Joe Flaherty (Longford-Westmeath, Fianna Fail) | Oireachtas source

I thank the Ceann Comhairle for selecting this matter and I thank the Minister for Children, Equality, Disability, Integration and Youth for coming to the Chamber to deal with it.

I understand that St. Christopher's special school in Longford town has formally applied to appoint a new school nurse on an increased weekly contract of 32 hours. At the moment, the role is contracted for just 14 hours per week, meaning that the school only has access to a nurse for three hours a day from Monday to Wednesday, and for two and a half hours on Thursday and Friday. It is very evident that this is a high-risk situation and has clear health and safety implications for some of our most vulnerable school-going children, while also putting extreme and unnecessary pressure on the staff.

A total of 14 hours simply is not adequate to meet the complex medical needs of the pupils attending this school. There are currently seven classes in the school and pupils have varying degrees of complex medical needs. Indeed, the profile of the pupils attending St. Christopher's has changed significantly in recent years. More than half the pupils at the school now have complex medical and care needs. At present, there are 12 pupils attending the school with a diagnosis of epilepsy who are prescribed emergency rescue medication. Two pupils have refractory epilepsy and may continue to seize on and off throughout the day. They require close monitoring and recording of vital signs. One pupil has a PEG in situ and requires bolus feeds throughout the school day. This is a time-consuming procedure that can take up to 45 minutes per day. This particular pupil, with whom I am very familiar, is a very lovable young child who is also a wheelchair user, is non-verbal and has a profound intellectual disability. The pupil has limited head, neck and body control and must be seated in a correct, upright position and remain in same for one hour, post feed, to ensure there is no risk of aspiration. A second pupil is due to have a PEG inserted in the near future, due to difficulties administering medication. Four pupils have severe allergies and are prescribed emergency medication in the event of a reaction. A further three pupils have asthma, one of whom requires a daily inhaler in school. There is always a risk that this pupil could have an asthma attack at any time during the day. Due to swallowing difficulties, there is a serious risk of choking among some pupils. Two pupils have very specific cardiac issues. Care plans are required for all students in recognition of their complex medical needs. Most pupils also have mobility issues and visual impairment and are at constant risk of falls. There are currently seven wheelchair users attending the school and up to ten pupils are hoisted in the school three to four times per day. Manual handling assessments are required for each pupil and this task is carried out by the nurse.

I am sure the Minister will agree that a nurse is best placed to decide if emergency medication needs to be administered and is also best qualified to monitor a pupil following a seizure or an allergic reaction. Due to the number of pupils with medical needs a large volume of paperwork, including emergency care plans and risk assessments, needs to be updated on a regular basis. Due to the demands on the school nurse while on the school grounds, it is simply impossible to get all of this administrative work done in a timely and efficient manner. I would go so far as to say that all of the nurses who were in this post previously voiced concerns about the role and the stress and pressure they were under. At the moment, the school is actually without a nurse, as the most recent incumbent resigned her position and has taken up a new post. We wish her well but it is an extremely high-risk situation for the school. The school wants to fill the post as soon as possible, but more importantly, it wants to fill it at 32 hours. I am particularly worried by the delay in approving the 32-hour role. It has gone to senior management in CHO 8 for a decision and I urge the Minister to take a hands-on role and ensure that this situation is remedied. The high-risk situation must be alleviated in this school, which is extremely close to the hearts of the people of Longford.

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