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In COVID-19 era, school nurses face different set of challenges

  • Grantham Village School nurse, Karen Eylander administers COVID-19 tests at the school on Wednesday, Oct., 6, 2021. Second-grade teacher Catherine Page and second-grade students Arden Heinsch and Otto Miletto were all participating in pool testing. The school will be performing tests every two weeks. It took Eylander about an hour to gather the samples in Grantham, N.H (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News photographs — Jennifer Hauck

  • Rivendell Academy school nurse Creigh Moffatt opens windows in the multi-purpose room at the school on Wednesday, Sept. 29, 2021, in Orford, N.H. Moffatt was on her way outside to monitor students during lunchtime. She carries a pool noodle to show students what social distancing looks like. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Rivendell Academy school nurse Creigh Moffatt changes her mask often during the day on Wednesday, Sept. 29, 2021, in Orford, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Jennifer Hauck

  • Kindergarten student Gryphon Jenkins is greeted by school nurse Karen Eylander, at the Grantham Village School on Wednesday, Oct., 6, 2021. Eylander watches students when they hop off the bus in the morning at the school in Grantham, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Rivendell Academy school nurse Creigh Moffatt takes a look at sixth-grader Joselynn Mack's finger after she hurt it on a swing at the school on Wednesday, Sept. 29, 2021, in Orford, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News photographs — Jennifer Hauck

  • Rarely staying still, Rivendell Academy school nurse Creigh Moffatt eats her lunch while standing in Orford, N.H., on Wednesday, Sept. 29, 2021. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Jennifer Hauck

Valley News Staff Writer
Published: 10/16/2021 9:46:42 PM
Modified: 10/16/2021 10:13:55 PM

Before she became a school nurse, Creigh Moffatt imagined that the role would consist of tasks such as doling out bandages and aspirin and testing students’ hearing annually.

Little did Moffatt know that being a school nurse, often the only health care worker in a building, can feel like operating a “very rural emergency room,” she said. (As it turned out, she was prepared for the job, having formerly been an emergency room nurse and a ski patroller.)

Now, with about 15 years under her belt as a school nurse at Rivendell Academy in Orford, the 70-year-old Moffatt enjoys the elements of the job that keep her on her toes. On any given day, she might encounter a serious playground injury, a case of strep throat or a hungry child.

In addition to addressing whatever acute needs the day may bring, school nurses track student immunizations, help students with chronic medical issues and arrange flu vaccination clinics for their communities. They alert cafeteria workers to students’ food allergies, and sometimes they help teach health classes or work in the school garden.

But in the last two school years, school nurses have been on the front lines of responding to and mitigating the COVID-19 pandemic. Those tasks have included tracking the evolving recommendations from health agencies and translating them on the ground and advising families on whether a test is needed and where to get one if it is.

When a test comes back positive, school nurses have often been tasked with determining whom that person has been in contact with at school and directing those people to quarantine or to monitor for symptoms and get tested.

Though Moffatt “never had anybody be upset with me personally” when she reached out to alert them to the need to quarantine, she said, “It’s a real hassle for pretty much everybody.”

Scheduling and getting test results back has been especially difficult this fall amid the delta variant-driven surge in COVID-19 cases, said Karen Eylander, school nurse at Grantham Village School.

“I have students that are out for a full week of school waiting on COVID test results and parents frustrated by the hours spent on hold trying to schedule the tests,” she said.

Amid those challenges, Eylander, who also works per diem as an emergency room nurse at Dartmouth-Hitchcock Medical Center, said tracking the school’s 276 students’ attendance and sorting out who needs testing, who is on quarantine and who is on isolation takes her about an hour each day.

“In the past, I only had students stay home or sent them home for a very few reasons, such as if they had a fever or vomited,” she said. “Now I have 20-plus students absent a day because their nose is stuffy.”

She said she understands that many children who test positive for COVID-19 have only one relatively minor symptom, but it’s hard on students, families and teachers to have so many students miss so much school.

This year, remote learning has largely been phased out in Twin State schools, so students who test positive have to isolate at home and must work to catch up as they would if they had another infectious disease such as mononucleosis, said Kathy Bonyai, one of three women who share a 1.4 full-time equivalent school nursing job at Hanover High School.

“Teachers work really hard at helping those kids catch up,” said Lynn McRae, one of Bonyai’s fellow Hanover High nurses, during an interview in their office in late September.

Bonyai, McRae and Candace Nattie wore masks and sat roughly 6 feet apart during an interview after school one day.

Their shared charge is to care for the school’s 850 students and employees. On a given day, they may see as many 40 people come through their doors.

On the COVID-19 front this year, the Hanover High nurses said they urge anyone with any symptoms to stay home. Masks also are required and distancing is recommended.

The Hanover High team worked this summer to get a clear picture of where the school stands with vaccination rates. As of late September, they had 85% of students and 97% of employees fully vaccinated. They hoped the rest would opt to get vaccinated at some clinics they arranged.

While Vermont schools, including Rivendell, which follows Vermont health rules, are still working to trace close contacts when positive cases arise, New Hampshire schools are simply asking those who may have been exposed to watch for symptoms and get tested.

“They really want to keep students in school,” Nattie said of New Hampshire health officials.

Daily temperature checks also have faded from their list of tasks this year, as such checks didn’t seem to help in identifying cases of COVID-19, Bonyai said.

Like Moffatt, the Hanover High nurses said they have to be prepared for a wide range of issues from upper respiratory illnesses to sports injuries such as concussions and anxiety. Also like Moffatt, McRae said they have to be prepared to look under the surface to determine whether a physical ailment is in fact the main issue a student may be facing or if it’s a symptom of something else going on emotionally or mentally. McRae described that work as “peeling back layers of the onion.”

There are times when getting to the source of the problem can be tricky.

“Sometimes a kid can have a lot of symptoms of anything, (but) actually they’re starving to death,” Moffatt said. “It can take a long time to figure that out. They aren’t saying.”

When a child says they had breakfast, Moffatt knows to ask, “What did you have?”

The Hanover High nurses meet weekly with the school psychologist, counselors and the dean of students to help them understand which students may need some extra attention.

In addition to the direct effects of the pandemic, Eylander said she’s seeing indirect effects as well. There are students that are behind on basic medical care, immunizations, dental and optometrist visits because offices shut down and families feared going into medical facilities. She’s also seen an uptick in mental health issues such as anxiety and depression.

“I feel like this goes for the adults too because everyone was hoping we could get back to school without masks this year and move towards being normal and that didn’t happen, so there’s a lot of frustration and people’s reserves are empty,” she said.

In addition to working to increase vaccination rates, the Hanover High nurses said they also are monitoring evolving issues such as booster shot availability and potential mitigation strategies for this latest surge. They noted that mask requirements have already been extended longer than they would have expected when COVID-19 case counts were low this summer.

“COVID hasn’t let us know what’s going to happen,” Nattie said.

Still, she said, once vaccination is open to everyone, including those younger than 12 who aren’t yet eligible, she is hopeful that the pandemic will move into an endemic stage, and COVID-19 will become something that everyone will learn to live with, like the flu.

“If we all step back to 10,000 feet, (pandemics have) been going on for a very long time,” said McRae.

On the upside, the Hanover nurses said they feel as though people have developed a greater appreciation for the work that they do amid the pandemic.

“Last year sort of pulled back the curtain,” Bonyai said.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.




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