Its the vicious circle of rural healthcare: Children rely on school nurses as their primary source of treatment, but school nurses are in critically short supply.

Preston County has about 15.

Monongalia County, 10.

Pocahontas County, just one.

For children in West Virginia who suffer from chronic diseasesincluding the 31,000 who have asthmaits a problem.

But WVU might have the solution. Nursing professor Heidi Putman-Casdorph, who conducts asthma research and so thinks about this problem constantly, was sitting in front of her computer, teaching a distance-learning class to her graduate students, when she had her epiphany:Why couldnt we use something like this with school nurses?

She hurried down the hall to Susan Pintos office. Pinto, a clinical instructor at the nursing school , had spent nearly 10 years working in Monongalia County high schools, so she would know whether Putman-Casdorphs plan to conduct continuing education classes online was wholly feasible or completely impractical.

Pintos reaction: Brilliant.

One of the biggest frustrations with my job (as a school nurse) was time,Pinto said.If I planned an educational activity, invariably Id get called away. Continuing education was non-existent. If I would have had the opportunity to hook up with a program like the one Heidis creating, it would have been wonderful.

The National Association of School Nurses thought so, too. Most of their members are assigned to multiple school districts and spend their days driving between them, offering the best treatment they can in limited amounts of time. Their ability to keep up with the latest recommendations for carewhat the nursing world calls evidence-based guidelinesis constantly compromised by their increasing responsibilities and shrinking numbers.

So the idea of logging onto a computer and being able to access the information and education they need when they need it was a concept that, frankly, Putman-Casdorph was surprised no one had thought of sooner.

If I hadnt, someone else would have,she said.Its a worthy topic and its important in this state. Were hoping to make a national impact eventually, but were starting it here at WVU , and that is very good.

The NASN rewarded her ingenuity with a $2,500 research grant, which she and Pinto, who she named her co-investigator, will use to create an online continuing education pilot program for the 25 school nurses in Monongalia and Preston counties.

For now, the program will focus on the evidence-based guidelines for treating asthma. Putman-Casdorph knows them well. She was hampered by the disease as a child and treated kids who suffered from it as a nurse. Today, research and medication have evolved enough that no one should have to deal with the agony of asthma, if they know what to do.

If the child is monitored, if the disease is controlled, if the treatment regimens are followed, its a very treatable disease,Putman-Casdorph said.They dont have to suffer if they get the proper care.

It makes me sad when people dont know what to do and dont follow the evidence-based guidelines that are out there. Its inexcusable. For children in some areas of the state, their only access to health care is the school nurse, so its critical to give nurses the help they need.

If the program works like Putman-Casdorph and Pinto envision it will, theyll present their findings at the NASN 2010 Annual Conference in Chicago, use the platform to help train nurses in other chronic disease guidelines and apply for a larger grant$272,500 largerthrough the National Institute of Nursing Research.

And, most importantly, children who suffer from asthma in Monongalia and Preston counties wont have to suffer so much anymore. Putman-Casdorph will have effected change, which is the entire reason she became a nurse and took a job at a land-grant university.

I feel like Im needed at WVU , not just for research, but because I can teach people to be nurses,Putman-Casdorph said.I can teach them how to help other peopleI can have a tangible impact.