n### Addressing the Nurse Shortage in Bulgarian Schools: Could Paramedics Be the Solution?
Bulgaria is facing a critical shortage of nurses in schools, leaving many educational institutions without the necessary medical personnel to address student health needs. According to an analysis by the Union of Paramedics for Medical Assistance in Schools, the appointment of paramedics could be a viable solution to this crisis. The study highlights that moast school health incidents involve traumas,urgent conditions,and first aid—areas where paramedics are highly qualified.
Currently, the Ordinance on Health Office in Schools restricts schools to hiring only nurses and paramedics. However, with only 30,000 nurses in Bulgaria and the profession of “paramedic” replaced by “medical assistant,” many schools struggle to fill these roles. The Union of paramedics has proposed a change in the ordinance to allow paramedics to work in schools, reducing the shortage of medical professionals and freeing up nurses for hospital care.
“We had a lot of conversations with colleagues from school healthcare. Our goal is definitely not a replacement of nurses with paramedics, but a model of cooperation and facilitating their work, which is also available in a number of European countries,” saeid Iva Pehlivanska, president of the Union of Paramedics.
The Current State of School Healthcare
In an average school with 700-1,000 students, between 100 and 300 visits to the health office are registered annually. of these, 10% involve incidents requiring wound treatment, another 10% are cases of worsening chronic diseases, and the remaining 80% include conditions like fever, abdominal pain, and insect bites.Emergency medical teams are called in only 1% of cases, averaging two calls per school annually in sofia.
“A qualified sister is indispensable in hospital care. But at school, she ties wounds once a week, and during the rest of the time, she is filling in journals, writing inquiries, and preparing health education plans,” explained Pehlivanska. “Some of these tasks can be taken over by a paramedic.”
The Role of Paramedics in Schools
Paramedics are already working in children’s camps and accompanying sports teams, demonstrating their ability to handle urgent health situations. In schools, their role would be to provide first aid, notify parents, and call emergency services when necessary. this would allow nurses to focus on more specialized tasks, such as hospital care.
For example,some nurses report that teachers often send children to the health office for minor issues like crying or being upset. “The nurse cannot prescribe treatment even for headaches becuase she does not have that right.She is also a psychologist and a social worker,” Pehlivanska noted.
European Practices in School Healthcare
In many European countries, schools do not employ nurses due to the high cost and specialized nature of their work. Instead, they rely on flexible and integrated solutions. As an example, in Germany, schools collaborate with local health services, while in Austria, teachers are trained to handle chronic conditions like diabetes. In the UK, several schools share a nurse, and emergencies are handled by paramedics.
| Country | School Healthcare Model |
|————-|—————————–|
| Germany | Collaboration with local health services |
| Austria | Teachers trained for chronic conditions |
| UK | Shared nurses and paramedics for emergencies |
| Finland | Medical teams with nurses, social workers, and psychologists |
A Call for Change
The Union of Paramedics is urging the Ministry of Health to consider amending the ordinance to allow paramedics in schools. This change would not only address the nurse shortage but also save the state notable financial resources, as paramedic training is shorter and more specialized.
As Bulgaria looks to improve its school healthcare system, the integration of paramedics could be a practical and cost-effective solution, ensuring that students receive the care they need while allowing nurses to focus on their critical roles in hospitals.
Addressing the Nurse Shortage in Bulgarian Schools: Could paramedics Be the Solution?
Bulgaria is grappling with a severe shortage of nurses in schools, leaving many educational institutions without the necessary medical personnel to address student health needs. In this interview, Senior Editor of world-today-news.com, Julia Carter, speaks with Dr. Iva Pehlivanska, President of the Union of Paramedics and an expert in school healthcare, to explore how paramedics could play a pivotal role in filling this gap. They discuss the current challenges, European practices, and the potential benefits of integrating paramedics into school healthcare systems.
The Current State of School Healthcare in Bulgaria
Julia Carter: Dr.Pehlivanska, thank you for joining us. To start, could you describe the current state of school healthcare in Bulgaria?
Dr. Iva Pehlivanska: Thank you for having me, julia. The situation is quite critical. Many schools lack sufficient medical staff, especially nurses, due to a nationwide shortage. Currently, the Ordinance on Health Office in Schools mandates that only nurses and medical assistants can work in school health offices. Tho, with only 30,000 nurses in Bulgaria and the profession of “paramedic” being replaced by “medical assistant,” schools are struggling to fill these roles. This leaves students without adequate medical support for both minor and urgent health issues.
The Role of Paramedics in Schools
Julia Carter: How do you see paramedics fitting into the school healthcare system?
Dr. Iva Pehlivanska: Paramedics are already proving their capabilities in settings like children’s camps and sports teams,where they handle urgent health situations effectively. In schools, their role would primarily involve providing first aid, notifying parents, and calling emergency services when necessary.This would allow nurses to focus on more specialized tasks, such as hospital care, where their expertise is indispensable.
For instance, many school nurses report that they often deal with minor issues like crying or headaches, which could easily be managed by paramedics. This way, nurses can dedicate their time to more critical responsibilities, and schools can ensure that students receive timely medical attention.
European Practices in School Healthcare
Julia Carter: How do other european countries handle school healthcare, and what can Bulgaria learn from them?
Dr. Iva Pehlivanska: Many European countries have adopted flexible and integrated solutions to address school healthcare needs. in Germany, schools collaborate with local health services, while in Austria, teachers are trained to manage chronic conditions like diabetes. In the UK, multiple schools share a nurse, and emergencies are handled by paramedics. Finland, on the other hand, employs medical teams consisting of nurses, social workers, and psychologists to provide comprehensive care.
these models demonstrate that there are multiple ways to ensure student health without employing a full-time nurse in every school. By adopting similar practices, Bulgaria could alleviate its nurse shortage and provide better healthcare support to students.
A Call for Change
Julia Carter: What steps is the Union of Paramedics taking to advocate for this change?
dr. Iva Pehlivanska: We are actively urging the Ministry of Health to amend the current ordinance to allow paramedics to work in schools. This change would not only address the nurse shortage but also save the state critically important financial resources, as paramedic training is shorter and more specialized than nursing training.
Our goal is not to replace nurses but to create a collaborative model that leverages the strengths of both professions. This approach has already proven successful in other countries, and we believe it can work in Bulgaria as well.
Conclusion
Julia Carter: Thank you, Dr. Pehlivanska,for sharing your insights. It’s clear that integrating paramedics into school healthcare could be a practical and cost-effective solution for Bulgaria. By learning from European practices and fostering collaboration between nurses and paramedics, Bulgaria can ensure that its students receive the care they need while addressing the current nurse shortage.
