Nurses go the extra mile to deal with H1N1

For PSEA members who work as school nurses, health care aides, public health care workers and hospital nurses, the surge of H1N1 cases this fall in schools and hospitals has made their jobs more stressful and hectic as they struggle to meet the demands of more sick students and patients, along with growing concerns about a possible pandemic.

For school nurses and health aides, the stream of sick children into the health room, along with the monitoring and reporting on the illness, means little time for other regular duties. In some districts, school nurses are also preparing to provide swine flu immunizations to students.

PSEA Legal has advised school nurses and health aides, who hold appropriate state licensure and who are authorized to administer immunizations under state regulation, that they are protected from state and federal liability while participating in clinics for H1N1 vaccinations.

The PA Department of Health and the Centers for Disease Control are providing updates and information to school and hospital health care workers. One of many problems facing health care workers is that students and patients can be contagious for several days before H1N1 symptoms begin, which means others can become infected even before a student or patient becomes sick.

“On the first day of school, I spoke to my faculty and reminded them of good hand washing and other ways to try to curb the illness from spreading. In addition, we made sure information was sent home to parents. The education part is important so they know what to look for and how to stay healthy,” said school nurse Carol Hackenbracht, a member of the Upper Dublin EA in Montgomery County and President of the School Nurse Section of the PSEA Department of Pupil Services.

Hackenbracht says that while H1N1 seemed to have hit the Philadelphia area in the spring, it is now very prevalent in the western part of the state as well.
“We started seeing some cases last year, but we were pretty lucky last spring. The flu seemed to phase out over the summer, but we definitely are seeing it again this fall,” Hackenbracht said  “There are certainly a lot more children absent and the visits to the school nurse are much higher than typical this time of year. Usually you don’t see flu cases until November.”

In Harrisburg, Cathy Sanford is in her 16th year as a school nurse at John Harris High School in the Harrisburg School District.

Sanford says that H1N1 has put her office on “high alert” for flu-like symptoms. “We send students home with fevers, diarrhea, coughing, chills and headaches and inquire whether anyone in their family is currently ill. We are seeing approximately 15 – 20 more students a day in our office.”

She and the other HSD school health nurses have been participating in the scheduled clinics for Harrisburg students. “We had our first weekend clinic on Saturday, October 24 on the John Harris campus. The following week there were two more – one after school and one on Saturday. We have nine more scheduled in the next two weeks (of November), and then we start the parochial schools.”

A significant part of her job, she says, is outreaching to the community. “All of us field a lot of calls from parents asking about the vaccine. We are continuously explaining the importance of young people getting the H1N1 vaccine. As a school health nurse, I feel that right now I am on the ‘front line’ of the education team.”

Hospital nurses on the front lines

Hospital nurses also face a heavier work load and growing concerns about the lack of vaccines, both for patients and workers.

“As the illness shows up in health care facilities, it may become increasingly more difficult to deal with. The vaccine supply is limited and sporadically available right now,” said Beth Pardee, President of HealthCare-PSEA, a Registered Nurse at Indiana Hospital.  “Delays in delivery of isolation supplies, limited supplies of the vaccine, and the possible decrease of health care workers due to their illnesses will all be factors as we deal with this problem.”

In Central Region, school health care workers say they are staying in close contact with nurses in other school districts to monitor the growing number of confirmed cases.

“I think we are just seeing the tip of the iceberg. Our number of absences and students going home sick are definitely up and I think it will just continue to climb. We are seeing about 90 sick children a day, which is almost double what is usual this time of year,” said Dawn Stabley, a school nurse at the Central Mountain Middle School in Mill Hall, and a member of the Association of Clinton County Educators in Central Region.  “We are also trying to keep an eye on our high-risk students and faculty and to make sure that our students and staff are educated about ways to reduce infection.”

School nurses and other health care officials have been receiving information and updates from the PA Department of Health, as well as educational posters, hand sanitizers, and tissues for their schools.

Stabley says that she expects to see H1N1 continue into the seasonal flu season, which will drive up the number of absences at schools into the winter months.

“There are already some schools in the state that have closed for a day or two because of the high number of sick students. Others have postponed after school activities,” Stabley said. “Some school nurses are also being asked to administer the swine flu vaccines, so that will make it even more hectic in the health room.”

Roxann Bentz, a member of the Bucks County Nurses Association, and a Nurse Coordinator- Epidemiology/Communicable Diseases for the Bucks County Health Department, said she is busier than ever just answering phone calls from people trying to find out how and when they can get a H1N1 vaccine. Public health nurses are also working in coordination with school districts to get ready for flu clinics in public schools.

“The Health Department is working with the school district in our county to set up clinics for school age children. There is a lot of coordination that needs to happen so that all of the correct forms and permission slips get covered. In addition, we are trying to answer questions and keep the hysteria under control and ensure that the public has correct information regarding the disease,” Bentz said. 

PSEA continues to post resources on H1N1 and the flu at www.psea.org/flu.