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What School Nurses Want You to Consider Before Re-Opening K-12 Schools During COVID-19

School Health

Robin Cogan is a school nurse in Camden, NJ and the author of the blog The Relentless School Nurse. In a recent episode of Frontline’s Field Trip podcast, Robin discussed questions school leaders would need to answer as they consider re-opening.

Where do kids go when they don’t feel well, skin their knees, or have a sore throat while at school? To see the nurse, of course. But when schools begin to re-open this fall, school is going to be a much different place.

In order to safely re-open in the fall, school administrators need to have clear plans in place. Robin recommends that school leaders include nurses on teams tasked with planning for re-opening. As medical professionals, school nurses can provide important input from the health office perspective, often sharing ideas others may not have thought about.

Here are five things school nurses want you to consider while planning to reopen schools.

1. Be prepared and be proactive

Being prepared extends beyond simply training students and staff to avoid touching their faces, wash hands thoroughly, and maintain physical distance from others. It may require rethinking what a nurse’s office even looks like. The nurse’s office is likely to be considered a high-risk area. Will schools require anyone who exhibits symptoms that could indicate COVID-19 to stay in an isolation area? What will that isolation area look like in your school? Is there a space near enough to the health office for the nurse to supervise?

2. New guidelines, protocols, and policies

New guidelines and protocols are needed that consider not only general education students but also those with special needs, medically fragile children, and staff members in high-risk groups. What about students with asthma? Nebulizers may need to be avoided because of the aerosol spray. Are there alternative treatments? Do fever policies need to be changed? Most schools require students to stay home for 24 hours if they have a fever of 100 or higher. How long should they stay out of school in the COVID-wary world? How will that be monitored?

What about tracking data to inform decisions? How can a school commit to contact tracing every symptomatic student? What about testing? There’s a need to collect actionable data, both quantitative and qualitative, but are schools equipped to do that?

All schools should have electronic health records by now, although many are still writing immunization records by hand on cardstock. Limited by strict privacy laws, schools can’t share student health records, electronic or not. But with revised guidelines, could those records be a key to help schools share appropriate information directly with the students’ physicians and the local health departments? COVID has shown us that technology is a vitally important tool in many ways. Monitoring school health is one of them.

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3. Maintain a healthy environment

We know that small rooms where people are in close proximity promote the spread of germs. Increasing ventilation can help. Keep adequate hygiene supplies stocked around each campus. Soap and paper towels should be available wherever there is a sink, and hand sanitizer stations should be placed throughout the building. High-touch surfaces must be cleaned daily.

What else can schools do to keep each campus safe? Should schools install High Efficiency Particulate Air (HEPA) filters in every room? Should face coverings be provided for everyone? How will any of these new protocols be funded?

With so many unknowns, local health departments are waiting for guidance from the CDC before making decisions on some issues. Each state is responsible for new legislation that may help answer some of those questions. There are no easy answers, and with no treatment or vaccine, this virus is different than anything schools have faced in the past. What school communities can do, however, is implement clear prevention protocols and share them with parents, students, and staff. School districts should have a staff member assigned as a liaison with the local health department so they can keep school administrators informed.

4. Provide resources and support

Be aware of the many challenges families are facing in your community, sometimes making it more difficult to follow school protocols. Some students may not have internet access at home, preventing access to remote learning. With unemployment at its highest in years, many parents are struggling under the stress of dealing with multiple crises. Meeting the needs of their children, trying to keep them safe, and keeping food on the table and a roof over their heads may be overwhelming.

We don’t always consider that school nurses address mental health issues of students and staff along with physical health. The time spent on those concerns will surely increase when schools re-open. Nurses serve a vital role in connecting families to services they need. They know how to find mental health and medical care, access to food and hygiene supplies, language translations, and so much more.

5. Remember: children think differently

As school leaders prepare their buildings for a safe re-opening, always remember that children think differently than adults. Once all of the safety protocols are in place, step back and consider how children will react when they walk in your doors on the first day of the new and very different school year.

In the podcast, Robin shared the story of a little girl’s strong reactions to school closures. The child cried herself to sleep at night, asking why she couldn’t go to school. She asked for her teachers and to play with her friends. She cried when she had to put on her mask, begging not to have to wear it.

Always searching for the right resources to support students, Nurse Robin found a book called The Sewing Lesson. It’s a children’s book about COVID-19, and a little girl whose mom sews masks for health care workers. The child didn’t want to wear a mask because it was scritchy and scratchy and she didn’t like how it looked, so her mom made her a pink mask. Wearing masks together, they went outside to look for pretty flowers. The little girl forgot she even had the mask on.

It’s simple story, but it reminds us of the importance of creating a school community that cares. When you welcome students back to school, display signs and positive messages around each campus to remind children and adults to help keep each other safe. And let them know the school nurse is there to help, answer questions, and provide support.

To learn more about safely re-opening schools, listen to the full podcast.

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Theodora Schiro

Theodora was a teacher and school administrator for over 37 years. After leaving the public education world, she started a new career as a freelance writer. She enjoys writing content that helps businesses and service organizations thrive.