids and families," she said. "In order for kids to be at their best learning, they need to be healthy."

And even though officials are aware of the unfavorable ratio, the problem might not be solved any time soon.

Susie Poulton — the School District director of health and student services — said the district has added three positions in the last six years. However, she acknowledged the difference in the student-to-school nurse ratio.

"We’re just not there, and we may not get there," she said. "We all work together to meet the needs of our children and provide support so they can be successful in school."

BarbouRoske said she sometimes lacks the time to attend all her assigned schools in one day, adding she would prefer only having one school to worry about each day.

"It would be nice to be able to set down roots in a school," she said.

Medication errors can arise from the lack of nurses, Davis-Alldritt said.

"The more students there are, the less time there is to focus on each and every one," she said. "The higher the number of students to be cared for, the risk [of error] increases."

But Poulton said she thinks medication errors are not a problem.

"We have very few errors, and [nurses] are always checking in with staff to follow with protocol," she said.

BarbouRoske said she agreed.

"We do a very good job with medication," she said. "We have protocols in place and forms made available to families."