Nurses in the News

BEATING THE ODDS FACED BY RURAL COMMUNITIES

Beating the Odds Faced by Rural Communities

Greenfield, MA:

Greenfield is a small city in Franklin County, with a population of just over 17,000. Like many rural communities in western Massachusetts, Greenfield faces many challenges. These communities have experienced a decline in population, a decrease in economic growth resulting from falling income levels and housing values, and aging infrastructure. Additionally, residents of these western Massachusetts communities have less access to workforce support services, higher public education, public transit, and broadband infrastructure.

Start of the Pandemic:

Due to the inadequacy of health and social services in Greenfield, they had difficulty fighting the unforgiving spread of SARS-CoV-2. With nearly 18% of their population school-aged children, Greenfield’s utmost concern was for the students’ health and safety. Rural schools often struggle with increased costs, decreased enrolment, and limited availability of health and social services. The school

nurses in Greenfield knew their role would be vital to ensuring the safety of the school population moving forward.When the pandemic hit the region in March 2020, it was clear that these challenges faced by rural communities would be compounded.

The Rural Policy Plan, put forward by the state of Massachusetts in 2019, had hoped to address many of the challenges through sustained implementation strategies. However, rural communities hadn’t made enough progress in addressing existing healthcare infrastructure gaps when the COVID-19 pandemic hit, which affected their ability to respond to the emergency.

Shifting to Remote:

As COVID-19 spread relentlessly through Franklin County, Greenfield made the tough, yet necessary, decision to transition to remote learning. Greenfield School nurses saw a major shift in their responsibilities. However, since school nursing practice is founded in population and public health, without hesitation, the Greenfield school nursing team began to focus on promoting a healthy home learning environment for their students and surrounding community. Health promotion efforts included:

  • increasing their connections to the school community and to families,
  • keeping track of student health and wellbeing, and
  • providing the public with accurate information.

In order to efficiently adjust their focus, school nurses strengthened their collective communication systems, which enabled them to effectively advocate for improving the physical environment of their school buildings and to stay positive during a time of dismay.

Collective Communication:

Maintaining the same level of collaborative communication that they had prior to the pandemic was a hurdle the Greenfield school nurses overcame in stride. They quickly adjusted to virtual meetings and began working toward the creation of a robust communication stream. Their goal was to stay connected with the school community and keep families updated and informed. To meet this goal, they used the relationships they already had in place to efficiently disseminate information. Along with maintaining continuous communication, the school nurses ensured that families had access to appropriate resources, from food to health services.

Promoting Health in the Physical Environment:

The Greenfield school nurses took every necessary action and opportunity to ensure the school safety guidelines outlined by the Massachusetts Department of Public Health (MA-DPH) and the Centers for Disease Control and Prevention (CDC) could be met. They made it a priority to obtain the appropriate supplies and equipment, and to advocate for their necessity.

As the school nurses worked tirelessly to keep their community healthy, they were met with rural challenges and barriers. First, the processing time for healthcare purchases in rural communities takes much longer. Second, the school nurses struggled to obtain HVAC filtration systems for the schools that would help ensure a safe physical environment for students and staff. Despite being met with resistance, the school nurses’ desire to reach meaningful health and academic outcomes spurred them to continue to advocate for the importance of the new filtration systems. Through their perseverance, they successfully convinced the administration that HVAC systems, while costly, were necessary to protect the health and safety of Greenfield’s students and staff, and the systems were installed.

Back to School:

Greenfield students are finally beginning to return to school, and school nurses are excited to have them back. Their current initiatives are focusing on disease prevention. As a means of disease prevention, the school nursing team is working towards being trained in BinaxNOW™ COVID-19 antigen testing and pooled testing for the city. The district will use these tests to identify positive cases and intervene quickly to prevent SARS-CoV-2 spread within schools. They are also focusing on employee and student wellness, by providing teachers with information on how to maintain safety in the classroom.

Rural communities often face physical barriers to accessing vital disease prevention tools, like vaccinationclinics. Even though Greenfield has four vaccination clinics, the rural nature of the city poses an accessibility challenge for residents. All of the clinics are centrally located, within 5 square miles of each other, but the town is spread over 21.87 square miles. This means many people have to drive a significant distance to reach them. There are two more clinics in surrounding communities, however, driving to those locations could take between 30-60 minutes.

Remaining Uplifted:

Maintaining a positive outlook throughout this pandemic has been challenging for everyone. Thankfully, Greenfield school nurses found a way to strengthen relationships and create a dependable support system for their community and families. They hold weekly virtual debrief and update meetings. These meetings are run without any hierarchy. Greenfield school nurses operate entirely side-by-side as a team, working together to check items off their collective to-do-list. Continual quality improvement assessment of their roles and responsibilities has allowed the school nurses of Greenfield to persevere and continue their crucial work.

Despite facing rural challenges and isolation, these school nurses are grateful for each other and for being able to virtually collaborate with colleagues across the state throughout this past year.

School Nurse, a Professional:

When explaining the resilience of school nurses, one said, “There is something about the nursing profession that draws-in incredibly hardworking individuals who are tremendously passionate about healthcare. Their philosophy to provide service allows them to prevail every day.” The school nurses of Greenfield have persistently applied their unique training and skills to ensure access to care, promote health, and reduce risk in their schools and community. They have been leaders in advocating for and creating a safer physical environment. Their efforts to educate themselves, their colleagues, and their administrators led to improved air quality, COVID-19 antigen testing, and safer classrooms, and has helped reduce the risk of SARS-CoV-2 spread through their school population.

 

Written by Hannah Burgess

SCHOOL HEALTH IS PRIORITY NUMBER ONE IN LOWELL MASSACHUSETTS

School Health is Priority Number One in Lowell Massachusetts

Lowell, Massachusetts At-a-Glance:

Lowell is a diverse city located north of Boston, near the New Hampshire border. With a population of almost 111,000, Lowell is also a large city. Lowell has a median resident age of 36 years, so it is mainly comprised of a younger working class. Lowell’s history is steeped in textile work, and it has worked to expand and diversify its opportunities in the education, technology, and healthcare industries. Despite this growth and allure drawing families to Lowell, 1/5th of Lowell residents live in poverty and many families face challenges, such as food affordability and internet accessibility in their homes.

Introduction of the Pandemic:

Like many cities with higher poverty rates, Lowell was harshly affected by the SARS-CoV-2 pandemic in March 2020. The safety of school communities became a priority for Lowell’s board of health, as roughly 21% of their population is under the age of 18.  Unlike most MA school districts that hire school nurses directly, Lowell’s school nurses are employed by the health department and are assigned to different schools and school buildings accordingly. This distinction proved to be a major advantage for Lowell over this past year, as school nurses and the health department could work collaboratively to keep school communities safe.

All about the Kids:

The primary concern of Lowell school nurses was, and remains, the health and safety of their students. Beth Moffett RN, BSN, NCSN, School Nurse Coordinator for Lowell Public Schools, describes how school nurses have worked tirelessly for the city and the schools over the last year to ensure that students and families were well supported throughout the pandemic.

Meal distribution sites were established across the city, so families of students could easily access food. School nurses provided support to community members who were isolated and needed guidance on how to receive food and medication. Lowell’s diverse population meant that language barriers were an additional challenge they faced when aiding the community. School nurses successfully utilized the “Language Line” to communicate effectively with community members of many cultures and varying native languages.

Since school nurses in Lowell are public health nurses, the pandemic also required them to take on new responsibilities to protect the city has a whole.  When schools closed in March, they had to quickly transition from focusing on their school communities, to contact tracing for the whole city. Beth states that school nurses immediately returned to their public health roots. All the nurses were incredibly busy getting training on efficient contact tracing protocols and procedures, as well as learning about the importance and details of this new responsibility.

Importance of In-Person School:

Schools serve as a safe place for many students in Lowell. During a typical school year, there are some students with non-ideal situations at home that school nurses make a point each day to contact, even briefly. When the pandemic hit, leaders in Lowell understood the importance of trying to keep students in school, and of remaining connected to members of the school community.

The school nurses and the health department recognized the toll that extended isolation and remote learning has taken on the mental health and well-being of faculty, staff and students. School nurses understand how important socialization and being with peers is for students. They saw the stress that working parents were experiencing having their children remotely learning at home. Beth believes remote learning simply cannot provide the same level of education as in-person classes can, since students aren’t immersed in the learning environment.

Realizing the significance of social connections and in-person learning, the Lowell school nurses have been doing everything in their power to get their students back in school, including assuming a higher risk themselves by continuing to work in-person throughout the entire pandemic.

Return to School:

School nurses in Lowell have focused on improving the health of the overall community, and getting Lowell students back to school safely. They worked with local agencies and community partners to address food insecurities, access to COVID-19 testing, and vaccine eligibility. The school nurses assisted with the Lowell COVID-19 emergency operations center. Here they triaged COVID-19 symptoms, self-care, food insecurities, and when to seek medical advice. They also explained isolation and quarantine protocols, and travel orders. Many of the school nurses also continued to perform contact tracing for the health department through the summer of 2020, a time that school nurses usually have off.

In September, 3% of Lowell’s students returned to school, beginning with high-needs students (i.e., students with autism, English language learners, and students with emotional and behavioral concerns). Some of the school nurses were back in the school buildings conducting their usual school nurse duties, while also continuing to contact trace for the school and the city.

School nurses also took on the additional responsibility of conducting pooled testing. Beth mentions that pooled testing requires significant planning and collaboration. Multiple pooled testing rosters must be accurately developed, and, if a pool tests positive, school nurses must follow up by re-testing all the individuals within that positive pool to pinpoint the individual that was positive. This process requires managing student flow to prevent further exposure and donning full personal protective equipment (PPE) to conduct testing. Once the positive case in the pool has been identified, the school nurse then turns to contact tracing, allowing them to keep track of those who had close contact with the positive individual, both in and out of school. Lowell school nurses were especially attentive to and supportive of positively identified students, families, and staff members in their school communities. They helped guide them through the quarantine/isolation process and educated them on the timeline and requirements for being able to return to school.

Having school nurses that work directly within the health department has been beneficial to ensuring the safety of the Lowell community.  When positive cases were identified within the city and the school district, the school nurses contacted members of their school communities and identified those who may have been close contacts. The school nurses assumed the responsibility of following COVID-19 positive patients throughout their 14-day quarantine to provide support and guidance. These connections allowed school nurses to actively monitor their school populations to ensure safety. The nurses know their school communities very well. They have established trusting relationships with students, families and staff, facilitating strong communication systems to effectively manage this crisis.

The New Year:

Starting in February 2021, Lowell brought 3% of their special needs population back to in-person learning. On March 1st another 25% of their student population (about 3,100 students) was brought back to in-person learning. On April 5, kindergarten through grade 5 students returned, and, on April 26, students in grades 6 through 12 returned. With more students in the school buildings, the school nurses hoped that their responsibilities would become a steady balance between providing an optimal learning environment for students and continuing their COVID-19 disease prevention strategies.

In Recent News:

Since Labor Day 2020, Lowell has experienced a continuous rise in COVID-19 cases. A recent 14-day report (April 2, 2021) showed the highest prevalence of new cases (26.3%) is among 0–19-year-olds. Of this group, 32.5% are children between the ages of 6 and 10. This is proving to be another challenge school nurses and the board of health in Lowell are facing as they identify contacts, determine causes of spread, and apply necessary control measures.

Beth mentions that her door, along with others at the Health Department, is always open for anything school nurses may need. This incredibly hardworking team will continue to persevere through these unprecedented times to ensure the health and safety of their school and city community.

As a result of the efforts of the school nurses tracing, teaching, and proficiency, Lowell is now experiencing a downturn in COVID-19 cases. Vaccine clinics began at Lowell High School for eligible students and are also open to family members. As of May 27th, 2021 the City of Lowell is in the Green on the Massachusetts Department of Public Health color-coding system, meaning less than an average of 10 new daily cases per 100,000 in the population.

 

Written by Hannah Burgess

WHOLE COMMUNITY HEALTH LEADS TO SAFER RETURN TO IN-PERSON LEARNING IN LAWRENCE

Whole Community Health Leads to Safer Return to In-Person Learning in Lawrence

Lawrence in a Pandemic:

Lawrence, Massachusetts is approximately 35 minutes north of Boston, and adjacent to the communities of Methuen, Andover, and North Andover. Covering only 7.5 square miles with a population of around 80,000, Lawrence is relatively small city. As of 2019, 21% of their residents live in poverty and 25% of their population is under the age of 18. The majority of Lawrence residents fall into minority groups, including Hispanic or Latino populations, who are already facing adversity.

Lawrence has been hit incredibly hard by COVID-19 and is facing many major resulting challenges. Since the onset of the pandemic, the city has consistently been in the top three for the highest number of COVID-19 cases in the entire state of Massachusetts and has been firmly in the red zone of the MA COVID risk color-coding system (highest risk). As of April 1st, 2021 there have been 250 COVID-19 related deaths in the city, and over 20,000 positive cases. One in 20 Lawrence residents has contracted COVID-19.

Role of Schools:

Schools in Lawrence not only provide quality education to the children within the community, but also provide meals and a safe space. When students transitioned to remote learning in March of 2020, it was clear that Lawrence families were going to need increased help supporting their health and learning from home.

The Role of School Nursing in Lawrence:

Nancy Walsh, BSN, RN, NCSN, Director of Health Services for Lawrence Public Schools, highlighted the important role school nurses are playing in supporting families. As outlined in the Framework for 21st Century School Nursing PracticeTM , school nurses are supporting student health and academic success by contributing to a healthy and safe school environment. Their efforts include delivering skilled nursing care to children with chronic conditions, infectious disease surveillance, conducting health screenings, and teaching skills to promote health. Further, school nurses are also connecting families to community resources. The Lawrence school community relies heavily on the important work these school nurses are doing to ensure access to care for all and overall health promotion.

School Nurse Response to COVID-19:

In addition to the typical school nurse duties that have remained in place, even amidst the COVID-19 pandemic, school nurses in Lawrence have also added tasks to their workload centered on addressing disease prevention and public outreach. They assumed the responsibility of making sure students are safe and healthy at home. They have distributed lunches to families. They supported students and staff, by holding virtual office hours, and connected with families to ensure they received the health care they needed. The school nursing team in Lawrence has also educated families about the importance of the flu vaccine, and organized clinics at the schools that were distributing lunches so students would have easy access. School nurses also continued to formulate care plans and update health records, so they would be prepared when schools re-opened.

In addition to all of these efforts, all 40 of the school nurses in Lawrence shifted a large percent of their time and energy toward contact tracing for the city. Collectively, since March, the school nursing team has put over 30,000 hours toward detecting every single COVID-19 case in Lawrence.

Acting Fast:

As an emergency response to the continuously climbing COVID-19 infection rate, in January 2021, the city of Lawrence opened a vaccination clinic at South Lawrence East Elementary. The city again turned to the school nurses to manage the clinic, and the nurses were eager to get started. They knew that focusing on vaccinations would improve the health of the community and make it safer for children to return to school.

Following the phased timeline recommended by the state, the clinic initially immunized approximately 400 people a day. Today, the clinic is now administering roughly 1,200 vaccinations per day.

Appreciative Public:

Despite every seat being filled at the vaccination clinic since it opened, Lawrence continues to experience an especially high prevalence of COVID-19. Nancy is excited that, in March 2021, the state opened a second clinic to help assist the city with their efforts to get the infection rate under control.

Comprehensive School Health:

Grounded in their belief that all students should achieve and maintain optimal health to attain their full academic ability, Lawrence school nurses strive every day to ensure community health. As schools have brought high-needs students back to in-person learning, many of Lawrence’s school nurses have returned to their schools, while also continuing to contact trace and work at the vaccination clinics. Lawrence has a goal of returning to in-person learning in April, starting with elementary students.

Nancy mentioned that the one of the most challenging parts of the pandemic has been staying current on the constantly changing guidance surrounding COVID-19 safety. She credits the Massachusetts Department of Public Health (MA-DPH) for running weekly webinars. She regularly applies the information she gains in these webinars to the schools and community. School nurses have been continually pivoting their practice to keep up with the latest guidance, and to disseminate accurate information to the school community.

A Thank You:

School nurses work at the intersection of education, public health, and skilled nursing services. It is for this reason that they are uniquely prepared to respond to public health crises. The school nursing team in Lawrence has applied their specialized knowledge and skills to ensuring access to care through providing food and health services to the community. They have focused on disease prevention through their contact tracing work, and health promotion through their efforts at the vaccination clinics. Their whole community approach keeps students in the center, always aiming to ensure they are safe, healthy, ready to learn, and able to return to school.

The community would like to sincerely thank each and every one of the Lawrence school nurses for their time, efforts, and smiles.

Written by Hannah Burgess

PEABODY SCHOOL COMMUNITY, A STORY OF TEAMWORK

Peabody School Community, a Story of Teamwork

Peabody, Massachusetts:

Peabody is a vibrant city in Essex County, along the North Shore region of Massachusetts. With 17.1% of their population under the age of 18, and a blossoming school system, Peabody is the perfect place to raise a family.

Since families within the area rely heavily on the schools for quality education as well as a sense of community, the district felt it was very important to keep students in school.

Collaborative Health Approach:

Prior to the pandemic, because school nurses work within Peabody’s health department, the school nursing team already had a strong working relationship with other members in the department. Health department staff and school nurses have always collaborated on seasonal flu campaigns and any other prevalent infectious disease prevention within the city.

Over the last several years, Brenda Wolff, RN, School Nurse Leader in Peabody, has been working to bridge the gap between the school district and community health at large. Brenda has been collaborating with Chassea Robinson, RN, a Peabody public health nurse, to create an immersive community health program that focuses on promoting a healthy community, which then leads to a healthy school community.

Having school nurses employed within Peabody’s health department has benefited the entire community. This model was especially important when the SARS-CoV-2 pandemic hit Peabody, allowing for a smoother transition into pandemic life than what would have been the case without it.

Transitioning into a Pandemic:

Like many other communities across the state, at the start of the pandemic, school nurses and health department staff in Peabody began contact tracing and investigating positive COVID-19 cases. The cohesiveness between the two teams allowed for a more personal approach to school community safety. The school nurses have strong established relationships with members of their school communities. This allowed community members to speak over the phone with nurses they were familiar with, making for more comfortable conversations for all parties.

As summer 2020 arrived, the school nurses shifted their focus toward a safe return to school in the fall for their students and staff. Because the Peabody health department structure gives school nurses direct access to department resources, school nurses could readily ask experts directly about air quality concerns and could ask health inspectors to assess workplaces and environmental exposure based on their knowledge of COVID-19 transmission.

Schools in Session:

The devoted efforts of the school nurses and health department in Peabody paid off. Peabody Public Schools were able to implement a hybrid learning model in September, allowing all students to return to the classroom two days per week, separated into two separate cohorts. One cohort attended in-person learning on Mondays and Thursdays, and the other on Tuesdays and Fridays. Wednesdays were fully remote for all students. This model allowed time for nurses to contact trace and investigate potential positive cases efficiently, because there was enough time between in-person sessions for students.

Case Investigation:

In October 2020, Peabody Public Schools had a positive case in the school system. As the school nurses began investigating the case, they noticed an alarming number of touch points and close contacts with this case, all occurring within the school building. Brenda and Chassea worked closely together to investigate the large complex ripple effect that emerged from this single positive case.

A New Perspective:

Understanding the reach that single case of COVID-19 had in the school community was overwhelming. Chassea used the information from the case to create a visual aid to help the team better understand the extent of the exposure. The graphic she created resembles a tree, with the positive case being the trunk. The groups of exposures are the branches, and the rectangular offshoots indicate individual potential exposure touchpoints. This image helped the school nurses identify clusters of exposures and narrow the questions they asked while contact tracing (i.e., “what places did you go on X day?”, “what tasks did you do?”, “who were you with?”, and “how long were you there?”).

The graphic also changed the perspective of many community members in terms of the impact a positive COVID-19 case could have. It allowed people to better understand the dangers and risks associated with COVID-19 transmission. As Brenda noted, “you can’t underestimate the powerfulness a visual can provide for someone.”

The graphic also became an effective method to collect, analyze, and use COVID-19 transmission data to ensure meaningful health outcomes for Peabody’s school community. Brenda and Chassea presented their case study and diagram at a regional nurse meeting, making it possible for other school nursing teams and boards of health across the state to adapt and apply the approach to their districts.

Applying What Was Learned:

The visual tool was a learning moment, not just for case investigators, but for the Peabody public school system as well. While the school department had been diligent in its implementation of all the safety recommendations from Massachusetts Department of Public Health and Massachusetts Department of Elementary and Secondary Education, the visual depiction provided an opportunity to identify gaps and to strengthen protocols.

After analyzing the graphic, showing the spread and exposure from the positive case, the administration decided they needed to rethink the use of their staff within school buildings. There needed to be a better understanding of how many staff members were in the buildings, how lunchrooms were being accessed, how tasks were being delegated, and how school spaces were being used throughout the day. Brenda mentions how, “it was honestly a blessing that the case that inspired the visual happened early on in the school year.” School leaders were able to quickly make the necessary and appropriate changes early in the hybrid learning model, so the potential for spread could then be better controlled and the learning environment could be safer for all students and staff. The Superintendent also noted the value of this approach, as large numbers of close contacts would inhibit the ability to keep schools in session. These changes in protocols, done in collaboration with the health department, helped to hinder the possibility of spread within the classroom.

The School Year Carries On:

Since October 2020, Peabody has not had another positive case within a classroom setting that resulted in the extensive exposure shown in the case detailed earlier. Thanks to the revision of policies and procedures the district made because of the case investigation and visual tool, the school nurses were able to improve student and staff safety. The Peabody K-5 students returned to fully in-person learning on March 29, 2021, and middle and high school student returned on April 7. The school nurses have amped up their disease surveillance and revised all safety measures to constantly ensure quality improvement.

The strong relationships between the schools and the health department in Peabody inspired innovation during these difficult times, which has led to a safer school community. The problem-solving skills the team demonstrated over these past few months has allowed for a supportive and optimal learning environment for students and staff.

Written by Hannah Burgess

RELYING ON BROCKTON SCHOOL NURSES: A STORY OF LEADERSHIP

Relying on Brockton School Nurses: A Story of Leadership

Brockton, MA:

With a population of just over 95,000, Brockton is the most populated city in Plymouth County in southeastern Massachusetts. The city has had over 14,000 positive COVID-19 cases and 434 deaths since March 14th, 2020. They currently sit in the yellow zone of the MA COVID risk color-coding system, as they regularly experience more than 10 new cases a day and a positivity rate of 3.06% (https://brockton.ma.us/covid19/).

Since almost 15% of Brockton residents live in poverty and roughly 25% of their population is under the age of 18, the Brockton school community was tremendously impacted by severity of the COVID-19 spread in their area.

Brockton Public Schools experienced difficulty adjusting to the transition to remote learning because of lack of technology, food accessibility, and mental health concerns. Their school nursing staff rose to the challenge and exemplified exceptional leadership skills.

System-Level Leadership:

In March 2020, when schools closed and students shifted to remote learning, Brockton began contact tracing. The Brockton Board of Health turned to the school nurses and asked them to build a robust contact tracing program. Trained in infectious disease, surveillance, and risk reduction, contact tracing was a natural fit for school nurses. While the effort started with only one public health nurse and two school nurses, the program quickly grew to include 11 school nurses from across the city.

In May, the Brockton Board of Health faced a new challenge with the passing of a health officer, and they were in need of a replacement. The Board of Health appointed Linda Cahill as the Interim Executive Health Officer. Linda Cahill, DNP, RN, has worked as a school nurse in the Brockton Public Schools for the past 18 years, and has been the school district’s Nursing Supervisor for 9 years. Although excited for the opportunity, Linda remarked that she did not feel entirely ready to assume this incredibly involved leadership position, while also continuing to serve as the school district’s Nursing Supervisor. Despite her apprehension, her knowledge of public health and her years directing Brockton’s school health program made her the perfect person to fill the role temporarily until a permanent Health Officer could be hired.

Linda’s devotion to lifelong learning, as well as the generous help of her colleagues at the Board of Health, aided her transition into her new role. When Linda was appointed to this interim position, she gained a lot more responsibility. Realizing she didn’t have a full understanding of the duties of the Board of Health, she asked coworkers for a summary of their job responsibilities, so she could better understand how the Board of Health operated. Responsible for new policy development and implementation of COVID-19 regulations citywide, Linda regularly researched guidelines and code enforcement for housing, restaurants, gyms, sports, and pools. She admits that this task was challenging, in part because the protocols were constantly changing.

Linda continued to work as the Interim Executive Health Officer through August, when the Board of Health hired someone permanent to fill the role, allowing her to resume her responsibilities as a school nurse and Nursing Supervisor.

Grounded in Community Health: Whole School, Whole Child, Whole Community (WSCC):

The work being done by Brockton’s school nurses exemplifies the Frameworks for the 21st Century School Nursing PracticeTM model, where nurses focus on children as members of a family and community. Linda and the school nurses are focusing not only on promoting community health by tackling the spread of COVID-19 with contact tracing, but also assisting many impoverished families with food and rental assistance. They hope that these efforts create a ripple effect and improve the health of Brockton students, linking back to CDC’s WSCC student-centered model that emphasizes the community’s role in supporting schools, health, and academic achievement.

School nurses in Brockton have also engaged in other important community health initiatives throughout the past year. In January, Brockton school nurses assisted the board of health with scheduling the city’s vaccination clinics. Linda also highlights a special project some school nurses undertook. The nurses were making phone calls to multilingual families and creating videos about COVID-19 in multiple languages for non-English speaking families.

By focusing on and building a collaborative communication approach, these school nurses have gone above and beyond to increase access to COVID-19 care and resources. Linda is proud of the professionalism and dedication the Brockton school nurses have shown in assisting families in need and promoting the overall health of the community.

Meaningful Academic Outcomes:

Ensuring students are ready and able to learn is paramount to school nursing. During this pandemic, not only have Brockton school nurses focused on building a healthy community through contact tracing and vaccination, but they also helped mitigate acute problems that were interfering with student learning and health.

Technology: Adequate access to technology was a major obstacle to learning when schools closed. The school department had to purchase thousands of laptops for students to learn remotely and for staff to teach remotely. The school nurses assisted with distributing the technology and keeping track of which students borrowed the equipment.

Food: Another critical concern was making sure students were still fed. The school nurses implemented a “Grab-and-Go” food program that allows families to pick up meals at 17 different locations across the city, with the goal of maintaining health equity during the pandemic. Some of the sites now offer breakfast as well, which families can pick up the afternoon or night before. Some sites are also running over the weekend.

Mental Health: The community is also experiencing an increase in mental health concerns. Many children and families are struggling with isolation. School nurses made it a priority to reach out to students and assist them in any way they could, focusing primarily on students with learning disabilities or a history of depression before the pandemic. School nurses collaborated with school counselors, making check-up calls every day to these students. This student-centered coordinated care approach aims to empower students, reduce risks, and improve overall health.

Collectively, these interventions are aimed at ensuring students are safe, healthy, and ready to learn, whether at home or in the classroom.

Back to a “New Normal”:

On April 11, 2021, Brockton students returned to school full time. Linda describes it as, “feeling like the first day of school again.” Having students back in the classroom has created new challenges for school nurses. Everyone – teachers, staff, and students – need ongoing education and reminders about COVID-19 safety protocols (e.g., mask wearing, handwashing). Linda and the school nurses have established medical waiting rooms within the schools, continue to contact trace as much as possible, and begun pooled testing on May 10th. They are juggling many tasks critical to school safety and are conducting continuous quality improvement on the safety measures in place.

School nurses focus primarily on student health, however, as they are often the only health professional in the school building, staff members frequently rely on them as well for information and support. School nurses often are the ones called upon to calm and allay the fears and anxiety of staff members who are nervous about returning to school and unsure as to when they would receive the vaccine. School nurses have been educating teachers on ways to protect themselves, and ways to keep health and safety a priority in their classrooms.

The Brockton school nurses, Linda included, have all applied their unique skill sets far beyond the school to address the challenges posed by the SARS-CoV-2 pandemic. They continue to go above their call of duty to support their community and school district. Their undivided attention to community health has allowed Brockton Public Schools to safely return to in-person learning and improved the ability for students to reach their full academic potential. The Brockton school nursing team deserves recognition for their depth of expertise and devotion to population health.

 

Written by Hannah Burgess

Massachusetts School Nurse of the Year – Denise Schwerzler!

Congratulations Denise Schwerzler, MSN, RN, NCSN of the Weston Public Schools as the 2020-2021 who was named Massachusetts School Nurse of the Year. Denise’s nomination was submitted by school nurses who work and have worked with Denise as well as her Principal John Gibbons.  Denise has led her district during some very difficult times as well as all of her work with the school and her local Board of Health during COVID.

Watch Denise receive her award, along with some heartwarming and well deserved recognition, here. 

Vaccinating Framingham’s Most Vulnerable

Assistant Director of the School Health Unit, Caitlin Pettengill, with Framingham's Mayor, Dr. Yvonne Spicer, and Chief Public Health Nurse, Kitty Mahoney made the local paper for their work in vaccinating Framingham's most vulnerable residents. 

Read the full story here.

CONGRATULATIONS NEWBURYPORT’S DIRECTOR OF NURSING & HEALTH SERVICES CATHY RICCIO

Cathy Riccio BSN, MS, MSN, Director of Nursing and Health Services for Newburyport, who has been named MA School Nurse Administrator of the Year by MSNO. 

Cathy also received a commendation from Governor Baker today for her work in Newburyport during the COVID-19 pandemic!

Thank you to School Nurse Regional Consultant for the Northeast, Shanyn Toulouse for this screenshot!

You can watch the video from today's press conference where Cathy received the commendation here. The presentation begins at about 17 minutes into the video.

Thank you, Cathy, for representing school nurses.