At an all-day work session yesterday, the Spotsylvania School Board discussed developing a schoolwide policy on "do-not-resuscitate" orders.
Such an order tells medical providers how to respond in the event of an individual's serious illness or injury. A personal doctor usually issues the directive, based upon a family's or individual's wishes.
Spotsylvania County has one student with a DNR order. Board members grappled yesterday with whether school personnel should observe the orders or give all the life-saving care possible to any student near death. Life-sustaining care could include mouth-to-mouth resuscitation or restarting a heart that stops.
Legally, only medical personnel are bound to follow a DNR directive. School nurses, as school employees, are not.
Representing different points of view were two school nurses and Don Taylor, assistant chief for Spotsylvania County's fire, rescue and emergency services.
Taylor referred to the orders as a means for someone to "pass away with dignity."
"That does not mean EMS personnel don't give care; it means we will not breathe for you or restart a heart," he said.
"We will respect DNR orders regardless of which policy you choose to follow," Taylor added.
However, if resuscitation of a person with a DNR is initiated by school personnel before an EMS team arrives on school property, Taylor said, emergency medical technicians would move the child to an ambulance, continue resuscitation and seek further direction from hospital officials.
"We'll say, 'This is what we have: a child with a valid DNR. Should we continue resuscitation or stop our efforts?'"
Registered nurse Patricia Smith, who directs the schools' health services division, said a schoolwide policy is needed.
"We are most liable when we don't have a policy about DNR," she said.
Board members asked the nurses for their opinions.
Laurie Dykes, Parkside Elementary's nurse, said she would follow school policy, whether it followed DNR orders or not. She just needed a policy, period.
Chancellor High School's nurse Maggie Mahalak took a different stance.
"If I have a doctor's order to DNR [a student] and the school issues an anti-DNR policy, I would be very troubled," Mahalak said.
The School Board members will discuss potential policy further and vote on the issue at their June 12 meeting.
In other business:
Mary Sutherland, director of testing and evaluation, and Brian Binggeli, director of K-12 curriculum and instruction, reviewed areas for improvement in school attendance and instruction.
Though math and science pass rates for the 2003-04 and 2004-05 Standards of Learning exams held steady or improved across grade levels, attendance is an area of concern, Sutherland said.
She noted that on an average day, 1,150 students are absent.
"We consider this as 6,000 missed assignments and opportunities to learn," Sutherland said.
However, "zero-tolerance policies with harsh consequences," don't seem to work, she said, noting several recent studies.
"What works is for students to feel a connection [to school]," Sutherland said. "And harsh penalties hurt our minority students the most."
The board passed a $241,875,696 budget for 2006-07 in a unanimous vote. The board had to cut $4,491,500 from the proposed budget.
They were able to preserve the third phase of teacher salary increases with this budget, choosing to cut 47.5 new personnel positions.
To reach MELISSA NIX:
Email: mnix@freelancestar.com