School nursing in a pandemic: a 24/7 job

BOSTON — From transformed sick visits to contact tracing, the role of the school nurse during the COVID-19 pandemic is as important as ever.

In the Natick School District, students are on a hybrid schedule, rotating between in-person and remote weeks. But the district’s 16 nurses are not just working when kids are in the building; their jobs are around the clock.

“It’s become a 24/7 job,” said Nicole Marcinkiewicz, director of nursing for Natick Public Schools. “It’s non-stop. COVID doesn’t rest and neither do we.”

Marcinkiewicz has been a school nurse at Natick High for 17 years. While she has always taken her job seriously, she knows during this unprecedented school year, she and her coworkers are helping keep the doors open and the community safe.

“It’s crucial and it’s critical,” Marcinkiewicz said of her and her staff’s work. “And having a nurse here is why the schools are open.”

The bulk of the nurses’ work is contact tracing and making sure students and staff members who have tested positive for COVID-19 or who may have been exposed are quarantining at home, according to protocol. Two remote nurses lead the effort and answer questions on a hotline.

“The challenge is the logistics and keeping track of who’s out and who’s due to come back in,” Marcinkiewicz said. “And we spend an amazing amount of manhours managing who’s in the building and who’s ill.”

Plexiglass dividers separate desks in classrooms, and hand sanitizer stations are in hallways. Each school building has an isolation room for potentially ill students. Students wear masks, and lunch is no longer served in school buildings to minimize exposure. In-person classes end before lunch and pick up remotely afterward.

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Sick visits look entirely different, too. Teachers call ahead when a student is heading to the nurse’s office to make sure the office isn’t at capacity. There, nurses in protective gear assess the student for potential symptoms of COVID-19 and determine if the student can be treated and return to class.

“If we do have ill students, we whisk them into an isolation room right away,” Marcinkiewicz said. “And we expect a quick pick-up and refer them for testing.”

School nursing in a pandemic: a 24/7 job

At the beginning of the school year, Natick High School switched to remote learning for two weeks after some students who may have been exposed to the virus went to parties and did not quarantine. But that was the only hiccup thus far, Marcinkiewicz said. Of all the COVID-19 cases the district has had, no one has caught the virus in school buildings, she said.

Marcinkiewicz attributes that success to what she calls strict measures the district has implemented, along with state-required protocols.

“Nobody could’ve expected this year,” Marcinkiewicz said. “But it’s panned out better than ever.”

Each morning, staff members, parents and guardians must answer questions about symptoms and exposure on a Ruvna app before staff and students can enter their school building.

“The nurses in the district all spend their mornings reviewing the failed Ruvnas, who’ve been denied based on symptomology,” Marcinkiewicz said. “And they call those families and staff members to double-check if they have these symptoms, and we refer them for testing.”

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The district’s latest safety measure is contracting with a local urgent care to get symptomatic staff members prepaid rapid COVID-19 tests. The goal is, if the test comes back negative, the staff member can return to school more quickly, a game-changer for keeping teachers in the classroom, Marcinkiewicz said.

With cases rising statewide and locally, the nurses’ workload isn’t diminishing. Nor is their sense of duty to keep kids in school and the community safe.

“How proud, how proud to be a nurse,” Marcinkiewicz said. “Most of us come from other institutions and end up in school nursing. And we are an exceptionally professional bunch of nurses who are just proud to be here in this moment and keeping schools open.”

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