Happy National School Nurse Day 2021

You deserve a STANDING OVATION for how tirelessly you have executed your position as a certified school nurse through a school year that will go down in history. Thank you for the love, care, patience, and perseverance through a year like no other.

A student’s vision of a school nurse                    

When a student is asked what a school nurse means to them, how will they answer?

This artwork and the inspiring words below were created by Rebecca Goldman, a sophomore from Twin Valley High School in Elverson, for School Nurse Day. Becca is a member of our HOSA – Health Occupations Students of America organization. You have Becca’s permission to print this picture and display it in your nurse’s office.

School nurses provide way more to the school than some realize. When I was brainstorming my design, I wanted to show the importance and impact of school nurses. I wanted to dig deeper and go beyond the stereotypical norms like Band-Aids and pills, without focusing on this pandemic. Not only do school nurses hold incredible knowledge, they provide safety, care, comfort, and support. They impact individuals, families, schools, and communities, and the painting’s silhouettes of people represent these individuals. They feel connected and important because of the amount of love and care the nurse will give to a student. "Nurses are the heart of the school.” Without nurses in the school, let's be honest, it will fall apart. Students need the sense of safety that the nurse provides. In other words, without school nurses, the world wouldn't be the same. The painting takes a look at all these inspiring aspects of school nurses, the heart representing the love for their kids, the nursing symbol representing knowledge, the heartbeat representing good health, and the stethoscope representing the actions and risk nurses take to ensure the safety of these kids. I believe school nurses are incredible human beings who should be more appreciated throughout society and schools.

 Becca Goldman, Twin Valley High School

 *right click on the image and save as a picture to print for your school health office*

- Alice Uhrich, PSEA School Nurse Section President

Save the Date

This year’s PSEA DPS conference will be held virtually on Aug. 4-5. Look for registration information soon! All courses will be free to PSEA members, and most will be recorded and shared on PSEA’s Online Learning Portal for viewing at your convenience.

Updates: SNS & PA DOH School Health Director Meeting

PSEA’s School Nurse Section (SNS) board, along with PSEA’s Department of Pupil Services (DPS) board, works hard to help Pennsylvania’s certified school nurse members. I’d like to take a moment to share an update from our recent meetings.

We met with Colleen Schultz, the PA Department of Health’s School Health Director and recommended a PENN LINK email be created to explain to school administrators how this year’s SHARRS report may include a statement to cover screenings that were not able to be performed due to COVID-19. Colleen plans to have that PENN LINK ready to be delivered when the SHARRS reporting period opens mid-May.

We discussed ACT 122 of 2020 and learned the process for promulgating these regulations may now take well over a year. Colleen plans to collaborate with both PSEA’s School Nurse Section and PASNAP to review current procedures and current evidence-based practice to formulate a proposal to the Advisory Board.

Colleen shared that she is reviewing the PA DOH Diabetes Training program. The program will need revision with the introduction of Baqsimi, the new nasal glucagon product.

Colleen wants Pennsylvania’s school nurses to be aware that she is formulating an updated Certified School Nurse orientation manual. This will be wonderful for new school nurses and a nice reference for seasoned school nurses.

There was a concern brought to our attention that CSNs were being requested to continue to complete COVID-19 reports after this school year ends. Colleen is speaking with the Epidemiology group for further information for the nurses who have been impacted.

PA AAP & PAIC’s: Stopping the Spread of the SARS-CoV2 Pandemic

Paul A. Offit, M.D., who is the Director of the Vaccine Education Center and an attending physician in the Division of Infectious Diseases at Children's Hospital of Philadelphia, presented the attached webinar.

PA AAP & PAIC’s Let’s Talk Stopping the SARS CoV 2 Pandemic Webinar by Dr. Paul Offit

Packing Her Backpack of Patience

Congratulations to Western Beaver County SD Certified School Nurse, Wendy Robison CRNP, PA-CSN, NCSN. Wendy was featured in a PSEA video describing the work done by certified school nurses during the pandemic to keep their schools and communities safe.

Wendy serves the PSEA SNS board for Midwestern Region and has recently joined the PASNAP board as the CRNP representative.

Meadville Medical Center Teams up With Crawford County School District for Teens COVID Vaccines

(Mary Groshner, North Western Region Rep)

Meadville Medical Center is facilitating the administration of the Pfizer COVID-19 vaccine to eligible students attending four Crawford County school districts. Students in Crawford Central, Conneaut, Penncrest, and Titusville school districts are being offered the opportunity to be vaccinated in April and May. Crawford Central, Conneaut, and Titusville School Districts will be getting their vaccines on-site in their school buildings while Penncrest school students will be traveling to a clinic site at the former Peebles Department Store in Meadville.

Letters and consents were recently sent to all families in the districts. In the letter, Philip Pandolph, President and Chief Executive Officer of Meadville Medical Center, strongly encouraged parents to “allow your child to be vaccinated as it is extremely important for the health and well-being of your child, family, and our community.” Beth Knight, Certified School Nurse at Meadville Senior High School echoes that message; "We are so thankful to MMC for continually working with our schools and providing innovative and convenient vaccination distribution sites to our students, staff, families, and the local community.”

“We are grateful to have Meadville Medical Center as a community partner,” Dr. Timothy Glasspool, Superintendent of Penncrest School District, noted in his communications with schools. Collectively, we can all be thankful for these efforts as they are an important part in the process of getting our schools back to some sense of normalcy for the upcoming 2021-22 school year!

Bus Accident Considerations

(Stacy Chiles, SNS Past President)

It is a good idea to have a district wide plan to be able to respond effectively in the event of a bus accident or an off-property accident.

• The school nurse should not leave their student caseload at the school building. There are likely more students in the school than those that are involved in the accident. And a student with special health needs in the building could need the school nurse to respond at any moment.
• For a student with special healthcare needs, it is prudent to plan for transportation delays and emergencies as part of the student's Emergency Care Plan. If you already have a district plan in place you can specifically reference this in the students’ ECP.
• When EMS is called, the school nurse relinquishes care to EMS when they arrive on site.
• A PHRN is a prehospital registered nurse who has passed both a written and a skills test to obtain a PHRN certificate to perform basic and advanced EMS skills. This would be outside the scope of practice for a school nurse.
• Coordinate with your local EMS agency to ensure that all parties are aware of policies and procedures.
• If you have more than one licensed nurse in your school, it may be possible to send a nurse to the scene to assist with documenting, making calls, and providing care that is within their scope of practice and training.

As the medical professional in your building, the CSN is an essential part of the planning team. Your knowledge and expertise is vital to make a safe plan to respond to unexpected off-grounds situations.

Symbol of the Times

(Wendy Robison, Midwestern Region Rep.)

“While conducting an additional vision screening for ‘my littlest humans’ I found many of them identifying this common item in a new way. It speaks to the world they are shaped by now. They have called this a - broken mask - instead of a cup.

Data Coding During COVID

(Wendy Robison, Midwestern Region & Alice Uhrich, SNS President)

We don’t know what the future will hold for COVID in our schools but if you haven’t already done so, it may be helpful to recode your electronic health records (EHR) to accommodate COVID nursing duties. Coding will make it easier to compile the data to present to your administration.

Also, some high school students have already received the COVID-19 vaccine, and more will be receiving it this summer. Take a moment to review your EHR’s immunization component and have your technology department update it to accommodate a place for the COVID vaccines to be recorded.

Medical Reserve Corp

(Karen Flad, SNS Vice President & DPS Secretary)

This past year the Chester County Medical Reserve Corp. has utilized school nurses in a variety of volunteer opportunities that have assisted their county in providing a wide variety of COVID care opportunities for their citizens. The Medical Reserve Corps (MRC) is a volunteer group consisting of medically and non-medically trained individuals who support public health operations throughout Chester County. Volunteers in the MRC serve in both clinical and non-clinical roles based off the support needs of the Chester County Health Department. School nurses who have signed up as members of the MRC have served not only as vaccinators, but as greeters, working the post vaccination observation areas and assisting at scheduling and screening stations.

Chester County currently has the highest percentage of its population vaccinated and has been very appreciative of those school nurses who have volunteered their time and talent.

Weekly Assurance Testing for Staff and Students

(Marisa Green, C.S.N., M.Ed., North Penn School District, Mideastern Region Representative)

In collaboration with the Montgomery County Office of Public Health (MCOPH) and Children’s Hospital of Philadelphia (CHOP) Policy Lab, North Penn School District began providing voluntary rapid testing for COVID-19 with staff members during the week of Jan. 18, 2021. Given the parameters of specific sports and the potential need to travel frequently on buses, student testing is mandatory for athletes in particular sports. Students who participate in arts programs such as theatre, band, and wind ensemble, as well as students attending the senior prom must also be tested.

Participants must register with the Penn Rapid Test web application to generate a QR code that is used whenever tested. Their demographic data and answers to clinical questions just prior to testing each time are entered into the app using a district IPAD and sent immediately to a secure server. This data does not remain on the device being used.

The testing program uses Abbott BinaxNOW Antigen Immunoassay test cards as a screening tool to detect the presence of a specific viral antigen (SARS-CoV-2). The credit card-sized rapid antigen test involves minimal nasal swabbing, and the results are available in 15 minutes. The actual testing/swabbing takes less than 25 seconds. Rapid testing for staff is scheduled before and after student arrival. Notification of results are sent via email and text within two hours. However, if someone is identified as being presumptively positive, they are notified in person by their administrator and are administered a CUE Health’s COVID-19 test. The result of the CUE test is obtained in approximately 20 minutes and is used as a confirmatory molecular test. If confirmed positive with the CUE test, individuals will isolate as directed by the MCOPH and North Penn School District protocols.

Principals and nurses in each of their assigned schools set up the weekly program for one or two days. Participation varies anywhere from 50-85% in each building throughout the district. Coupled with the convenience and benefit of testing, Superintendent Dr. Curtis Dietrich has permitted any staff member participating in weekly testing who tests positive and is physically able to work can do so virtually from home without using sick time.

North Penn’s success in the Assurance Testing Program is in part due to the support that the nurses have received from their building administrators who are involved with all testing. Dr. Neil Broxterman, Special Education Supervisor and Special Projects administrator, is the liaison between the MCOPH and CHOP’s Policy Lab. He has developed protocols and procedures for testing, trained staff involved in all aspects of testing, and created permission forms and FAQs for parents in collaboration with district nurses and leaders. Dr. Dietrich’s support from the beginning of the project has been crucial to the overall success and continued efforts to leverage this tool to help our safe return to in-person instruction.

Assurance testing is one of many tools for making in-person instruction safer. It provides a sense of safety and security among staff and students knowing that they are not positive for COVID. Individuals who are asymptomatic and test positive are identified immediately and isolated, and as a result schools can remain open thus maximizing in-person instruction for students.

PA Coalition for Oral Health (PCOH) Basic Screening Surveillance (BSS): Fall 2021 or Spring 2022

Deb Barr, retiring President of the DPS Dental Hygienist Section, has shared this important information with school nurses. PCOH would like the support of superintendents, teachers, and school nurses to carry out this important state assessment of our children’s oral health needs.

Our state has been given an abysmal rating in all things dental related. During the 2021-22 school year, the PA Department of Health, in cooperation with the PA Department of Education, is conducting a statewide assessment of the oral health of elementary school students. This Basic Screening Survey (BSS) is an attempt to utilize a valid tool to collect surveillance throughout the state as to the dental health of our third-grade students. The Pennsylvania Coalition for Oral Health (PCOH) has been asked by the Department of Health to be the contractor for this initiative under a CDC grant. The BSS tool was created by the Association of State and Territorial Dental Directors (ASTDD) to assist state and local public health agencies to monitor the burden of oral disease at a level consistent with the Healthy People objectives. This screening tool is not meant to replace the more thorough evaluation that is required by those mandated by the state in third grade. It is hoped that the acquired BSS statistics will help to drive future oral health initiatives in our state.

There is a list of 80 schools that have been chosen throughout the state based on a randomized selection by the ASTDD of districts of different socioeconomic backgrounds. This was done to give more validity to the study. In addition, this is a tool that has been used around the country to assist in determining the status of children’s oral health and has been shown to have validity by the ASTDD and by the CDC. This tool can be used to compare the results with other states. The statistics that are collected for SHARRS are not the same statistics that are collected by this study nor by most other states. Also, the statistics that we collect for SHARRS are data, not surveillance. There is a difference. In a surveillance study, all examiners are calibrated. This is necessary for comparable data.

PCOH understands that minimal class disruption is essential in the operation of schools, especially considering the pandemic’s impact on the education system. Because of this, each school will only be asked to participate from grades one to three, depending on the enrollment in third grade (selected schools vary from 30 students to 300 students). Schools will incur no cost for participating; the screenings will take place on-site at the elementary school.

Best Wishes and Welcome - Thank You

Best Wishes and Welcome

Lin Wesolowski, who was the Southeastern Region representative for the past few years, has retired from school nursing. Thank you, Lin for all the work you did on the School Nurse board. We wish you the very best in retirement.

Deb Weber, who works in the Owen J. Roberts School District, will join the SNS board as the Southeastern Region representative. Welcome, Deb!

Thank You 

Once again, I want to thank every school nurse in the commonwealth. The COVID-19 pandemic certainly highlighted the importance of nurses, and especially the importance of having a school nurse in every school. The end is in sight. Remember you will still need that backpack of patience to push through into June. Have a wonderful remainder of this school year, and I wish all of you the best summer! Hope to see you at our conference in August!

We Value You!

Remember you have an important and valued voice in your union. Please reach out to your region representatives with questions or suggestions to be brought to our statewide board!