School Nurses Are in Short Supply During the Pandemic
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[bell rings]
[Melissa Harris-Perry: You know what that sound means. School is now in session, and with the start of school comes the arrival of some familiar faces. Parents packing up school lunches, students bustling down the hallways, hopefully, we're six feet apart, and teachers frantically preparing their classrooms.
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Melissa Harris-Perry: Let's not forget our school nurses who have taken on a lot of new responsibilities amid the COVID-19 pandemic.
Gloria E. Barrera: For many of us, it's just doing a lot more than expected. We've been on the front lines since the pandemic closed schools back in 2020. Many of us now work long hours of contact tracing, and a lot of us are planning for some to just play a key role in COVID testing. Basically, we're taking on the work of the Public Health Department, but without adequate staffing or support. My name is Gloria E. Barrera. I'm currently a certified school nurse at a public high school outside of Chicago, and I also teach at several universities. I am the president of the Illinois Association of School Nurses.
Melissa Harris-Perry: Despite this critical role that they play, our schools have suffered from a shortage of school nurses for years. According to one study from the National Association of School Nurses, 25% of schools nationwide did not have a school nurse, and that shortage on top of the pandemic has led to some burnout among school nurses.
Gloria E. Barrera: Many, especially those in the trenches, are repeatedly exposed to high levels of stress and direct trauma. Like soldiers, some may have returned from this battle with psychological scars that run deep from their time at the frontlines.
Melissa Harris-Perry: For more on the experience of school nurses amid the pandemic, I spoke with Linda Mendonca, president of the National Association of School Nurses, and she started by telling me a bit about the pathway into school nursing.
Linda Mendonca: It involves making sure that the school nurse has some knowledge level around education courses as well, so it involves more coursework to become a school nurse. The National Association of School Nurses, currently we have approximately 18,000 members across the country.
Melissa Harris-Perry: For parents or maybe for those of us who remember our school nurse as a young person, we might think of them as just the friendly, nice lady in the office. I just wanted to remind our listeners the level of professionalism required.
Linda Mendonca: Thank you. I appreciate that, because the misinformation, reputation, if you will, of being the band-aid nurse or the ice pack nurse. Clearly, the role is much more than that, where school nurses are monitoring student's routine immunization records, making sure they're in compliance for the beginning of the school year for required immunizations. They take care of students with chronic health care needs, diabetes, asthma, seizure disorders, for example. They definitely monitor, yes, ill children and children with injuries, but it's a big care coordination effort that school nurses are involved in on a day-to-day basis.
Melissa Harris-Perry: Take that overall role and help us understand it in the context of the fight against COVID-19. What kinds of responsibilities have school nurses taken on over the course of the past year and a half? How's it looked different with remote education?
Linda Mendonca: It's been challenging last 18 months, and technically, we're moving into a third school year that's being impacted by this pandemic. The school nurse is really an essential member on the pandemic preparedness team for reopening and re-entering plan teams in their districts. At the local level, school nurses have collaborated with public health authorities in the implementation of federal and state health and education guidance, so looking at all of those different guidances and what works best for their school community around COVID-19 mitigation strategies. The school nurse has established partnerships and collaborations, were really trying to do this work, and to make sure that their school communities are healthy and safe for when students and staff are coming back this school year.
Melissa Harris-Perry: Help me out here. What's been the role of school nurses in COVID vaccine efforts so far?
Linda Mendonca: They were there helping to do school-located vaccine clinics, however it was rolled out. There's different-- in every state how the vaccine was rolled out, and they were there to really get those faculty and staff immunized. Then, it became available for our student population, 12 and up, and again, taking a big role and coordinating clinics and getting their students vaccinated. They'll be ready when the vaccine becomes available for children under 12. As far as the mental health goes, that's a concern. We are all dealing with mental health, not just our students, but I think we all are in some form living through this unprecedented pandemic in our lives. We are concerned about the mental health of our students and our staff and faculty returning. Many have not been in the classroom in some places in 18 months or so. They've been doing their learning at home. For them to come back into the school setting may produce some anxiety. We need to be ready and have that on our radar returning to the school setting and making sure that we have resources.
Just to add one important piece, where parents really can help is our communication. School nurses really are key to communicating information to families, but it needs to be a two-way street where the parent communicates to the school nurse as well and to the school. Really establishing a clear line of communication and collaboration is really vital, more now than ever, as we continue to navigate this pandemic together.
Melissa Harris-Perry: Do school nurses right now have a collective position, even if it's not every single school nurse, but is there a kind of institutional or organizational position, one, about their own vaccination status relative to the COVID vaccine, and secondly, about in-person schooling, given the realities of the Delta variant?
Linda Mendonca: Right. We do have a position, it's actually located on our website, around returning to in-person learning. It basically states that we support what the American Academy of Pediatrics has come out with around returning to school and universal masking to keep all students, faculty, and staff safe in the school environment. Of course, vaccination, whether it's COVID vaccine, or measles, mumps, and rubella vaccine, we clearly support immunizations as a public health measure or strategy to save lives and to keep people safe from acquiring any virus or disease.
Melissa Harris-Perry: School nurses are overwhelmingly women, is that right?
Linda Mendonca: Correct. Yes, that's what our demographic data has shown, yes.
Melissa Harris-Perry: I'm wondering if there are pay differentials, if there are differences in workplace stress experiences, but the ways that some of these equity issues might affect nurses themselves?
Linda Mendonca: Right. I think, again, pay is different across our country. Cost of living varies across the country, so that's certainly going to impact pay. Many school nurses are paid on teacher's salary schedule, so that salary looks a little different than what they could make perhaps in a hospital setting. Then, others places also have a separate pay scale for an RN, for example, so it definitely does vary. I think our workforce diversity is important, it's important to our organization, and we're really trying to focus and look at that a little bit more, and really, how can we make our workforce look a little bit more diverse? The equity around pay has been a problem for many years I think for school nurses. I think being on the teacher salary schedule is usually favorable. It is better than being on a separate schedule because I'm not sure that sometimes the education world realizes the value of the nurse and what the nurse can bring to the table and into the school community and their pay as opposed to what it would look like in the hospital or acute care setting.
Melissa Harris-Perry: Do you think the pandemic is going to encourage state legislators, cities, schools to invest more in school nurses?
Linda Mendonca: I certainly hope so. I do think that it will. I believe that they have realized the value. The school nurse brings this public health expertise to the table, to the school, and has that knowledge to do that. They have been invaluable throughout this entire pandemic. The American Rescue Plan, for example, that provided funding of $500 million to hire school nurses, and that money is being spread out throughout the country for states to invest and to do that. I don't have data to tell you what that's looking like or what the outcome will be, but we're hoping that that's what happens. The School Nurse Act that is in Congress has been introduced a couple of times, and we're hoping to move that forward as well to provide equity and to make sure that there are school nurses in our schools across the country.
Melissa Harris-Perry: Linda Mendonca is the president of the National Association of School Nurses. Linda, thanks for joining us.
Linda Mendonca: Thanks for having us. Really appreciate you inviting National Association of School Nurses.
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Gia: I'm a school nurse, but I am a teacher. Funny thing is we actually don't have a school nurse, and all teachers who are already spread thin are basically part-time nurses as well. Gia calling from Charlotte, North Carolina.
Marcus: Hi, my name is Marcus. I'm from Palmetto Bay, Florida. When it comes to being a school nurse, I've already reached about 10 years as a school nurse in Palmetto Bay, and I would say that what it means to me as of right now when it comes to the current situation going on with the COVID pandemic is that to stay strong, focus on what needs to be done when it comes to taking care of medically fragile children, and staying the course in a way that as long as I do my part, then I can contribute to helping making sure that as a link in the chain, together we can work together and get through this kind of pandemic. As long as we work together in unison, be safe, wear our masks, get our vaccinations, taking precautions wherever we can, washing our hands, then ideally, we can put this COVID pandemic behind us sooner rather than later.
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