Nurses’ role returning to in-person school

In late October, families with students in grades K-2 in the Philadelphia School District were offered the opportunity to transition to hybrid learning or remain online. In early November, nurses and staff were still expecting to return to a hybrid model. However, on November 10, a rise in cases in Philadelphia caused the Philadelphia School District to announce that school will be virtual until further notice.

Although Philadelphia School District schools don’t seem to be ready to try reopening anytime soon, other educational centers, like the Penn Children’s Center, have tried in-person teaching. Ms. Li is the parent of a three year-old who attended the Penn Children’s Center for only a month before it shut down in early October due to a teacher being diagnosed with Covid-19. After thorough testing of all the teachers, a total of seven were diagnosed with Covid-19, she explains, but they were mostly asymptomatic carriers. Luckily, her son was not in close contact with the diagnosed staff, but there were two classes of students who were. For both the students and the students’ families, this is highly dangerous—the young children are a potential high-risk group and considering the fact that so many teachers were asymptomatic, punctually diagnosing sick people and contact tracing could be very difficult. Situations like the one at Penn Children’s Center added with the recent rise in cases in Philadelphia have proven that reopening schools may be trickier than thought.

As for Masteman and other SDP schools, it is unclear when students will be able to return. There have not been any plans for middle and high schools yet. However, Ms. Shalala, Masterman’s school nurse, states that on the Friday half-days, she has received extra training to prepare for a possible return. “There will be some changes to the actual health room. Instead of just having one health room, they want to have a medical waiting room… like an isolation room for students that have covid symptoms, so we can keep them separate from students that may be coming that are diabetic, just to check their blood sugar, or someone that has to use an asthma inhaler,” Ms. Shalala explains. “Students no longer will be able to come to the office by themselves. An adult is going to have to escort them to the nurse. The teacher will have to call first to notify the nurse of the symptoms” so that the nurse will know which health room to put the student in. She adds that if the student has Covid symptoms, things may get complicated.

Students that present two or more of the following Covid-19 symptoms: fever greater than 100.4°F, chills, cough (non asthma related), shortness of breath, diarrhea, vomiting and unexplained rash “will be sent home for evaluation of Covd per the School District,” Ms. Shalala explains. Then, if the student tests positive, it would be reported “to the Department of Health and they would start contact tracing and determine who would be quarantined.” Furthermore, Ms. Shalala explained that the district has stocked up on some PPE (Personal Protective Equipment) such as masks, gloves, shields, and gowns for certain staff, like nurses and special ed teachers. “I know in the K-2 schools there’s some teachers that have to be in classes that have special ed students that might not be wearing masks… because of their disability.” Also, “the cleaning staff will be increased, they have a protocol too with their cleaning and the supplies that they’re given with high touch areas such as doors and railings and things like that,” says Ms. Shalala.

Ms. Applegate is another nurse who is new to Masterman, but she is also assigned to two other non-public schools that have partial in-person learning. At these schools, she has been doing her usual job as a nurse to ensure students' health, such as addressing “any acute illness or injury that students may have” and performing “mandated health screenings such as growth, vision, hearing and scoliosis screening.” Since these schools are on a hybrid model, Ms. Applegate states that they have certain safety procedures put in place, including wearing face masks, plexiglass within the classrooms, and constant reminders urging students to social distance. She says that these schools are much smaller than the School District of Philadelphia schools, in addition to the fact that one of the schools has only a 30 percent in-person attendance rate.

Like many other elementary schools in the district, Shawmont Elementary planned to return to a hybrid model last week. Ms. Scheier, ther school nurse, was still preparing her office for the return until Tuesday’s update. Safety protocols that Shawmont Elementary staff have prepared in conjunction with the Philadelphia Department of Health are generally the same as the ones for Masteman, including the staff taking an online survey every day prior to entering the building and parents monitoring their children’s health at home, making sure they do not go to school with a temperature above 100.4°F. If they do go to the nurse with a temperature higher than that, Ms. Scheier states that she would have to “call the parent, isolate the student, and then they are sent home.”

With the come of the holiday season, it is likely that cases could rise even further, so returning to school in 2020 may not be possible. However, since it’s hard to solidly determine what we should expect, students should still be prepared for a potential return. Ms. Scheier says that the staff at Shawmont will continue to undergo professional development to provide a safe environment for everyone at the school. “We must not drop the ball as we need to be prepared to safely re-open.”