What School Nurses Are Saying About Back to School

Back to school brings bandages, bumps and bruises, but it also brings meeting students’ needs for sensory challenges, chronic conditions such as diabetes and food allergies, emotional needs such as anxiety and depression, and battling infectious diseases — including COVID. What should families know for the 2022-2023 school year? These school nurses will tell you themselves.

School nurses need up-to-date information on a student’s needs — including medical conditions, changes in the home, and other factors that could affect the ability to learn and to stay healthy. “The school nurse should really know about any medical, emotional or behavior concerns,” said Barbara Conley, nursing director for the Burlington school district.

The district’s health services team includes 15 registered nurses, a medical assistant and certified nurse’s aide, and an administrative medical assistant. This school year, the nursing staff expects to serve 3,600 students.

“We should know their child. That would really foster growing development of the child. We can’t do that if we don’t know what is going on with their kid. A healthy child will learn,” Conley said.

“If there is a change in the child’s health status, let us know,” said Elizabeth Quaratiello, school health services director of the Somerville school district. A total of 17 registered nurses, an enrollment screening specialist and nurse manager are ready to serve a projected student population of 4,700. “If it’s a diagnosis of asthma, or diagnosis with a life-threatening illness, or diabetes — it’s so important to tell the school nurse,” she said.

“Our biggest priority all year long, but especially at the beginning of the year, comes down to safety,” said Sarah Bolduc, school nurse at Minuteman High School in Lexington. The vocational school district serves Lexington, Acton, Arlington, Bolton, Concord, Dover, Lancaster, Needham, and Stow. Bolduc and fellow registered nurse Annie Quill serve a school population of about 700 students as well as 20 preschool students as part of the school’s early childhood program. Here are the three most important things school nurses would like parents to remember:

1. Nurses are there to help, so contact them. Bolduc said, “Make sure physical exams are sent in, immunizations, and action plans for conditions like diabetes.”

“Make sure you communicate with your school’s nurse about medication, and any issues your child has,” said Joanne Chadwick, chair of health and nursing for grades 7-12 at the Acton-Boxborough school district. Chadwick works with Diane Spring, nurse leader for grades pre-K-6. The school district has 11 registered nurses covering nine clinical centers throughout the district, serving about 6,000 students.

“Make sure records are up to date through the school year. Try to keep up to date with medical issues around any changes. If anything changes in your family, please let us know,” Chadwick said. The nurses said schools are increasingly diverse, and nurses are serving students of many cultural backgrounds, as well as with myriad health needs. The nurses urged all families to reach out to keep nurses informed of any factors that can affect a child’s health, behavior, and success at school. Nurses can also help link families to resources such as getting answers about insurance, and access to vaccinations.

“We’re evaluating students with special services, providing mandatory screenings for vision, hearing and [body-mass index.] Another big thing is we assist families in accessing health insurance and care services, and if they have newly moved in, and need help with MassHealth,” Conley added.

2. Vaccinate kids against COVID, and keep them home if they’re sick. Although the state does not require students to get COVID vaccines, school nurses urge parents to vaccinate children, and to understand COVID is not going away. “COVID-19 is still a thing,” said Bolduc. “That has been the biggest change, and that has continued to be a big piece of our day.”

The state is discontinuing COVID testing programs and contact-tracing, but nurses said testing and reporting results remain vital. Leigh McGillivray, a nurse at the Marshall Simonds Middle School in Burlington, with a knapsack that nurses bring on field trips, Aug. 31, 2022.

“Just because they’re negative for COVID, doesn’t mean they should come to school.” Conley added, “Fever, cough, if they are clearly ill … just because they’re COVID-negative doesn’t mean they’re not ill with something else.”

“If you don’t know if they need to stay home, call the nurse. If you have a question about when they should return, call the nurse,” Quaratiello said. “A child may be feeling better and have a negative test, and be perfectly ready to come back. But, maybe there is more to the story. Maybe if they were exposed a few days ago, there are just other facts to consider now.”

3. Keep them in the loop about allergies and medications. School nurses still provide many traditional services, such as treating students for cuts or falls. But students are coming to school with more complex needs. “We have kids who need help with assistance devices — walkers, wheelchairs, braces, things to help them with movement and mobility. We have children with feeding tubes and feeding issues, food allergies,” Quaratiello said.

Many allergies can affect children, but in schools, food allergy concerns predominate. “I think around 6-7% of our students have diagnosed life-threatening allergies. That’s a huge portion of the student base,” said Quaratiello. “That is a lot of restrictions on what kids can eat, and who needs to have an EpiPen.”

A critical part is communicating with the school staff as a whole. “If the kid frequently comes up and says ‘I need to go to the nurse,’ they know what is going on — about the administering of medications, monitoring medications,” Conley said.

Allison Green
Boston Tutoring Services