7 actions school nurses are taking during coronavirus closures

The school nurse's role has evolved as confirmed cases of the virus have grown and more districts have closed schools and shifted to distance learning. Here's how school nurses are maintaining contact with students with health conditions in a time of social distancing.

The school nurse’s role in response to COVID-19 at its initial outbreak in the U.S. was one of surveillance of students and staff for symptoms of the disease. But as confirmed cases grew and more districts closed schools and shifted to distance learning, that role evolved, says Kathleen A. Hassey, director of the School Health Academy and an affiliate associate professor at Northeastern University in Boston. 

Now, school nurses are playing a key part in delivering essential medications and medical equipment to students. They’re reaching out to families of students with chronic health conditions to connect them with needed supports. “And, they will be vital when schools reopen to make sure procedures are in place to keep everyone safe,” Hassey says.

Here are a few ways school nurses across the country have stepped up to help at-risk students and their communities during this time, using platforms ranging from direct emails and phone calls to website postings, videos and telehealth appointments.

  1. Returning school-stored medication to students. 

The first concern for many school nurses in the face of school closures is getting medications and medical equipment stored at school back to families, says Hassey.

Access to medication could be crucial for a student, adds Linda Kimel, a certified school nurse for Rockford Public Schools in Illinois. This is especially the case for stimulants such as ADHD or seizure medications that are controlled substances and not easy to refill.

Kimel worked with her school administration to arrange a pick-up day for parents. Her two schools were already closed to students, and parents were not allowed to enter. Instead, they called Kimel to alert her when they arrived. She then took the medication outside and verified the identity of each parent, examining an ID held up to the car window. “I would set the medication outside the car door and go back inside,” she said. “Then they would open the car door and pick it up.”

  1. Checking-in on students with chronic health conditions. 

School nurses are calling students with chronic health conditions such as diabetes or asthma to make sure they have the resources and supplies they need, Hassey says.

“As part of providing case management, school nurses are experts in locating local resources for their students and families,” says Louise Wilson, school nursing and health services consultant at the Wisconsin Department of Public Instruction. If they discover students are missing necessary supplies or medications, school nurses are taking steps to determine if such items are at school and could be safely delivered, mailed, or picked up using social distancing, she adds. 

Nurses in Wisconsin and beyond also are helping families connect with local resources, such as through the national 2-1-1 helpline, and charities that might help with the purchase of items and medications. 

Emergency communication: Creative ideas for using mass notification systems during school closures

Mass notification approaches have been evolving—along with every other aspect of school district leadership—as learning has shifted from school to home. For example, in a large school system in North Carolina, mass emails were used to deliver messages on behalf of local health agencies, in consultation with school nurses, explains Nate Brogan, president of notification services at Intrado, provider of the SchoolMessenger platform. “School districts are finding it invaluable to have a way to quickly reach very large audiences with a consistent message in multiple languages,” he says.

Blackboard, which offers the Blackboard Mass Notifications platform for K-12, has found that districts are updating families frequently. “With voice messages, some districts have found success using familiar, recognizable voices for recordings to instill trust and garner optimal engagement, retention and attention,” says Christina Fleming, vice president of K-12 product management and marketing.

– SchoolMessenger is delivering millions of messages per hour, says Brogan. Ideas worth modeling include:

Sending messages with instructions about picking up free meals.

-Using survey functionality within the system.

-Sending parents automated alerts if students don’t participate in distance learning courses.

– Utilizing unified messaging capabilities to instantly post instructions on school websites.

– Sending targeted messages to families to provide reassurance and let students know they are missed. —Melissa Ezarik

  1. Distributing lunches. 

Taking part in delivering free school lunches gives nurses another opportunity to check in on students and their families, particularly students who are considered at risk. 

For example, Marie DeSisto—a nursing instructor at Cambridge College in Boston who teaches a health office management class to school nurses—says one of her students helped with delivering lunches to children with free and reduced meal plans and with medical needs. She was able to leave the food at the students’ front step and talk with families through the door.

“We are a face most of our students recognize,” says Kimel of Rockford schools. “We can wave or give a thumbs up through the window without risk to any of us. It’s another way we’re indirectly reaching out.”

  1. Working with other medical professionals. 

Some nurses are working with the public health nurses in their local area to answer phone calls and provide health information and physician contacts, DeSisto says. A few school nurses in Massachusetts are also members of the state Medical Reserve Corps. As volunteers, they help with a variety of tasks, such as organizing and providing supplies for facilities that need them, she explains.

“School nurses are working with their local boards of health, especially with tracking COVID-19 cases and follow-up calls,” Hassey says. “Many are now trained on the statewide system for tracking communicable diseases.”

  1. Donating supplies. 

With permission, school nurses have donated their gloves, gowns, masks and other needed items to local hospitals and clinics, Hassey says.

As Kimel notes, if schools are shut down for the rest of the year nurses will be able to donate extra masks and gloves to nursing homes and health care providers.  “I have nine boxes of gloves,” she says. “I can certainly donate seven of them.” School nurses should just be sure to have enough for the beginning of the next school year.

  1. Revising student care plans. 

School nurses also can use this time to look ahead and review care plans for students with chronic health conditions, Wilson said. 

The National Association of School Nurses agrees. Its publication Ideas for School Nurse Activities During the COVID-19 Pandemic, states that these professionals should “review records of students with chronic conditions who may need 504 accommodations, individualized healthcare plans, or emergency care plans for the coming year or who are transitioning to a new school in preparation for when schools reopen; and begin the processes now.”

Related: Technology used for virtual school nursing

  1. Answering questions and providing reassurance. 

Parents in Kimel’s school district have her email address so they can contact her with any questions or concerns they have.

“A lot of parents, especially those with vulnerable kids, are scared,” she says. “If they’ve built a good relationship with the school nurse, they will trust her to give them accurate, reasonable information. Nurses can be a sounding board for reassurance, providing information, and promoting compliance with social distancing while minimizing panic.”

Florence Simmons covers Section 504, paraprofessionals, and transportation for Special Ed Connection, a DA sister publication. Subscribers can access additional stories and guidance on this topic via www.specialedconnection.com.

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