As school districts around the nation are putting together task forces to tackle the reopening of school, health experts advise that including school nurses and local state health officials could help provide more insight on how to safely receive students back in class as well as on the school bus.
They hold potential answers to vexing questions. How do you properly screen students prior to boarding them on a school bus? Should some students with underlying health issues not be transported on a bus at all? How do you make the school bus a safe environment when it’s essentially an enclosed box?
Laurie Combe, the president of the National Association of School Nurses (NASN), spent 12 years as a school nurse and 13 years as a health services coordinator managing nursing staff, support staff and all things health-related. She discussed with School Transportation News the various roles that school nurses can play on school district teams tasked with properly and safely reopening schools.
Combe, who also works with the Texas Education Agency’s Region 4 Education Service Center that serves the Houston area to provide school nursing, professional development and networking sessions for school nurse administrators, said having school nurses on the various task forces being created by districts will give a fresh perspective, as the practice lends the expertise of someone who can best interpret medical advice.
“[School nurses] can help those task forces consider the health implications of proposed plans, so that the task force can lay out the advantages and disadvantages of any plan,” Combe discussed. “One plan versus another plan, and the risks that might be associated with it. Often, we find that people have a plan, but they don’t think of it through the health and wellness lens, so the school nurse can add breadth to that consideration.”
However, she explained that 25 percent of public schools nationwide don’t have a school nurse on staff, and 35 percent only employ a part-time school nurse. In the event that a district doesn’t have a school nurse, she advised the task forces to consult with a state school nurse consultant.
“I would look either to the state department of health, the department of epidemiology, or the local health department, to have them vet any proposed plan,” Combe suggested. “And I think that any plan should include possible alternatives, Plan A, Plan B, Plan C. Maybe even Plan D.”
Dr. Nathaniel Beers, president of the HSC Health Care System in the Washington, D.C, area and a member of the American Academy of Pediatrics Council on Children and Disasters, agreed. “We have really pushed to say that those task forces should be pulling in the support from their local counties or state health departments,” he commented. “They will have the most accurate information on what state of coronavirus that region is in, and be able to help create a more specific plan for that community and be part of that assistance. We also strongly believe that pediatricians can be extremely helpful in playing a role in thinking about those strategies.”
He posed questions that transportation directors should consider before creating transportation plans. For example, what about a child who has chronic asthma and takes immunosuppression medication? Such prescriptions limit the ability to fight infection, which can be especially perilous when an active virus without a vaccine is present.
What about the child who is recovering from cancer? Is it safe for them to ride the bus? What about the child who rides with a ventilator or a gastronomy tube?
He added that seeking the advice of health experts and pediatricians can help with some of these more specialized questions that transportation directors might encounter.
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He said that ensuring there is health expertise on the district task forces can better allow school districts to answer, “global questions for the broader communities, but also the more nuanced questions about the specific needs of the population of kids who are going to your schools.”
Beers said that ensuring different viewpoints are shared at the task force table, allows districts to better reassure the parents and staff that they are taking all the proper precautions as districts transition into opening post-COVID-19.