School nurses already have a lot of responsibilities, but the possibility of students being back in classrooms this fall may add a new duty: screening for COVID-19.
"There seem to be no certainties. The guidance changes frequently and there is some concern that the guidance doesn’t take into account the realities in a school building," says Laurie Combe, the President of the National Association of School Nurses.
Combe says the pressure will be on school nurses to help screen and isolate any students or staff who could be showing symptoms of COVID-19. But not all schools across the country have the ability to do this.
"We're supposed to isolate those students or staff members and does a school have the space or capacity to do that?" says Combe.
According to the Department of Education, there are 98,000 public schools in the United States. The National Association of School Nurses’ research has shown 25% of those schools have no access to a school nurse.
"Not part-time, not one nurse covering multiple schools, just no school nurse," says Combe.
“COVID has revealed to us is that schools are relying heavily on school nurse expertise to guide their procedures and policies moving forward into reopening,” Combe added. “So what do those schools that don’t have a school nurse do?"
Visalia Unified School District in California has about 32,000 students. The district's 12 credentialed school nurses help lead an additional 36 nurses in meeting students' health needs.
"Our health department reached out and identified the 12 school nurses as emergency disaster workers so instead of enjoying a summer vacation, the nurses are working at the health department and helping to monitor COVID," says the district's Director of Health Services Suzie Skadan. Skadan says that extra experience will be helpful when school is back in session.
"They will have this additional experience and hands-on happening so they will know what to do when we come back," says Skadan.
Visalia unified is working closely with their local health department to put every CDC-recommended protocol in place come the fall.
"It is an added burden for the school nurse but it's very necessary to keep our students safe. So we think planning ahead and having systems in place will make the best of this situation," says Skadan. Both the National Association of School Nurses and Visalia Unified say ideally there'd be more nurses on hand this fall.
"Unfortunately, we're having big budget cuts. It's been a bad budget year and then we have COVID on top of that so we are not hiring additional nursing staff. We schedule people around to make things work so hopefully we can manage it this way," says Skadan.
While not every school will have the ability to test students for COVID this next school year, the National Association for School Nurses expects more students will be tested. Combe refers to a recent conversation she had with a teacher.
"I said, ‘So what are you going to do if a child in your classroom starts coughing?’ Normally you would send that child to get some water or you know help them manage that. She said, ‘I’m sending that child to the school nurse,'" says Combe.
Combe says nurses focus much of their time on health education for students, faculty and their entire school community, a role that will be amplified come next school year.