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School nurses in Peoria area carry ‘fierce’ workload during COVID-19 pandemic

Leslie Renken
lrenken@pjstar.com
Illini Bluffs School District #327 nurse Erica West, right, checks the temperatures of middle school students as they enter the building Tuesday morning, Oct. 6, 2020 in Glasford.

While nurses in the Dunlap School District felt well-prepared for the challenges of COVID-19 when classes began in August, there was still a bit of trepidation as children filed into the district’s eight schools that first day.

“I think it was just the unknown of what we were gonna face, and how everyone would do in this new normal,” said Dunlap High School nurse Michelle McDonald. “But honestly, when I left that first day, I felt just such a huge sense of relief, because I do feel like we are keeping kids safe. So I guess that was the biggest thing, just knowing that we could do it.”

The pandemic has brought a lot of added duties to school nurses. Between caring for children with special needs, keeping track of immunizations and health records, responding to emergencies and communicating with the local health department, school nurses already had a lot on their plate. And many districts, including Dunlap, had nurse shortages before the pandemic began.

But while COVID-19 has added to the workload for school nurses, those duties are familiar, said Juanita Gryfinski, president of the Illinois Association of School Nurses.

“We’ve always done disease surveillance, we’ve always done mitigation in terms of prevention of the spread of disease in our school,” said Gryfinski, a school nurse in the St. Charles Community Unit School District 303 in Chicago’s western suburbs. “The difference is we are now doing it on a much more fierce level.”

According to the Illinois State Board of Education, 900 certified school nurses work in schools across the state. Illinois has more than 4,100 schools and 850 school districts, according to a January story by NPR Illinois. Nurses with other classifications work in schools, however.

Dunlap employs a number of part-time nurses, so the true number of school nurses in Illinois is unknown, Gryfinski said.

As frontline workers, nurses are likely being exposed to COVID-19 as part of their work, but information about the number of school nurses who have tested positive is not available, Gryfinski said.

"There is no data gathering on this information as schools must protect HIPAA and FERPA when reporting,“ she said, referring to the Health Insurance Portability and Accountability Act and the Family Educational Rights and Privacy Act.

At least one study is showing that virus transmission in classrooms is low. Emily Oster, an economic professor at Brown University, launched a dashboard tracking COVID transmissions in about 1,100 schools, according to District Administration magazine. Classroom transmission is uncommon and the rate of teacher infection is nearly identical for in-person and online learning, Oster said.

“People are being really careful in schools in ways that they’re not when they’re just out at a barbecue,” Oster told District Administration magazine.

The nurses interviewed for this story said they were focused on protecting students and staff at the schools where they work, and many of them worked with administrators over the summer to craft protocols to achieve that goal. Now, about two months into the school year, many nurses said they were pleased with the way things are going.

“Once school started, the flow was just kind of natural for everyone,” said Erica West, school nurse for almost 900 students in the Illini Bluffs District in Glasford. “I feel like we’d been living it for six months before school started. Most everybody had been used to wearing masks and washing their hands. Some of these little kids, they are doing awesome.”

Administrators at schools all over central Illinois worked with their local health departments to craft back-to-school plans instituting requirements set by the Illinois Department of Public Health.

“We had committee work over the summer, administrators and parents and staff were on these committees coming up with a back-to-school plan,” said Alyssa Hart, director of student services at Dunlap School District. “They really took the time and effort and worked their tails off to ensure the students were ready to be here on Aug. 17. Then we really allowed staff to have that time to prepare.”

The IDPH plan requires parents to do a health check on their children every day before sending them to school, and children are checked again by school staff before they enter the school. Anyone with symptoms is taken to a special quarantine area where they are further evaluated.

“We have a process where our teachers are taking temperatures, and we have a process that they follow on who they would send to the cares area,” said Hart. “Every building has a cares area — if a student needs to be quarantined, that’s where they would go.”

Children sent to the quarantine area are further evaluated by the school nurse. Unlike in years past, headaches, runny noses, coughs and stomach aches now result in the child being sent home since they could be symptoms of COVID-19.

“I think that was the rough part of the first few days was getting parents to understand the guidelines,” said McDonald. “If a student had a headache two years ago, parents would say ‘I’ll bring them in some Tylenol,’ and we’d send them back to class.”

IDPH guidelines require children with symptoms, and their siblings, to be sent home, and everyone has to get a doctor’s note or a negative COVID-19 test before returning to school. Even children who don’t make it into the school with symptoms are required to get checked by a doctor or tested for COVID-19 before returning. School nurses are calling the parents of everyone who is absent, a new duty added to their workday.

“Before COVID-19, absences weren’t as closely monitored,” said Tonya Johnson, district nurse for Princeville schools who is responsible for about 780 pre-K through high school students. “They were monitored, but now we have to know why they are out, what they are out for.”

Johnson said she makes calls every day, sometimes 30 to 40 phone calls a week.

Nurses in the Dunlap School District are also feeling the added workload.

“There’s not enough hours in the day to get it all done. But we do, all of the nurses, we know how to prioritize,” said McDonald. “We know all of our students that need the daily care from us. We prioritize that. We are able to figure out a good balance. And we also have some great help.”

Both the Dunlap School District and Princeville Schools have seen positive cases in their student body and faculty. When that happens, administrators determine who those students were in contact with so they can be sent home to quarantine.

“The administrators go into the classrooms that those students were in to determine the spacing between desks,” said Amy Cranford, district nurse for the Dunlap School District. “They’re trying to figure out if people are within six feet of each other for more than 15 minutes throughout the day. So they go classroom by classroom to identify if those are classrooms where people aren’t spaced out enough. And then we determine who sits around that student and who gets quarantined. I don’t determine who — administration determines who — but I do make those phone calls to the family. And we let the health department know as well.”

In spite of the added workload, the effort has been worth it, the nurses said, because in-person learning is important to them.

“So many people are rooting for in-person learning,” said Hart. “There are students that need in-person learning. There’s the socialization piece that we need in our lives. There are so many positives that come from being around people. It’s a huge mental health thing, to be back around people.”

Leslie Renken can be reached at 270-8503 or lrenken@pjstar.com. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.

A special camera system takes a student's temperature in seconds as they line up in front of a screen before entering the school Tuesday, Oct, 6, 2020 at Illini Bluffs Middle School in Glasford.