Trained, certified school nurses function as first responders for children and adolescents, especially in poor communities where many lack adequate health insurance. Children are going to school with serious medical issues that require hands-on, professional intervention every day.

That's why the Philadelphia School District's latest attempt to cure its perpetual budget problems by eliminating school nurses is ridiculous. The district already eliminated 47 school nurses in June, leaving just 230 to address the complex health needs of 161,000 students in both public and private schools. Now the district wants to lay off another 51 nurses, hurting more of the city's most vulnerable.

Many of us remember school nurses cleaning up scraped knees and calling stay-at-home moms to pick up sick children. Today, however, they provide vital medical care to children with complex physical and mental health issues. In a city where 26,000 children are uninsured, their work is lifesaving.

According to the National Center for Education Statistics, chronic and acute health issues among students have increased by as much as 60 percent over the past two decades. The incidence of childhood diabetes has doubled in 10 years. Children today may require complex medical treatment and medication during the school day for asthma, lead poisoning, AIDS, abuse, malnutrition, pregnancy, substance abuse, and more.

State guidelines prohibit school officials from delegating the dispensing of medication to anyone other than a school nurse. But some school administrators in Philadelphia have ordered counselors and teachers - without training - to administer medication and manage complex medical conditions.

School nurses protect the community by ensuring that all students have their vaccinations. And they screen students for vision and hearing problems, scoliosis, lice, infections, and substance abuse.

Studies show that schools with nurses have higher attendance, achievement, and graduation rates. And they handle medication and chronic illnesses more successfully.

Cutting nursing services for medically fragile children won't solve the School District's budget problems. In fact, it may worsen them by increasing legal liability costs.

Last fall, apparently to no avail, the Philadelphia Federation of Teachers voted to give the district $58 million in financial relief to prevent more disruption of services. It's time for parents, educators, and community leaders to tell the district "Enough!" If we don't, I guarantee those who think it's OK to deprive our students of nurses, bilingual staff, music teachers, and extracurricular programs will be back next month demanding more.