BEVERLY — A wall in the nurse's office at North Beverly Elementary School is covered with dozens of packets of medical information, emergency shots and doses.
Each packet is for a different child, and they contain doctors' phone numbers, allergy information, EpiPens, pills and dosage instructions. It's how head nurse June Kazes keeps track of the growing number of children with specific medical needs.
"You really don't know how much the role has been expanded over the last 10, 15 years," Kazes said of her job. "There seem to be more students with complex problems than there used to be."
So, the Beverly School District is hiring a nurse supervisor — someone who can establish policies across the board, fill in during professional development days or simply drive from Cove to Hannah to give a second opinion about a rash.
"The nurses are no longer just cleaning up skinned knees," School Committee President Annemarie Cesa said. "We have children with horrific, life-threatening allergies. We have children with more than one medication that has to be given at specific times."
Statewide, the number of school nurses has grown significantly in the past 20 years, said Jennifer Manley, a spokeswoman for the Massachusetts Department of Public Health. The number jumped from 300 in 1990 to 2,100 today, and the position also comes with more state regulations and mandates.
As neighborhood elementary schools have closed and merged, the remaining schools have gotten bigger. Enrollment in Beverly elementary schools is between 400 and 500 students. The district has also created more in-house special education programs, with students who have a wide range of medical problems.
"It's you, and you have to rely on yourself," Kazes said. "You have to make the quick decisions. You don't have the advantage of conferring with other health care professionals like you would in a hospital."
She said she's looking forward to having the nurse supervisor position in place.
"It would really give us some added support, regular support we can count on," she said. "It would be a great asset."
The nurse supervisor is in addition to having a nurse at every school. The district hopes to hire someone by the fall for about $80,000 a year but is having trouble finding the right candidate, Superintendent James Hayes said. The position will be based at Cove Elementary School.
The district is also hiring for a nurse's aid position at Cove for $33,000, because longtime nurse Elissa Simard is retiring. Together, the positions will provide adequate nursing coverage at the school, Hayes said.
After savings from the retirement, it will cost the district an additional $52,000 for the new model, Hayes said.
"We're not expecting a significant increase in cost," Cesa said.
Instead, it's more a safety issue. It's becoming essential for school nurses to have that added support and supervision, she said.
In the last decade, they've taken on more responsibilities, like managing kids who are tube-fed, calculating and administering insulin for diabetics, monitoring serious food allergies, and distributing doses of medication to students who are depressed and anxious or have Asperger's syndrome or autism.
They're the damage control during disease outbreaks like swine flu. They become social workers if they suspect a child has a problem at home. And many are turning into teachers as they help develop curriculum and give lessons on hand washing, nutrition or even fifth-grade puberty, Kazes said.
They also maintain a high level of personal attention, said Brian Turgeon, whose fifth-grade son, also Brian, visits Hannah school nurse Leann Moody's office at least three times a day to receive insulin shots for diabetes.
A couple of weeks ago, Moody noticed he was acting like his blood sugar was low.
"She had to get his attention and got him to drink some juice," Turgeon said. But she also had the emergency shot ready in case he went into a diabetic coma.
He said he's not worried when he drops his son off at school.
"She keeps me informed about everything," Turgeon said. "I talk to her every day."
Staff writer Cate Lecuyer can be reached at clecuyer@salem news.com.
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