On slow days, COVID-19 precautions and protocols are simply one more thing to check off on school nurses’ ever present lists which include daily medicine distributions, reports, ordering supplies and checks on everything from AEDs to staff wellness. On other days, Whitney Cates comparison fits perfectly: “I feel like I’m juggling glass balls and when one falls it all crumbles.”
That’s how the Dresden Middle School nurse summed up the beginning weeks of in-person classes to fellow nurse Holly Spaulding at Dresden Elementary. Both agree that when contact tracing who has been within six feet of an identified positive case of the virus – an act that involves seating charts, measuring tape, and interviews with students who may or may not want to be quarantined – days can still be overwhelming.
“In the beginning, it was all Greek,” acknowledged Spaulding, referencing the frequently changing and sometimes conflicting guidelines from the Centers for Disease Control and Tennessee Department of Health. “It took a while to get our bearings. But now, I feel like we are doing well. We’ve still got challenges but the kids are excellent about the masks and I’ve been pleased because our parents have done a great job of keeping kids at home if they feel sick.”
Both Cates and Diane Lillegard at Dresden High School serve students who spend their days in a variety of classrooms and potentially near a variety of students. They agree that a good team to help with seating charts and measuring distances makes a difference in dealing with the difficulty of ongoing contact tracing.
“I don’t think it’s harder. It’s just different,” Lillegard said. “I’ve got a great team and when we can work together it’s manageable.”
The good news is that after recently pressing the need to keep desks six feet apart, the last contact tracing she did at DHS resulted in no one having to be quarantined due to close contact in a classroom.
All three agree that for the most part they adhere to the 7.5 hour work day.
“There is a normalcy to the abnormality of it all,” Cates points out. “The normal now is for me to wear my mask just like it’s normal to wear a seatbelt.”
Teachers, administrators, and board members frequently call the ten nurses in Weakley County Schools the “frontline workers and glue that is holding us together” during the COVID-19 crisis. But the critical need for their role was evident and supported long before this virus emerged.
The National Association of School Nurses says nationwide 25% of schools have no nurse at all and 40% only budget for part-time. In Tennessee, a 2018-19 state comptroller report revealed only 60% of public schools in the state had a full-time nurse even though Tennessee’s education budgeting system allows for one nurse per district and another for every 3000 students.
The state allocation would provide for one nurse for all Weakley County Schools. Local funds are utilized to ensure a nurse is located on each campus.
“We have known since we expanded our nursing staff that it was the right thing to do,” said Randy Frazier, director of Weakley County Schools. “But the pandemic has certainly underscored the vital role our nurses play in the overall health of our student bodies and faculty – not just the physical but the emotional as well.”
A behind-the-scenes glimpse at what WCS nurses are dealing with reveals that the same even keel and calm demeanor that allows them to quickly respond to a rolled ankle, cut in need of stitches, or feverish child is employed to take on the additional tasks of managing the COVID crisis.
Cates and Spaulding both cling to their clipboard lists of daily tasks and the sense of accomplishment they feel as they tick through the morning procedures and medicines that must be accomplished and/or administered daily. Then there is the as-needed medications for headaches or asthma and up to 25-30 drop-ins with injuries from outside play or “tummy aches” because they skipped breakfast.
“A lot of times, they just need a hug,” acknowledges Spaulding, who, with three sons says she understands how hectic mornings can be for families.
Cates and Lillegard are equally focused on communication. A student steps through the door and what sounds like a casual conversation is actually a quick intake and assessment. Calmly and pleasantly, they dispense a sometimes steady stream of both compassion and medicine without the slightest indication of irritation.
Ongoing issues such as diabetes, asthma, and allergies as well as cuts, scrapes, and rolled ankles are addressed with the demeanor of a good friend, somewhat belying the fact that both are RNs and Spaulding is an LPN.
They also have longevity going for them. Weakley County was once served solely by Beth Kempton, RN, now Westview’s nurse and the nursing supervisor. (A job Lillegard says was painfully hard to substitute for as it involved an insulin treatment at one school, a drive to another for asthma medications and another for a cut, with lunch in the car.) Spaulding joined the growing nursing team in 2001 at Sharon and then in 2007 switched to Dresden. Lillegard went from substituting to fulltime in 2009. Cates is now in her fifth year.
During the COVID crisis, Coordinated School Health Director Bethany Allen has switched her focus from her usual health screenings – an activity not possible with COVID precautions – to helping nurses keep up with COVID guidelines and crafting communications that are uniform throughout the county.
The combined effort regarding health and safety gets high marks from the nursing staff.
“As far as protocols go, it looked to me that this school system was one of the most prepared around … and thoughtfully done,” notes Lillegard. “I’m totally on board with the CDC. Schools are the best place, the safest place, for the kids to be.”