The Sacramento City Unified School District recently sent a newsletter to families about the novel coronavirus that is spreading around the world — it’s already in Sacramento — to explain the measures the school system is taking to protect students, teachers and others. The first point of action was this: “School Nurses are advising and providing classroom lessons on handwashing and proper coughing/sneezing etiquette.”

What it doesn’t say: Not every school in the district has a dedicated nurse. So nurses travel among numerous schools to take care of children — a situation hardly unique to the school system in California’s state capital. There is a school nursing shortage throughout the country at a time when nurses are arguably more important than at any time in the recent past.

According to the National Association of School Nurses, 25 percent of schools do not employ a nurse, while 35 percent employ part-time nurses. That leaves school personnel with little or no medical training to handle sometimes serious medical situations. But even schools that have full-time nurses often share them with other campuses because there simply are not enough for each school building in districts throughout the country.

“It is really dangerous,” said Nho Le-Hinds, a licensed school nurse in Sacramento who travels between multiple campuses to treat children. Nho, who has been a nurse for 25 years, said she has five traditional public schools in her portfolio and 15 private schools, where she tends to students who have been placed at those schools by the district.

“We have to train nonmedical people to do all kinds of things that are medical,” Nho said. “When we break our legs, we don’t go to our accountant to get it fixed. At the school site, we ask kids with serious conditions to go to someone who has never been trained in anything medical.”

Medical authorities recommend schools have one full-time licensed nurse for every 750 students. According to Kidsdata.org, California has one nurse for every 2,500 students, among the nation’s highest ratios.

But in the Sacramento school system, there is just one nurse for every 3,600 students, according to Victoria Flores, director of student support and health services in the district. Last month, Sacramento’s Board of Education voted to cut a number of items, including nurses — which it also did in 2019.

Flores said each nurse has a caseload of about six schools. The school system is employing nursing interns to help educate students on proper handwashing and on etiquette for sneezing and coughing.

Nho said combating misinformation about coronavirus at the schools where she treats students is a formidable task. Some people tell her they are afraid of the virus and the disease it causes, covid-19, because they’ve heard it’s as deadly as ebola, which is caused by a highly lethal virus. That is not at all true, health officials say; the latest estimate of the global death rate for covid-19 is 3.4 percent, according to the World Health Organization.

One office manager asked if she should purchase masks for everyone in the school.

“We have many people triaging, dealing with kids who have different symptoms,” she said. “On site, though, it’s a lay person, a clerk or an office manager. There are not enough nurses in the district.”