COVID-19 has brought to the forefront the critical role that school nurses are uniquely able to care for communities. As the pandemic COVID-19 spreads, the school nurse was thrust into the center of the challenge. As the central health resource for their entire school communities, students, teachers, the staff, administrators, it has been a daunting task for an already largely unstaffed role.
As such, the Back to Schools conference assembled school nurses in leadership positions from around the United States to provide insight. (see panel);
The toll on kids. An estimated 45,000 children have lost one parent from COVID, many of these from socially economically disadvantaged. The toll has been extraordinary and the school nurse is often to witness how this as the emotional impact has it has physical symptoms.
And the toll on nurses considerable. Panelist state that COVID is 24/7 challenge and estimated that 50% of their time on COVID, taking away all the time for the rest of the critical functions they had offered.
Despite this critical functions, surprising statistics point out that this role and is unfilled at nearly half our schools to not have a nurse. In the United States:
- 96,000 school nurses
- 56,000,000 million students
- 33% of the schools have a part time nurse
- 25% no school nurse
The costs of this are considerable as the absence of a school nurse eliminates a point of preventative care that could save the health care system overall.
A simple example is requires parents to come and pick up kids that are not feeling well. Causing major disruption for parents (particularly working moms) who must leave work. Competent nurses can better assess the risks and avoid what is often an unnecessary interruption.
According to the panel, what it means to be safe versus feeling safe are very different. Parents are afraid that putting their kids back into schools is a dangerous. 50% of parents are remote because the parents don’t feel it safe. A lot of misinformation and miscommunication has lead to this problem because in fact kids are safe in schools. In fact probably the safest place they can be.
They are the ones recognizing these challenges that kids have early. Nurses are on the ground on the front lines. A role of communications to help keep parents informed. parents and can help for example to foster confidence in the safety of vaccines.
The senior level nurses who shared their insights.
- Laurie G. Combe, MN, RN, NCSN
- Robin Cogan, MEd, RN, NCSN
- Kathleen A. Hassey, DNP, MEd, BSN, BA, RN
- Kate King, DNP MS, RN, LSN
- Rebecca Love, Clinical Advisor, Meenta, RN, MSN, FIEL
What we learned from the panel is that school nurses are widely regarded as the most trusted healthcare professionals. The nurse is the translator of critical information. They are the key educators of their community. They can play a central role in contact tracing.
Continuity. When a nurse stays in a single community there is tremendous capacity to build trust. Nurses work with families over time, in the case of an elementary school, over the course of 6 years. Families really do look to the school nurse as a trusted source of information.
Expanded role of schools. Schools have become more and more important in terms of meeting needs of children. And are often schools are asked to do everything. School are now responsible for much more than reading and writing, They are providing for the general health services. They have become an important source of nutrition and socialization.
The school nurses bridges that education gap and health. They can help to keep students in the classroom.
Opportunities for improvement. Ways that we can support school nurses:
Electronic Health Record. Nurses report that take the EHR if accessible to everyone would have a dramatic impact on providing quality health services and help them become much more efficient.
Wrap around services. Build relationships in a non–emergent time. need a complement of services. Cited the need to invest in the wrap around services such as counselors, psychologists. Partnerships are essential. Nurses can’t do it all. The health system, faith related organizations can also make a major impact.
Funding. Funding is the key issue. 79% of expense for school nurses is funding by a our local education agency. School districts are faced challenges to hire and return schools. Schools can bill Medicaid for services, in many states insurance reimbursement to keep kids on schools.
Administration support. Nurses cannot attend meetings but the need to have representation at the high level decision making. They also need staffing support. They have no substitutes. A back up support.
Telehealth in schools is a critical need and opportunity. This is particularly important for those living in poverty and rural communities. Technology now makes it possible for a school nurse to have the diagnostics tools and telemedicine access to become a means to early intervention and thereby reduce healthcare costs.
The panel recommended the following priorities.
- 1st priority is to hiring more. nurses and supporting admin support and counselors.
- 2nd is to improvement of facilities, ventilation etc.
- 3rd is to broadband equity and the critical need of giving every student access to internet.
Schools nurses can provide the bridge of communications by the schools and the community.
Reducing overall healthcare costs as school nurses can reduce cost of care by collaborating to chronic care of insured students.
This crisis may offer a moment of time to improve the role of nurses in the schools and the healthcare system.
Relative to their contribution, the value of the school nurse seems under appreciated. of trust There is no one better than the nurse to deal with these challenges. We need to have a more forceful position for such.