School Nurses’ Resilience Through the COVID-19 Pandemic

At the Core of Care

Published: June 28, 2021

SARAH: This is At the Core of Care. A podcast where people share their stories about nurses and their creative efforts to better meet the health and health-care needs of patients, families, and communities.  

I’m Sarah Hexem Hubbard, executive director of the Pennsylvania Action Coalition and the National Nurse-Led Care Consortium. 

As part of our special Access to Care series, we’re going to learn more about what it’s been like to be a school nurse during the pandemic. 

Three school nurses in Pennsylvania will share their experiences with us about being a nurse leader in their community at this time and their efforts to help keep their schools, staff, students, and families healthy and safe. 

They’ll touch on a range of issues… including how they’ve done contact tracing, supported both educators and students virtually and in-person… and been a valuable resource in their communities around COVID-19 vaccination. 

First, we’re going to hear from Tracey Glynn-Roulinavage in northeastern Pennsylvania, followed by Wendy Robison from the western part of the state, and finally Diane Shannon from southeastern Pennsylvania. 

Tracey is a nurse in northeastern Pennsylvania. She works within the Wilkes Barre Area School District at Heights Murray Elementary school. 

Tracey has been a registered nurse for more than 20 years. And she previously worked in acute care hospitals and homecare, specializing in vascular access and also provided cardiac telemetry monitoring. 

Four years ago, Tracey made the switch to school nursing and became certified in the field two years ago. As we’ll hear, Tracey’s acute care experience has actually informed the approach she’s taken during the pandemic.

TRACEY: I'm taking experience from an acute care setting and placing it, as I see fit in a healthcare setting for students, a school. We have to be realistic with what we can do: appropriate guidelines, rules, and regulations, social distancing in a school, an isolation room that I don't have, you know, a privy to like I do at a hospital. So we've had to come up with how can we say, a combination of resources that we've gotten direction from the Pennsylvania Association of nurses, and CDC, working in very close contact with the Department of Health and also the public Department of Education, of course, we have to abide by not only health regulations but school regulations as well. So, with that said, we did create a very brick and mortar so to speak isolation room here at the school. And working together with the administrators very closely, we were able to come up with plans that can repurpose rooms, we have gotten air purifiers, we have increased our ventilation systems, we have purchased PPE for students, staff, and visitors, we limit visitors, of course, but if one has to come in the peri area, we always make sure that they're protected and maintain that social distance. 

We have, I have shower curtains held up by coat racks to maintain that aspect of quote-unquote, isolation without scaring the kids into such a thing as you're going into an isolation room. But for your protection, we're going to sit in a special room to minimize the exposure to other children as they're coming in for maybe not health visits, but maybe sick visits that are you know, in coordinates with COVID, like COVID-19 like symptoms. So, it's been a work in progress. And it's been communication to advocate for students to the best of their abilities as in a school setting, where you don't have the resources at your fingertips that you might have at an acute care setting.

We do have over 900, probably close to 1000 enrollees in one given year. We do have some regulations on how many students like a ratio, Pennsylvania does have a nurse ratio law, thank goodness that we can only have 1500 students to one nurse, thank goodness, I am the one nurse. But I do have close to 1000 students that I do, maintain contact with, or try to during the pandemic. And what we had to do was develop a plan with our administrators with our Wilkes Barre area Superintendent closely with the Department of Education when we return the kids, virtually. So, what happened was we sent out a survey of parents if you had to return your children to school, would you want them option one? Would you want them option two, which is virtual? Or would you want to send them to cyber School, which is another option three. And there's a couple different areas of cyber. So, when we got those surveys back, our administrators worked closely with the superintendent to see how many parents were interested in returning their child to 100% in person, or 100%, virtual or cyber school. So, with that said, we developed this plan for virtual kids that the teachers god bless their amazing skill set, were given kids to teach in person and along with the virtual kids simultaneously.  So, it has been amazing. They did return this past February, around the 12th. We have a large percentage still on virtual. And we do have about 20 to 25% here in person.

With a pandemic, not only is there change, there's fear. There's, you know, are my kids going to be at risk if they return? Should I keep them home? What about my job? There's so many caveats that that come with this pandemic, and school nursing that I am glad that I was able to help and be a resource for despite most of the issue is in a classroom and is how we're going to maintain social distancing regulations, how are we going to keep these kids safe? How are we going to assure the parents that when they do come into school, if that's the choice they were given? And they chose? How are we going to honor that and with the socioeconomic status of our area? The kids are better off in school. A lot of them don't have internet that works. A lot of them have multi, you know, blended families that have many children, that when you're on the internet at home, it's hard to get service. It's hard to have the children online enough times and enough devices for them to get to get their education. But then again, when they're in person, there's always that fear that comes with it. So I think the parents, the teachers, the administrators, and our amazing United Way that have donated some money to the nurses pantry, and also donated money and meals to help with before and aftercare services for families that have to go virtual because their parents have to go to work. It has been a plethora of help and resourcing, to figure out how we can get these kids there. They're deserve it education. They're required education and they're healthy person to be educated. As a whole being, if we meet their basic needs, we can educate them. But with pandemic, meeting those basic needs was a marathon, not just a race.

And the mental part of it is so overwhelmingly crucial that we've seen so much anxiety, depression, withdraw, because of this need to, you know, maintain virtual status, or be in person and worry about, you know, not being able to sit at lunch with your friends and, you know, keep your mask down. We have to follow the rules, but we've done a fabulous job of keeping in contact with parents. Now, I've learned two things over this virtual start. And then when they came back in person, this partial virtual partial in-person school nursing as far as my responsibilities. 

Number one, I learned how to utilize space. Number two, I utilize other staff members to help me keep in contact with these kids and families. Because if it wasn't for them, teaching me how to use Google Classroom, I actually did create a virtual Google school nurse office. So when I was home, I did create a page with an interactive link to parents on our home website, that when they click on my office, certain areas of my office would be a bookshelf you know, book on the shelf would be a CDC recommendation for quarantine up on the other, you know, pegboard I put a link how to wash your hands properly for youngsters that, you know, maybe just do a quick swipe here and there, but how important it is to maintain good handwashing, the policy on COVID-19 for the school website, I did post the link, easy quick reference for parents. So within that Google Classroom, school nurse office, I was able to reach out to families and students I always say patients, I always have to correct myself, my students, and my families and maintain that, that degree of communication where they feel comfortable and confident that someone else is there. If they can't reach their doctor, they have questions. I am here, please use me please call me please contact me. I've used many resources like ClassDOJO, it's an email system we use to contact our parents. A good thing about that is the parents that don't speak English as primary language can translate that in a click of a button. So if I'm reaching out to a non-English speaking family, I can instead of using a translator, a third party, I can directly contact parents through ClassDOJO and communicate with them about their child's immunizations, about their current health status, about their current mental state about their recent physical, you know, to try to maintain some sort of normalcy for them, because they're not in school.

We still do have we still do have kids with allergies. We still have kids with a history of Diabetes that come in and get their blood sugar checked on a healthy, you know, state every day, we have kids that come in to get their medication every day for behavior purposes. And for any kind of medical histories, we come in, we have children come in for band-aids and stomach aches, whether it be somatic or physical, you know, it's still a stomach ache, whether it's based on anxiety or an actual physical illness, we still have that other than the COVID-19. So, we, we did see a lot of flu cases that were in conjunction with COVID-19. But there hasn't been a lot of school transmission, but there has been a lot of illness out there in the community. So in addition to the pandemic, and watching what we do, as far as you know, social distance in school, we also maintain the health and wellness of our students that are healthy, we still do require our state, you know, still do, excuse me, we still do have to complete our state-mandated screenings, which includes height, weight vision, monitoring, their BMI, their hearing, giving some education as far as how to continue to be healthy, and or how to make some healthier lifestyle changes with our little ones. 

So we do have that, that hurdle to, you know, overcome as well, our children, number one, we closed down, let's say in March, April, May, June, July, August, September, October, November, December, they have been home with their parents and family for that many amount of months. And then they have to come back to school so that we have separation anxiety, we have Oh, I can't learn virtual and do whatever I want anxiety, we have sleep issues, because it the screen time alone messes with their eyes, with their mind, with their, with their well-being because of the exhaustion. You know, it's not easy for me to even sit in front of a computer for a long period of time, let alone try to accomplish a lesson and then learn from it. 

The teachers not only are teaching them virtually but they also have the in-person learners as well. So those learners that are present, do also have a classmate of virtual children as well. So they do they try to maintain that, you know, compatibility and the organization and the children are, you know, sometimes used to, you know, sitting on the couch using their switch, you know, they don't want to learn but it is up to us to kind of target that. That problem, and, you know, a lot of them don't see a doctor regularly. So, another goal of mine, another passion of mine, I'm working really closely with our student wellness committee, with our United Way funding for the nurse’s pantry. They have funded a vision program that we are trying to get underinsured and uninsured children classes because they have failed their vision screening in school. And because of that, they're sleeping a lot. They might not pay attention, they're distracted. Some might not even know their colors or letters. And it's because they can't see them. So, if we could get them glasses and we can get a student wellness program here on campus because they can't get to the doctors. We're trying everything we can to help our community stay monitored. stay updated on their physicals get their immunizations, where some of the clinics have closed during pandemic. vaccine clinics around the area, just advocate resource out, communicate. I think it's been. It's been something every day I try to think of somehow some way, and some other area we can improve on. But man, I'll tell you what we've been doing a good job. And I commend my fellow nurses who we have a zoom meeting every now and again with to, you know, bounce off issues and problems and how we can most efficiently and creatively solve them.

SARAH: We’re going to head now to the western part of the state and hear from Wendy. Wendy is a certified school nurse within the Western Beaver County School District and covers pre-K through the 12th grade. She received a 2021 School Nurse Excellence Award from the Pennsylvania Association of School Nurses and Practitioners. She’s also a certified registered nurse practitioner and worked 30 years in a hospital clinical setting. When not at school-- meaning weekends, holidays, and during the summer-- Wendy works in an urgent care clinic as a nurse practitioner. And as Wendy will share, there’s been some crossover between the care she’s providing at the school and the walk-in urgent care setting. Some of the latest challenges have included cases of students, mainly at the high school level, contracting COVID-19. 

WENDY: What we see now is quite a bump in the young people getting COVID primarily through social, you know, gatherings as they are social beings. So, we're trying to navigate through that right now. And any school nurse right now could tell you that they're inundated with contact tracing, and it's very difficult. These are moving objects. And so, we're trying to do our best to contact trace to mitigate the spread. But sometimes it's a losing battle and involves many stakeholders. And we're always aware of that. So, you know, it involves sports, and perhaps we've just stopped a sporting event for a week and have to reschedule and, and testings and proms and graduations and things like that, and the parents have to take off work. And so, we're aware of all that. And we're placed in a difficult situation right now. 

And all I can pretty much say that whole school nurses are feeling a lot of pressure from all different stakeholders, and we're trying to do our best to follow the guidelines. We can't please everyone. 

But I would say, for myself, I'm looking forward, you know, eyes forward, always looking for evidence and what can change because we've changed so many things since the beginning of COVID. And we learned a lot. But right now, in this just this little stall point where I think that we could move forward with some different mitigation measures.

And it's hard to create evidence when you're in the thick of things, you know, be great to do a study, but it's hard to set it up and to control any variables to make it valid. You know, that's, that would be really helpful if we had studies that suggested that some of the things, we do are beneficial, or some of the things we're doing, don't have much use.

What I like to see is when educators come and ask me, pointed questions and, you know, thoughtful questions, and that's what we aim to do as educators is to, you know, show our students that they should question and they should look at evidence, and they should weigh that. And so, you know, that was appropriate, I thought, and hopefully, that's a good model for the students that they're teaching.

But right now, there are some students that are vaccinated. So that's great. If they're two weeks out of vaccination, we don't have to quarantine them as long as they're asymptomatic. But we also have students who've already been through COVID. But perhaps they had COVID during Thanksgiving or Christmas. If it's been greater than three months, then we have to quarantine them again, and it just doesn't sit right. And so that is where the evidence would be so beneficial to say that, yes, the innate immunity that they acquired is sufficient that you don't have to quarantine but we don't have those directors right now. And that's where the school nurses, I think, are feeling a little bit frustrated that we want to have some evidence to be able to tell our, you know, principals, teachers, and students. This is why we're doing it this way. Or this is why we're doing it this way.

I vaccinate on weekends, and I did see quite a number of teenagers come through, which was nice to see. And yes, they have questions. And it's you know, I've talked to parents too, they'll call in and ask things about it. And they have a really good conversation with their, with their students with their children. So that's, that's a good thing. And I hear a lot of, and it makes some sense that we have, you know, vaccinated those that are most vulnerable, and children seem to do fairly well through COVID. So, at the point that, that we've insulated as much as possible, is it okay to just let it go, and, you know, come back to school in the fall and see what happens. So, you know, I don't know the answers to that, and the rules of the game in the fall, if you're not vaccinated, and you're sick, or, you know, what's the end game? So, we're not sure we're still looking forward to see what happens. And we're not sure about herd immunity? You know, we have questions that is that fully a vaccine-driven immunity, or are they accounting for those that already had COVID. So, you know, I think I think we have to wait and see how long it's going to hold. And whether we need boosters too.

We were out for so long that the kids seem to grow an inch, or two or three, which was neat. And with masks on it was hard to identify my friends. So the other thing, I noticed that either they gained a considerable amount of weight from sedentary, you know, kind of locked down, or they lost a lot of weight from, you know, depression and things like that. And they had a hard time to get back in the rhythm of school, I could say that, and you can see the stress.

We know that children need routine, that they thrive on routine. And, you know, I did talk once about an analogy of a tree, tree rings. And when you cut a tree down, you can kind of look at those and see what years were the hard years maybe. And I think if you did that, you would see that this period of time and their development, you know, could be quite affected. And we know that educationally it has been so I'm hoping that we can move forward and look ahead to repair some of this and make a game plan to catch them up and make them feel safe and get moving again.

And I think it's ironic that you have to look at what have we learned during COVID. So, when I look at the staff, at the schools, they have changed their skill set dramatically. So, to be able to do the virtual models and simultaneously teaching the class. I don't know how they manage all of that, but they have learned so much about the online platforms. And students are very comfortable with that, especially teens, and so they communicate with their teachers quite a bit and they may divulge more that way than they would face to face and so I think that is a plus.

Certainly, for me, I get messages on the school platform all the time, night, day, evenings, weekends, which is fine. That has changed for all school nurses, we don't just work a steady daylight job anymore. It's, it's all weekends and, and anytime, but so I think some of those pluses there and also virtual visits. So, with the clinic setting where I work, we do virtual visits. And that has kind of tipped over into school. So now, I offer virtual visits for students who may need to see their physician for a follow-up for something maybe like ADHD, which doesn't require an in-person visit just a talk or counseling session. So, you know, we have computers and they can have their sessions and not have to leave school to go or have their parents leave work to take them in. That's something that's new that's come out that may be beneficial as well. So, you know, I do I think that we're going to have some counseling. Yeah, I think so. This after this dust settles, but everyone's trying to stay afloat right now. And be honest, I see the stress and the administrators, the guidance counselors, and everyone, you know, cafeteria, everybody?

The big lessons learned are to be nimble, you know, I think you have to be ready to change and have a lot of patience and compassion, be aware of everyone's viewpoints and the difficulties they experience. So, yeah, I know, it won't be an off summer, it's that's not how I operate, I'll continuously look at how we're moving forward and what's new, and continuing to talk with the physicians, infectious disease doctors and, and then plan ahead, and hopefully, we can restart rejuvenated and have some other protocols in place, but a little more stability, I think, a little more stability will go a long way for everyone.

Just to have the kids in school, all you know, and they know they're not going to start hybrid and be an A and B group. And they know, you know, they're going to be with their friends, and they won't have people going move apart, move apart, put your mask up. And, you know, maybe that would relieve some pressure on them. And then just the consistency for the teachers and the students as far as education goes would be phenomenal. They're struggling. And you know, when the kids are off, they have anxiety because they can't keep up and they're not doing well. And then they're back in school and trying to catch up. So, I feel for them, it must be difficult for all of them. And then the parents feel stressed trying to help the children. And the teachers feel stressed because they're trying to do their best to so I think going back full time knowing what the game plan is, hopefully, you know, we don't have the numbers that we see and we can keep going get some momentum.

You know, I'm hearing from all the nurses and the administrators, everyone's ready for summer, and they have some battle fatigue.

And I think they're getting frustrated. And I just would love that everyone could keep in perspective, that we are a group. We were good before, and we can be good after, but we just, we need to be kind to one another and patient and understand that, you know, this is the way the game is played right now. And as much as we don't like all the rules, you know, we have to get through this. And, you know, this, maintain those professional relationships and just eyes forward. And, you know, that's, that would be my message. I see a lot of battle fatigue right now. And I just hope that everyone can get through.  

I did a speech for a nursing award I just recently received in for school nurses. And you have to do an acceptance speech. And I said I know. But I was buried in contact tracing and things that were happening, and I'm like to move. So, I'm driving home, it was a Friday. And that was the night that I needed to do this virtual acceptance speech in front of like 300 people, and I didn't have anything written. And so, I was thinking about how things were going. And you know, I was getting kind of yelled at by parents and everybody and they're mad about this and that. And so, my acceptance speech was like a parody of A Few Good Men movie.

“Like the movie A Few Good Men, starring Jack Nicholson, we have become many great school nurses. We live in a world that has halls and those halls have to be guarded with exceptional caring insight and education. Who's going to do it? You, we have a greater responsibility than they can fathom. They don't want the truth because deep down in places they don't talk about at parties, dances, and gatherings, they want us in those halls, they need us in those halls. We use words like vaccinating, isolation, and quarantine, we use these words as a framework for protection. Many use those as an argument, we have neither the inclination, nor the time to explain ourselves to those that demand education and safety, and then question the manner in which we provide it. I would rather that they just say thank you and go on their way. Otherwise, I suggest that they mask up and walk these halls.”

SARAH: And finally, we’re going to hear now from Diane Shannon who works as a school nurse at Kennett Middle School in Southeastern Pennsylvania. She’s been a school nurse for 23 years and the nurse coordinator for the Kennett Consolidated School District in Chester County for 21 years. This past year, the district also tapped Diane to be the pandemic coordinator. Her work as a nurse leader has also been recognized and she received a 2021 School Nurse Excellence Award from the Pennsylvania Association of School Nurses and Practitioners. 

Prior to working as a school nurse, she was mainly a clinical nurse specialist and worked in labor and delivery and high-risk and critical care obstetrics.

Diane is going to break down for us what this past year has been like, and the ways in which she and her nurse colleagues have responded to the pandemic’s demands on schools. 

DIANE: Our job duties were the same as what they always are when we had students in the building. But of course, we didn't have as many students in the building. So, we weren't as busy doing, taking care of students with illness and injuries and medication administration and health screenings, like hearing and vision, height, and weight scoliosis screenings, because we didn't have as many students in the building. However, we were kept very busy doing contact tracing and providing quarantine instructions for families who had COVID, and staff who had COVID. So, we worked very closely with the health department. And in the fall, when the health department became totally overloaded with trying to do contact tracing. They put that responsibility on the school districts and specifically on the school nurse. And then we were also given the responsibility, providing the quarantine instructions from the health department. So, we kept very busy doing all that tracking all those cases, doing the follow-up. And then also continuing to evaluate our safety measures and what was working and what wasn't working and educating the staff and parents and students about COVID and strategies to prevent to prevent the spread.

Our cases at our school district have been very similar to how Chester County has had abs and flows and peaks and, you know, post-Thanksgiving, we had pigs post-Christmas holidays, we've had peaks after spring break. When we came back to school, we had peaks. I mean, I think the whole winter was, was pretty tough. But we have seen a drastic drop in cases now with all the vaccinations that are happening. I mean, I'm so thrilled with Chester County Health Department and all the other places where people are administering vaccines from, you know, pharmacies, to hospitals, to the health department. So, and many of our nurses I encouraged our nurses to join the Medical Reserve Corps through Chester County Health Department, and it's a tedious process of paperwork and clearances and watching videos on how to administer vaccines which is funny after 43 years as a nurse, but we went through the process and on the weekends whenever we can we volunteer our time to help administer vaccines in our community. So, we have really been working hard to, to make our store community safe and decrease the spread.

So, we're really promoting the health department vaccine clinics for this for the kid’s children. And it will require an educational process because especially when they pulled the J&J vaccine for a while, and, you know, there's been controversy regarding COVID all along about everything. Right. It's, it's, there are definitely a lot of differences of opinions. And we have just tried to really follow the recommendations of the scientists and the physicians who are providing guidance for the CDC, and health departments. So, we're definitely on the science side and, and trying to follow their lead. So that's, that's what we're presenting to parents.

There’s risk in everything right, but we don't we know at this point that COVID has killed over 500,000 people and, and children had initially, you know, fared very well with COVID. But we've been, you know, we've been now that kids are back in school, we definitely saw an increase in COVID cases among children. Young children to children in daycares children in kindergarten and elementary schools and the middle schools and high schools. So we would like and I feel like we just have to give vaccines a try because we really need to try to minimize the number of cases of COVID, we want kids to be back in schools, again, sitting closer to each other, not wearing face masks, you know, this is, this has just been so hard for all the teachers and all the children, the students who have to be in school wearing face masks, it's really hard not to see their faces.

The mental health issues have skyrocketed, you know, sense of isolation has been really difficult. And, and, and joy, you know, they've missed out on a lot of joyful events, dances, and parties and clubs and sports and things that bring children joy, and it's an and just totally different experiences than the academics. I mean, we have kids going, we're going to be doing an outdoor prom with face masks on. That's just, it's really been a rough year for children. And the children who, last year, graduated with no graduation ceremonies. I mean, those are like some big rite of passages that are important for children and families. So, you know, the children who ended their school years from May till June, not in school, it would that's really sad for those kids, especially who were seniors, and went off to college without, you know, feeling like they missed out on their, their font, their senior year of high schools. So, it's, it's had a huge impact on the children socially.

I'm on the board of the Chester County School Nurses Association and have been for decades and we have meetings every few months, we're really ready to have this year-end. And we're just so hopeful that next year will bring more normalcy because everybody's ready for some normalcy. This has been a very challenging year and year and several months, you're in a quarter. And it's been challenging in so many ways, challenging in terms of how many hours we've all worked and being on call 24-7 to answer and deal with phone calls about COVID symptoms and COVID diagnoses, doing testing and one of the things that's I think that's just this whole COVID situation has been amazing from, you know, the days when there wasn't hand sanitizer, there weren't wasn't toilet paper, there weren't supplies. And now there's just an abundance of everything. Remember, before the holidays of Christmas, you couldn't get a COVID test. The COVID tests were costing hundreds of dollars, and you couldn't even find one just to get scheduled. And now there are just tons of places to get COVID test we've been doing COVID testing in our schools since January, we do rapid antigen testing, we do q tests. So, we there's just an abundance of supplies and resources for COVID. So that was one thing that's very interesting to me to watch that whole, that whole cycle progress, you know, in terms of, of supplies. And now the same thing with vaccines. Remember, nobody could get an appointment for vaccines. And now, there are just dozens and dozens and dozens of places to get vaccines as a walk-in. So, it's very interesting.

No matter what people say, children sitting at home learning from a computer sitting in front of a computer, it is just not the same as being in a classroom and learning from a teacher in front of them. And I, I'm really worried, I think we don't even know the impact that we've had in terms of lost education for these children. You know, it's we have children that I think some students are not even when they were virtual, they really weren't logging into classes, and there was really nothing that teachers could do about it. So, it's, it's I feel like we've had a last year with children and that's sad.

We've now done contact tracing on between people who have had COVID, and people who have been identified as close contacts, we've, we've done contact on tracing on over 800 people, and we have not had any in-school transmission of COVID. So, I think that that's some, that's a really powerful observation. And other school districts are in the same boat, we've, we've had to quarantine people for 10 to 14 days because they were sitting near somebody. And that's what the regulations say, that's what we have to do by the health department guidelines. And yet, you know, the chop, Karen, the chop policy lab, physicians are saying, like we really haven't seen in school transmission. And we haven't, which is amazing, that maybe we haven't seen in school transmission, because they've been masking and because they had physical distance. But it is remarkable that the transmission of COVID that's been happening has mostly been in households. And it's been in community settings, where people aren't masked and where they're let their guard down. It's when they're with their friends and family. And that's been the vast majority of the transmission. So, it's, maybe it's prevented in school because of all of our mitigation strategies. And we can just say, hey, that's great. It worked. Or maybe we could say, well, why are kids still having to wear masks and set? You know, six feet apart from somebody? So, it's, it is just interesting. concepts.

When we say 800 cases, it's, you know, like one, for instance. Now one student that has COVID, in an in middle school, and they have seven or eight classes in the course of the day, and they have three or four students sitting around them, we have to put into quarantine like 12 kids because of one student who was positive. And we have families living in close quarters. So, one or two family members who get COVID we have to write quarantine orders for eight people, you know, so it's certainly I don't even know how many positive cases of COVID we've had at this point. I just know that the documents that we use to track we have a lot of names on it at this point.

It's been a very challenging year. And I think one thing that has been crucial for school districts to survive and thrive in this pandemic, is that the school nurses have become a very important cog in the wheel. And they've had to work very closely with the administrators, the health department, the families, the students, and of course each other are, we have way more meetings, we have weekly staff meetings earlier, we were having meetings several times a week, just to make sure that everybody was understanding the rules and the regulations and the regulations were changing very frequently. And we had to make sure that we were keeping up with the most current guidelines. So, we have worked together as a team more than ever. And that's been a plus. I mean, hopefully, that part of it will stay.


SARAH: Special thanks to Susan Cole of the Pennsylvania Association of School Nurses and Practitioners and Christine Marcos at The Moses Taylor Foundation for their assistance on this episode. 

Funding for our special Access to Care series comes from the Center to Champion Nursing in America, which is a joint initiative of the Robert Wood Johnson Foundation, AARP, and AARP Foundation…along with the National Nurse-Led Care Consortium.

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In the meantime, definitely continue to stay up to date with us on social media @PaAction and@NurseLedCare.

At the Core of Care is produced by Stephanie Marudas and Emily Previti of Kouvenda Media and mixed by Brad Linder. 

I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition. Thanks for joining us.