Nurses Are Essential To The Reopening Schools Conversation, So Let's Discuss

Anytime there is a discussion on schools right now, a flood of “reopen schools!” comments are inevitable. And although these feelings are understandable—of course we all want our kids back in school and this pandemic to be over—simply saying “schools need to be reopened!” as a blanket statement doesn’t address the myriad of issues making that impossible right now. It’s just not that easy, and it’s definitely not safe until vaccines are widely available to the general population.

Because reopening schools isn’t just about the kids. We know kids need in-person instruction. We know virtual learning is a nightmare for many, especially for younger children. We know this past year has been an endless Groundhog Day hell scape and their educational experience wasn’t the same.

We know.

But asking a school to safely reopen its doors requires a huge group of adults—many of whom might be immunocompromised and many of whom might not yet be vaccinated. And all of them will be interacting closely with hundreds of potentially maskless children (because kids often don’t wear masks well) or germy children (because kids often forget to wash their hands and could be carrying COVID without knowing it). So yes, we absolutely need to talk about those adults and be honest about what, exactly, we are asking them to do.

Also, it’s not just teachers who are putting themselves at risk as schools reopen. It’s the office staff, the lunchroom staff, the custodians, the bus drivers, and the social workers too. But one person on the school staff is perhaps the most vulnerable as COVID makes it way through a building—and that person is the school nurse.

If you volunteer in your child’s school or hear about what’s discussed at board or budget meetings, or have a child who has fallen ill at school or who has a chronic condition, you might already know this upsetting fact—America’s schools already had a severe shortage of school nurses before the pandemic hit.

“According to the National Association of School Nurses, 25 percent of schools do not employ a nurse, while 35 percent employ part-time nurses,” The Washington Post says.

Why is it so problematic to have a school full of kids with no full-time nurse? Well, lots of reasons.

“A shortage of school nurses means that schools may have to ask staff without medical training to dispense students’ medication, manage allergies and asthma, monitor blood glucose levels, and handle medical emergencies,” Frontline Education explains. “And although educators are trained in CPR and first aid, there simply is no substitute for an experienced, trained medical professional in case of an emergency.”

Furthermore, school nurses also handle a slew of other essential responsibilities to protect children’s health and safety.

Frontline Education goes on to add that school nurses “consult with school and district leaders, educate students and their families on how to stay safe and healthy, and provide training for staff.”

In an interview with WPR (Wisconsin Public Radio), Brea Sanders, nurse for the Whitnall School District, adds to the list as well. “I think the common misconception is that we’re just handing out Band-Aids, and that’s not the case. There’s a lot of case management, and a lot of supporting students to remain in school that have chronic health conditions.”

Like many staff members, school nurses were already overwhelmed with their responsibilities, especially if they were “shared” and had to move from building to building. Now, consider all that the COVID-19 pandemic has added on to their plates, like keeping up with ever-changing COVID-19 protocols, administering daily COVID screenings, assessing children’s symptoms, and isolating those who are sick as they wait to be picked up. All the while worrying that they can be infected with this deadly virus at any moment.

Also, have you ever seen the nurse’s office? It’s hardly a space big enough for social distancing.

So no, it’s not surprising to hear that school nurses are burnt out. And it’s not surprising to hear that some aren’t willing to return to such unsafe working conditions, fearing that they could contract COVID-19 and spread it to students, other staff, and their own families as well.

Amy Westmoreland, a former school nurse in Lithia Springs, GA, wrote an op-ed for The Washington Post last summer as her school was getting ready to open in the fall. And it didn’t contain the normal “back to school excitement” school-related articles usually contain. It was sobering, and it reflected a sentiment of frustration and fear that many school teachers and staff members have felt since the start of this pandemic.

“I loved my job, which was about so much more than temperature checks and phone calls home,” her emotional piece reads. “My days were spent helping kids with special needs, kids who had seizures several times a day, or kids who needed help with medications or tube feedings. I made my clinic a place where students and staff felt safe, and where people could come talk about whatever bothered them, physically or just in general.”

However, once Westmoreland found out what her school’s COVID precautions (or lack thereof) were going to be, including that mask-wearing was going to be optional, she quit the job she loved so much.

“Of course, I was afraid of catching the coronavirus on the job,” she confesses. “But my bigger fear was that I’d unknowingly spread it to students and their families, or to my colleagues. I refuse to be complicit in endangering the health or the life of a child. I refuse to act as a prop, making people feel secure when, in reality, we’re putting their health at risk.”

And, most poignantly, she adds, “As a nurse, I developed trust with families, with children. Going back to work, as if everything were fine, would betray that trust.”

Westmoreland also addresses the fact that most schools do not have a big enough space to keep potentially COVID-positive kids in isolation. And, even if they do, one nurse is still running back and forth between that child and the rest of the kids in need, and they likely aren’t provided the type of protective covering doctors and nurses in hospitals are.

For all of these reasons, Amy Westmoreland joined the ever-increasing number of school personnel nationwide who have quit their jobs as COVID rages on.

We know that school nurses are incredibly valuable, pandemic or no pandemic. Frontline Education reports that having a full-time RN in a school building leads to fewer student absences (which means increased funding), increased immunization rates, fewer student pregnancies, and better health outcomes for students with asthma or diabetes, among other factors.

But COVID-19 has added even more reasons why we need a dedicated full-time nurse in all of our schools. For example, there is still so much we don’t know about the long-term effects of this virus on the human body, particularly on children. “If it does prompt chronic respiratory or circulatory issues later on,” WPR explains, nurses like Brea Sanders “will likely have to figure out how to monitor those conditions in their students, and treat them.”

Katie Johnson, nurse and researcher at the University of Washington says, “I’m worried that we’re going to see long-term chronic conditions similar to what we saw with polio in the ’40s and ’50s” as the world tries to move past this devastating pandemic. We will need nurses to help monitor these issues in students.

Now, more than ever, schools—all schools—need full-time nurses on their staff. We cannot possibly even talk about opening schools without properly trained medical professionals on hand. And without adequate space to isolate kids who show symptoms. And without safe, effective protective gear for the nurse we are expecting to care for these kids. COVID-19 is very much still here, and the long-term effects of this virus are still yet to be determined.

We all want our kids back in school, but we need to reopen schools only when it is safe. Ensuring our schools have nurses, who are protected and supported, is one piece—an essential piece—of that puzzle.