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The success of in-person school this fall relies in part on school nurses. They're often the first people kids go to when they don't feel well, and lately, they have been busy. Lots of school nurses are working with their districts to make tough choices about the coming school year, but some don't have much of a say. NPR's Clare Lombardo reports.
CLARE LOMBARDO, BYLINE: Ask a school nurse what they've been thinking about lately. You might hear something like this.
EILEEN GAVIN: Bussing is a concern.
GLORIA BARRERA: Water fountains, contact tracing - ventilation is also a big concern, maybe grab-and-go meals.
DAWN MACADAMS: It's very daunting and overwhelming.
LOMBARDO: That was Eileen Gavin, Gloria Barrera and Dawn McAdams, school nurses around the country. Gavin leads a team of nurses in New Jersey. She says she's been a big part of her district's plans for the fall.
GAVIN: I feel as though it's a rabbit hole. Once I go down the hole, I think I solved something. There's another issue with that, so we go down that hole. It seems endless.
LOMBARDO: Things like hallways in a high school with thousands of teenagers.
GAVIN: I know to avoid those hallways (laughter). On a normal school year, you could just get picked up by the crowd.
LOMBARDO: But she says masking protocols and one-way hallways could help decrease transmission.
GAVIN: Honestly, I feel like - would you want your child to return to a school where a school nurse was not part of the plan?
LOMBARDO: Gavin says she feels lucky to have a voice in her district's reopening because there are lots of other school nurses that aren't involved in decision-making, like Colleen. She leads a team of school nurses in Texas, and she says she asked her district leaders if she could give her input.
COLLEEN: Overwhelmingly, the response has been, well, let us get some decisions made. And then once the big decisions are made, you and your nurses can implement plans around that.
LOMBARDO: We're using her middle name so she can speak freely about her employer.
COLLEEN: They're our kids. We care for them. That's what we do. It's why we're in this job.
LOMBARDO: But Colleen isn't the only one who feels left out of the decision-making. In April, back when lots of schools were closing their doors, the National Association of School Nurses took a poll. They found that 40% of school nurses were not involved in the discussions in their school districts around COVID-19.
COLLEEN: A lot of school districts don't even realize the resource that they have on their staff as a specialty public health nurse who knows their campus community and culture.
LOMBARDO: Colleen says school nurses need to have a voice in big decisions like whether to resume in-person classes and how to do that safely.
COLLEEN: The conversations that they're having now - man, this is the stuff that nurses gear up for.
LOMBARDO: But sometimes there isn't even a nurse on staff. Just half of all schools have a full-time nurse. And this fall some who already work in schools can't because they're high-risk for COVID-19, so the need for more nurses will be even greater.
MACADAMS: But you need funding for that, you need money for that, and you need personnel. But right now the need is very high in the hospitals for nurses.
LOMBARDO: That's Dawn McAdams, who oversees health programs in her district outside Columbia, S.C. She says it's not just staff that schools need money to pay for this fall.
MACADAMS: We also need funding for the PPE. I mean, the amount of masks, face shields, gowns, gloves that are going to be needed by districts, hand sanitizer, cleaning supplies - it's very overwhelming when you think of the cost.
LOMBARDO: And here's the thing. Even if schools got all the funding they need, there are still lots of unknowns.
MACADAMS: Heaven help us when the regular flu season hits and you have a blur between influenza or influenza-like illness and COVID-19 symptoms.
LOMBARDO: So for now school nurses are just doing the best they can to prepare.
GAVIN: I do feel the weight of the world and the weight of my community as we return to school at that we're doing everything right; that, you know, there was nothing else that we could have done if there is an outbreak.
LOMBARDO: But Eileen Gavin says that feeling would be much worse if she didn't have a say in her district's plans. Clare Lombardo, NPR News. Transcript provided by NPR, Copyright NPR.
