The Nurse’s Note: A School Nurse Speaks Up

Heart with a medical symbol.

By: Catie Ensz, BSN, RN, CPN

The school nurse author who wrote this blog.

Nurse Catie (as her students and staff refer to her) has spent the last 7 years as a Title 1 school nurse. She works in a predominantly-Latino school and speaks Spanish. She lives with her husband and children in Northern Virginia.

Adjusting to School Changes

There has been a push across school systems in the United States to become “trauma-informed.” Teachers, as well as school administrators, nurses, social workers, counselors, and psychiatrists, gather in crowded auditoriums each August and listen to experts teach us to better assess students’ exposure and response to trauma. It is safe to say that the COVID-19 pandemic has been traumatizing on a global scale.

As you prepare to enter another school year in the United States, whether you are teaching completely remotely, in-person, or in some form of a hybrid model, you may be trying to wrap your mind around how to reach each student assigned to you. Even more, you might wonder how to prepare to eventually resume full in-person teaching post-onslaught of the novel disease.

School Nurses Understand

As a school nurse with a 1:1,200 RN to student ratio, I am aware of your concerns. Some of your concerns echo my own. I am acutely aware of my population and that the vast majority are uninsured or under-insured and non-English speaking. I am aware that over 10% of my student body has an asthma diagnosis, not uncommon in urban settings. We know that asthma is considered an underlying health concern for COVID-19. I have my own family and, like you, I don’t want to bring this illness or any other home from work with me.

All of this may feel overwhelming for teachers; you’re professionals who went into this line of work because you love students. You literally chose to spend the majority of your waking hours helping expand students’ horizons and inspire greatness in young people—and this is why you are the right person for the job! How many students are going to forget the teacher that held their hand (or rather, virtually fist-bumped) them during a global pandemic?

We’re Here to Help!

This is a photo of a school nurse

Who is the first person to notice when your class clown keeps laying his head down and just “seems off,” necessitating a trip to the school clinic? That’s you! I frequently tell my staff that they are my “eyes and ears” in the classroom. Even in this dare-we-say “unprecedented time,” teachers are reaching out to school nurses to alert them of students who are suddenly not showing up to a virtual class meeting or to let the nurse know that a family has had a COVID-19 related illness so that the nurse can follow-up and/or trace the family’s contacts. While you may not have signed on to be monitoring symptoms of a novel illness, you did sign on to be an advocate for children and what an honor that is.

School nurses across the US are preparing to guide you in your efforts to support students and families. The National Association of School Nurses as well as federal, state, and local health districts are empowering nurses to educate teachers and staff on the latest guidelines and recommended practices to help keep you, your students, and families safe. Like teachers, we consider students our own while under our supervision and want only the best for them.

How to Partner with Your School Nurse

1) Reach Out

Send an e-mail or text before school resumes just to check in. Respect and rapport make for great nurse-teacher relationships. Hint: Learn what your nurse likes to be called by staff and by students. Using his or her preferred title means the world to a nurse.

2) Share Concerns

Let your nurse know if you have specific concerns about a student assigned to you, whether remotely or in-person. The nurse may not be aware that Student A contracted COVID-19 in April and is now using a rescue inhaler or that Student B has not shown up to any virtual classes this week after complaining of chills during Friday’s final class session.

3) Trust Our Expertise

This takes the burden off of the teaching and administrative staff. It is our job to make sure students enter school systems appropriately vaccinated and having received some sort of physical exam by a medical provider. We monitor attendance and we communicate our concerns regarding illness and injury with families and medical providers. Experts, including the CDC, are clear that routine medical care of children and especially scheduled vaccines should not be skipped. School nurses ensure this information and other COVID-19 specific education is being communicated to families.

4) Ask Us!

Nurses may not have gone to school to do what you do, but we teach all day long. I can’t think of a school nurse who doesn’t have a creative way to get students to wash their hands or how to explain to a newly diagnosed diabetic student the importance of maintaining a reasonable medicate-eat-exercise schedule when in a remote learning environment.

Supporting Student Trauma

I started off talking briefly about trauma. Some trauma is unavoidable. We know that, statistically, some students will have lost at least one family member to this novel disease. We know that being away from peers and other school supports can leave students feeling isolated and vulnerable. As a teacher during this historical time, you have an opportunity to help mitigate some of this trauma. You are going to show up in whatever way that means for your district and school. You will develop a rapport with your students and get to know their families. You will learn who needs to go to the clinic for medication after lunch to take her ADHD medication and who sustained a head injury playing outside this summer and has a concussion recovery care plan.

We’re in This Together

Teachers play a critical role in helping students retain some semblance of routine and will help our children navigate the upcoming school year. Please, allow your school nurse to come alongside you in this. We are here for our students and families, and we are here for you!

 

 

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