President's Message July 2020

The Importance of School Nurses in the Year of a Pandemic 

It is already the second week of July – a time that in other, more “normal” years, stores were filling with back packs, pencils, computers, notebooks and paper, lunch boxes and school clothes, all in preparation for the upcoming school year.

Today, while stores may be filling with supplies, many parents may be hesitant to purchase them.  We are, after all, still in the midst of the COVID pandemic, and plans for opening schools remain tentative while school superintendents and faculty determine what it will take to safely reopen. Should students attend in person at all?  Maybe in split sessions of one to two days a week?  Maybe all teaching should take place “online”?  Will we have outdoor tent classrooms? What about eating in a cafeteria?  Problems abound. Solutions to be determined. 

From a nursing history perspective, one solution seems patently obvious. To borrow a phrase from Oprah, “what I know for sure” is that we need a nurse in every school if and when schools open.

One hundred years ago, school nurses not only taught children to wash their hands and use a handkerchief, but also screened them for contagious diseases and quarantined those found to be infectious to their homes, checking on the children periodically to assess their health status. The nurses also referred seriously ill children to physicians and taught parents how to care for them. [1]

School nurse, circa 1919, Library of Congress

Over the course of the 20th century, budget cuts have eroded the number of nurses available in schools throughout the nation. According to Willgerodt et al, only 39.4% of U.S. schools employ a full-time school nurse.[2]  In 25% of schools where there is no nurse, administrative assistants care for children who are hurt or sick.

Given the COVID pandemic, it is time that local and state governments ensure that the hiring of a nurse for each school is a priority. Teaching children to wash their hands, wear masks, and cover coughs is now more critical than ever before. Moreover, each school needs a nurse-run clinic: a room where feverish, coughing children can be isolated and cared for until their parents retrieve them.  It is a recycled solution from the past: one that is critical to society today. 

To comment on this message, feel free to contact me at [email protected].

Wishing you a safe and healthy summer.

Arlene W. Keeling, PhD, RN, FAAN 

[1] Keeling, A., “Organization and Innovation in the Early 20th Century,” in Keeling, Hehman, and Kirchgessner: History of Professional Nursing in the United States, (Springer, 2018): 136-138

[2] Willgerodt, M.A., Brock, D.M., and Maughan, E.M., “Public Health Nurse Practice in the United States,” Journal of School Nursing, 34, (2018): 232-244.