Expert school nurses' experiences of reopening schools during the COVID-19 pandemic: A qualitative study.

BACKGROUND: There is limited information about expert school nurses' experiences regarding the reopening of schools in the school setting during the COVID-19 pandemic. PURPOSE: This study aimed to explore the views and experiences of reopening schools among expert school nurses during the COVID-19 pandemic. METHODS: We conducted semi-structured interviews with five focus groups of 24 school nurses. A grounded theory methodology was used to analyze emergent concepts, categories, and themes. DISCUSSION: We identified five themes related to the experiences of expert school nurses during the COVID-19 pandemic: unprepared response system, fighting alone, centering the response system, redefining roles, and together against. CONCLUSION: Despite the high workload of school nurses during the COVID-19 pandemic, the expert school nurses led to clarification and expansion of the role of the school nurse role, and highlighted the relationships among school staff who were essential participants of the school health team during the pandemic. PRACTICE IMPLICATIONS: It is imperative to shift the perception that school nurses are health professionals who play key managerial roles with collaboration within and beyond the school.

Cultivating Student Belonging and School Connectedness.

The effect on students from the COVID-19 pandemic, violence related to racism, and loss of customary school routines may cause loss of both school connection and a sense of belonging. School nurses can positively influence student belonging and school connection as they encounter students throughout in-person school and virtual school environments. School nurses build connections with students whom they know and outreach to students whom they identify as vulnerable in the areas of belonging and school connectedness. With a mind-set of the Framework for 21st Century School Nursing Practice and in collaboration with a school team implementing a multitiered system of support, school nurses intentionally outreach and cultural sensitivity to grow positive school climate that benefits students.

Advocacy for School Nurses and Student Health and Safety: Highlighting National and State Efforts.

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. The COVID-19 pandemic brought attention to the need to heighten advocacy efforts, specifically to provide for additional school nurses and supplies necessary to meet the challenge of safely returning students to school. While advocating at the national level, NASN also encouraged advocacy at the state and local levels. This article provides a brief summary of NASN's advocacy efforts as well as providing examples from two different state associations demonstrating the importance of collaboration in advocacy efforts in areas related to the pandemic and in general areas related to school nursing.

An Informative Discussion for School Nurses on COVID-19 mRNA Vaccine.

School nurses are advocates, caregivers, and teachers. It is the responsibility of school nurses to understand current prevention and treatment options. In understanding how and why coronavirus disease 2019 (COVID-19) mRNA vaccines work, school nurses are in a trusted position to explain and advocate vaccination to students and their caregivers. The messenger ribonucleic acid (mRNA) vaccine is a product of the latest scientific and medical technology. A better understanding of how and why this vaccination is effective may prevent vaccination hesitancy and provide reassurance to those choosing to accept vaccination. In December 2020, the National Association of School Nurses publicized its support for vaccination against COVID-19. As the COVID-19 pandemic lingers school nurses will step toward the front line to aid in the abatement of poor public health outcomes that may be severely affecting their schools, students, and caregivers.

The Silver Lining of COVID-19.

The 2020-2021 school year has been a challenging year like no other. This article shares one large, suburban school district's experience in using data to make nimble decisions related to COVID-19 (coronavirus disease 2019), and lessons learned from that experience.

Reimagining School Nursing: Lessons Learned From a Virtual School Nurse.

The COVID-19 pandemic has required thousands of public schools to quickly adapt to hybrid or fully remote models. These new models have presented unprecedented challenges for school nurses as they learn how to optimize their interactions with parents and students to provide ongoing support and monitoring of health. The growing reliance on virtual and hybrid public education is also placing new demands on school nurses to be versed in telehealth and school physicians to support their work. Greenfield Commonwealth Virtual School (GCVS) and other public virtual schools have been meeting these challenges for many years prior to the pandemic and have "lessons learned" to share with traditional "brick-and-mortar" nursing staff. GCVS students benefit from a climate that rewards collaboration between the health team, parents, teachers, and administrators, and this article will describe the role, job description, and other practices related to school nursing in a primarily virtual world.

Addressing Stress in High School Students During the COVID-19 Pandemic.

Safety isolation protocols in response to the COVID-19 (coronavirus disease 2019) pandemic have had the unintended consequence of social isolation for adolescents, youth who have a developmental need for autonomy and peer connection. Social isolation alone can lead to various psychological effects such as anxiety, stress, low mood, fear, frustration, and boredom. School nurses serve a vital role in addressing stress among adolescents by initiating early interventions, ensuring positive school experiences for students, and providing support surrounding the development of mental health disorders. Through implementation of NASN's Framework for 21st Century School Nursing Practice, school nurses address stress among high school students during the COVID-19 pandemic. Innovative interventions can include recognizing signs and symptoms of stress on physical and emotional health, advocating for mental health literacy curriculums, social prescribing, incorporating anticipatory guidance related to health promotion lifestyle practices into each school health encounter, and creating a virtual school health office to reach students while COVID-19 safety isolation continues.

Preparing for a School-Located COVID-19 Vaccination Clinic.

School-located vaccination events (SLVE) have a long history in the United States and have successfully contributed to lower morbidity and mortality due to vaccine-preventable diseases. The school is an ideal place to reach children from all cultures, socioeconomic groups, and age-groups and is conveniently situated in communities for ease of accessibility for students, parents, and staff alike. School nurses play an important role in planning for SLVE and are ideally positioned to initiate this process and provide accurate information, dispelling myths about vaccines. Because school nurses are considered a trusted source of health information by the school community, they can provide valuable education on the impact of vaccination on student and staff attendance. Conducting a successful SLVE requires research, planning, and partnerships, and these partnerships are needed both within the school setting and outside this setting, within the community at large. The proliferation of the current COVID-19 pandemic and the subsequent vaccine production has caused school nurses to take the lead in preparing for mass vaccination clinics in order to help mitigate this serious public health threat. This manuscript describes the process a group of school nurses used to develop SLVE plans in response to a pandemic.

COVID-19: Planning and Postpandemic Partnerships.

The emergence of coronavirus disease 2019 (COVID-19) has highlighted the need for strong partnerships between educators and healthcare professionals to facilitate the reopening of schools. School nurses are uniquely positioned to bridge this gap because of their role as a healthcare professional in the educational setting. Past research identifies the effectiveness of collaborative efforts to serve students by community partners, school system personnel, and school nurses. However, partnerships have been episodic and reactive rather than ongoing and proactive. The circumstances of COVID-19 present an opportunity for school nurses to promote collaboration and planning as an ongoing practice. Recommendations for school nurses to form ongoing public health and school system partnerships, as well as with teachers, parents, and school nursing colleagues, are presented.

Community Health Workers: Connecting Communities and Supporting School Nurses.

For over a century, community health workers (CHWs) have acted as agents of social justice, health care promotion, and change for the underresourced communities they serve and come from. Over 50,000 CHWs are employed in the United States, and this number is growing with the need for CHWs to help fight both the COVID-19 pandemic and social injustice plaguing our nation. Even with many students learning from home, it is crucial that healthcare be integrated into the school system since a child's health greatly affects their ability to learn. CHWs in schools can help overcome community and cultural barriers to connect families to various community resources and provide important health screenings and education. On return to the traditional classroom, the myriad of tasks such as infection prevention, contact tracing, and temperature screening are not feasible for a school nurse to do alone. CHWs may be just the leaders we need to help schools address the challenges faced in 2020.

School Nursing Data Collection During COVID-19.

COVID-19 has affected the 2020-2021 school year for everyone and thrust school nurses into the spotlight. Some school nurses are too overwhelmed to even think about data; others want to collect data differently to illustrate the value of the role of the school nurse. This article provides guidance on data collection during this unique time period. The article is based on a blog originally posted on National Association of School Nurses's website.

Adoption of Emergency Action Plans in Secondary Schools: A Study of School Nurses' Knowledge and Behavior.

BACKGROUND: The adoption of an emergency action plan for athletics (AEAP) minimizes the consequences of injuries. School nurses may play an important role in the adoption of an AEAP. The purpose of our study was to describe school nurse's knowledge and perceptions related to AEAP adoption. METHODS: An online survey, following the Precaution-Adoption Process Model, examining respondents' readiness to act, was distributed to 1228 school nurses to evaluate their knowledge and perception of an AEAP, with N = 131 (10.6%) responding. RESULTS: Sixty-one school nurses were unaware of AEAP adoption at their school. A lack of athletic training services at the school was associated with not adopting an AEAP. The most frequently reported barrier to adopting an AEAP related to finances. When nurses reported perceiving more barriers to adopting an AEAP, their schools were less likely to adopt one. CONCLUSIONS: A large number of nurses were unaware if their school adopted an AEAP. There is a need to improve nurses' knowledge and perceptions to promote AEAP development.

School Nurses on the Front Lines of Healthcare: Infectious Diseases Popularized in the News.

School nurses may deal with students presenting with symptoms associated with infections popularized in the news. Although rare, the implications of missing or misdiagnosing these infections are potentially life-threatening and devastating. We present three students presenting with febrile illnesses associated with neurologic symptoms, a rash, and fatigue, focusing on the initial assessment and management of these students and their associated "hot topic" infection. The authors also discuss two public health organizations, Centers for Disease Control and Prevention (https://www.cdc.gov/) and the World Health Organization (https://www.who.int/), online references for the school nurse to research both emerging and common infectious diseases.

School Nurses on the Front Lines of Healthcare: The Approach to Maintaining Student Health and Wellness During COVID-19 School Closures.

In response to the novel coronavirus disease 2019 (COVID-19) pandemic, most states in the United States enacted statewide school closures, ranging in duration from 1 month to the remainder of the academic year. The extended durations of these closures present unique challenges, as many families rely on the school as a source of physical activity, mental health services, psychosocial support, child care, and food security. While the school doors may be closed, the school nurse can still play a vital role in emergency management. This article discusses challenges and proposes solutions to maintaining student health and wellness during extended school closures due to the COVID-19 pandemic. Furthermore, it is inevitable that until a vaccine for coronavirus is developed and readily available, many schools will continue to see future closures, though likely for shorter periods of time, as they respond to local outbreaks.

Using Data and Research to Heal the Future.

This invited testimony was given during a Robert Wood Johnson Foundation and Campaign for Action meeting held in New Orleans, LA. The meeting was held in conjunction with the Future of Nursing Town Hall in Chicago that focused on social determinants of health. The focus of the meeting was school health and social determinants of health. The author, serving as Director of Research for NASN, was asked to specifically focus on NASN's efforts related to data and research, as well as social determinants of health.

Does Every Student Count! in Your State? Update on the National School Nurse Dataset.

The NASN launched a new data initiative in 2018 called: The National School Health Data Set: Every Student Counts! The initiative includes three distinct foci or prongs. This article reports on the progress of states participating in Every Student Counts! For more information on NASN's initiative and to learn how school nurses can join the data revolution, go to http://nasn.org/everystudentcounts .