School nurses are on the frontlines of the pandemic

When most school buildings shuttered in April, the National Association of School Nurses (NASN) sent out a survey to its members. The nonprofit specialty nursing organization wanted to know what school nurses were doing during the pandemic.

The findings showed that school nurses were still working with students and families, even if they couldn’t see them in person. Of the nearly 5,000 nurses who responded, over 70 percent said they were still helping to manage the health plans of students with chronic health conditions. Over 40 percent were holding virtual office hours, and nearly one-third were assisting with remote meal deliveries.

“School nurses have a role whether school is meeting virtually or in person,” says Donna Mazyck, executive director of the NASN. They’re working on their school’s pandemic plans, educating students and staff on COVID-19, and screening the sick — all while continuing their normal task of helping kids with chronic illnesses, checking in on the emotional health of their students, and making sure immunizations are up to date.

Mazyck spoke to The Verge about the role of a school nurse during a pandemic and why they’re more important than ever.

This interview has been lightly edited for clarity.

Some schools are planning for in-person instruction this year or at least part-time in-person instruction. How do school nurses help plan for that?

It’s working with school facilities, leaders, and experts and making sure that the physical space is the way it needs to be. They need to be in collaboration with the local health department to make sure that there is a plan for the school and for what happens when there are students or staff who have symptoms of COVID-19. Nurses make sure there are isolation rooms, and that there’s enough ventilation in the buildings. If there are cases of COVID-19, they work with the health department to find close contacts of those cases.

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The idea is to make sure that there’s a pandemic plan for the school and that there are clear steps to take when there’s a case. It’s also making sure there are clear things that would trigger the school to close.

That takes resources and funding. The NASN believes that federal investments are critical to make sure that school districts are able to have the funds they need, and we’re advocating for that.

Around 25 percent of schools don’t have nurses. That’s a concern all the time, but is it more worrisome this year?

We’re living in an infectious disease pandemic. And when you have an infectious disease pandemic, you want to make sure you have experts in infection control on hand, which is a school nurse. When a school doesn’t have that, there are things they can do — make sure kids wash their hands, keep their distance, wear face coverings. But it’s thorough assessments and health care decisions made by professionals that you need in a time like this. With flu season coming up, and under-vaccination of school-aged children generally, there’s a huge potential for an infectious disease outbreak in a school building. A school should want to have every possible person on board who can help with that.

There’s a gap when there’s not a school nurse in the building to help work through all of the issues around infection control.

Some schools have already said they’ll be online-only this fall. How do nurses work with students from a distance?

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They’ll be providing for students’ health and safety needs virtually. That could be virtual office visits or something more like telehealth.

For a student who may have Type 1 diabetes and is learning how to take care of it, school nurses could speak to that student on the phone or in a video chat to walk them through the process of checking their blood glucose. For a student with asthma, they could ask them if they’re sleeping or if they’re coughing to detect if their asthma is controlled. Then they can offer guidance or let them know if they need to check in with their primary care provider. These are things they would be doing during a normal year, it’d just happen over the phone.

One of the key roles that the school nurse will play is addressing the issue of under-vaccination for students right now. There weren’t many well visits to doctors in the spring, so many kids may be behind schedule. Nurses always review immunization records, and that’s just as important when they’re virtual. School nurses can give those recommendations to parents or families, especially for those students who may not have caught up.

What platforms are school nurses using to connect with students and families?

Generally speaking, it’s been by telephone or some of the videoconferencing platforms. Some school nurses are also making and uploading videos for students on things like how to wear a mask.

School districts or school websites have information on how to connect with nurses. That information is available, and it’s definitely being used. That’s what I’m hearing from nurses I’m in touch with. Nurses are the medical professionals that have relationships with students and their families, so they’ve been available.

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The Verge

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