Not long ago, Denver Public Schools nurse Rebecca Sposato was packing up her office at the end of a difficult school year. She remembers looking around at all her cleaning supplies and extra masks and thinking, "What am I going to do with all this stuff?"
It was May, when vaccine appointments were opening up for the majority of adults and the Centers for Disease Control and Prevention were loosening mask guidance.
"I honestly thought we were trending down in our COVID numbers, trending up in our vaccine numbers," she says. "And I thought the worst was over."
Now, four months later, the pandemic is already upending the new school year across the country, as the highly transmissible delta variant continues to cause a spike in cases. In Arizona, coronavirus outbreaks are forcing thousands of children and teachers to quarantine. In Georgia, many districts that began classes in-person without mask mandates switched back to remote learning after the virus spread. And in Oregon, some districts delayed the start of the school year after teachers were exposed to possible infection.
School nurses are tasked with caring for the health and safety of children at schools, and managing a third school year in a pandemic has put even more strain on those in a profession already facing staffing shortages.
It's Groundhog Day for overwhelmed school nurses
Katherine Burdge is a school nurse in Tampa, Fla., where classes started at the beginning of August amid a struggle between school districts and Gov. Ron DeSantis, who threatened to cut state funding for public schools that required students and staff to wear masks.
A judge ruled that DeSantis' executive order banning mask mandates was unconstitutional, but Burdge says school nurses are "dealing with the repercussions" of the back and forth. Her district of Hillsborough County had to isolate or quarantine more than 13,000 students and staff in just the last month — over 2,500 of whom tested positive for the coronavirus.
"We're dealing with COVID on the front lines every day," she says. "It's a serious manifestation that is just overwhelming the district, the state, everybody."
Eileen Gavin, a school nurse in Monmouth County, N.J., also says it's been overwhelming and cites a beat up and faded "Parking For School Nurses Only" sign as a visual representation for how she and other school nurses are feeling.
"It's kind of like Groundhog Day: another year of contact tracing and vaccinating and kind of leading the kids back to school safely," Gavin says. "So, I do think we are traumatized."
Nurses are caught in the crossfire between parents and public officials
Gavin says nurses continue to show up and do their jobs, but are feeling the strain of a workload that has expanded beyond what they could have predicted.
"It really is a lot to bear," she says. "We are the only healthcare professional in the schools and we have input and weigh in on so many things."
Gavin says she spends a lot of time talking with parents to help them sift through "the noise and the misinformation and give them valid resources" on dealing with the coronavirus.
"We assist in giving them the information so they can make an informed decision to keep their child healthy and safe," she says.
Burdge, who's also the President-elect of Florida's School Nurses Association, similarly says that school nurses want to be a resource for parents, but that the fight over masks between public officials in her state has caused some grief.
"We don't want to have those nasty words or fights or debates or anything along those lines with them," Burdge says. "We are a resource for them, and open communication, I think, is key at this point."
Sposato says that where she is in Denver is "very pro mask." She thinks Burdge's experience dealing with outbreaks — likely intensified by DeSantis' order to eliminate mask mandates — indicate "why we need to be following the health guidelines and scientific evidence on this," she says. "The health guidelines work."
Fears over the safety of students and staff have grown going into a third pandemic school year
Sposato says her greatest fear heading into this new school year "is that one of the mutations is going to outflank the vaccine, and we will see steeper, higher numbers of COVID being present in our community."
Gavin says her biggest fear is over school closures. "Kids need to be in school. We need to be in school," she says. She hopes that putting layers of protection in place will allow the year to commence safely. "We need to kind of stand firm with that so that we can keep our schools open for our kids.
Burdge says school closures are on everyone's minds, but that she's also concerned "for our nurses and their safety and well-being — that we are going to get burnt out."
"Our school nurses are exhausted," Gavin says. "I think last year I had said school nurses felt like the weight of the pandemic was on their shoulders. We're on our knees now, with the weight of the pandemic on our shoulders."
ARI SHAPIRO, HOST:
It's only the first week of September, and the pandemic is already upending the school year. In Arizona, coronavirus outbreaks are forcing thousands of children and teachers to quarantine. In Georgia, many districts that began classes in person switched back to remote learning after the virus spread. And in Oregon, some districts delayed the start of the school year after teachers were exposed to possible infection. School nurses are often on the frontlines of these challenges, and we're joined now by three of them. Katherine Burdge is in Tampa, Fla., Eileen Gavin is in Monmouth County in New Jersey, and Rebecca Sposato is with Denver Public Schools in Colorado.
Good to have all three of you here.
EILEEN GAVIN: Thank you for inviting us.
KATHERINE BURDGE: Thank you.
REBECCA SPOSATO: Thank you. We're glad to be here.
SHAPIRO: How was preparing for this school year compared to last year? I mean, we now have vaccines, but we also have the much more contagious delta variant.
SPOSATO: This is Rebecca. I remember in May, looking - when I was closing out my office, looking at my cabinet of excessive cleaning supplies and masks going, what am I going to do with all this stuff?
SHAPIRO: Won't need those anymore.
SPOSATO: I honestly thought we were trending down in our COVID numbers, trending up in our vaccine numbers. And I thought the worst was over. Our district and myself started to realize, you know, in August that we were trending up again, and we are all hands on deck about keeping COVID mitigated in our schools.
SHAPIRO: So that's the view from Colorado. What about in Florida and New Jersey?
BURDGE: I can say in Tampa, we have already started school throughout the state in Florida as well. We went back beginning of August. It's more overwhelming this year. We do not have the e-learning option as we had last year across the state. So we are now having more of our ESE special needs population come back, which require at times different medical procedures and treatments to be done on a daily basis in the clinic, as well as having our children come in for their daily medications, dealing with COVID and dealing with just everything else that school nurses do, our health screenings and all with pretty much - we're talking about a skeleton crew. School nursing has a shortage to begin with, and this is just making it that much harder for all of us.
SHAPIRO: Eileen, what does it look like from New Jersey, where you are?
GAVIN: I think last year I had said school nurses felt like the weight of the pandemic was on their shoulders. We're on our knees now with the weight of the pandemic on our shoulders. It really is a lot to bear. We are the only health care professional in the schools, and we have input and weigh in on so many things.
SHAPIRO: As the health care professionals who are embedded in the schools, do you feel like you are also on the frontlines of the debates over mask mandates and vaccination policies? Are you clashing with parents, other teachers, students, administrators about that?
SPOSATO: I feel that Denver proper is very pro-mask. But I know some of the surrounding counties are having much more heated discussions about people resisting mask mandates.
SHAPIRO: Katherine, what's your experience been in Florida?
BURDGE: We had a ruling last Friday stating that our governor had overstepped his boundaries in not allowing masks in schools. So we're dealing with the repercussions of that right now. We have your counties that are for masks, your counties that are for against masks. And then you have everything in between, where counties are split on that. So we want to be a resource for parents. We don't want to have those nasty words or fights or debates or anything along those lines with them. We are a resource for them. And open communication, I think, is key at this point.
GAVIN: I really spend a lot of time with parents that come to me and help them shift through the noise and the misinformation and give them valid resources so they can make an informed decision to keep their child healthy and safe.
SHAPIRO: Katherine, I know your district in Florida had to isolate or quarantine more than 13,000 students and staff, and over 2,500 tested positive. Can you walk us through where things stand now and how serious this was?
BURDGE: So currently where we're at is that we do have a mask mandate with a health opt-out from a health care provider - can sign a waiver for that. Our numbers are high. They're high across the state. So that led to having an emergency meeting to have a mask mandate issued in our county. So we are dealing with COVID on the frontlines every day. It's a serious manifestation that is just overwhelming the district, the state, everybody.
SHAPIRO: Rebecca, what's it like for you to hear about what Katherine is facing in Florida?
SPOSATO: I think it's important that - it indicates why we need to be following the health guidelines and scientific evidence on this. The health guidelines work.
SHAPIRO: We've heard so much during this pandemic about burnout among doctors and nurses. And even though you're not working in ICUs, you are still on the frontlines of this crisis. How are you all holding up?
GAVIN: I do have to say there's a picture of a parking sign, and it says parking for school nurse only. And it's all dented and beat up and faded. And it really does give that imagery of how we are feeling. But we really rely on our colleagues and our associations to support us through another year. It's kind of like "Groundhog Day" - another year of contact tracing and vaccinating and kind of leading the kids back to school, you know, safely. So I do think we are traumatized, you know, to use that term. We are traumatized, and we - just like the children are, just like the teachers have, just like everybody has been with the pandemic. And just like our front workers in the hospital have, we do continue to do our job. We show up, and we continue to do our job. But we are feeling it.
SHAPIRO: Katherine, Rebecca.
BURDGE: This is Katherine. I'd have to agree with Eileen again on this - that school nurses are our biggest cheerleaders. We champion and cheerlead ourselves to each other and stuff. And I think that that's truly important that we know that we are not alone. We've always been there for each other. But now during this time, more than ever, it's important.
SPOSATO: This is Rebecca. I have said for the past seven years, I got the best job in the world. I'm a school nurse. And I still say that, and I still mean that. But we are the only health officer for the entire building. And so many of us - we are just a one-person show. And the stakes are real this year.
SHAPIRO: What's your greatest fear or concern about the year ahead?
SPOSATO: My greatest fear is that one of the mutations is going to outflank the vaccine and we will see steeper, higher numbers of COVID being present in our community.
GAVIN: My biggest fear is closures, school closures. Kids need to be in school. We need to be in school and, you know, putting all those layers of protection in place that they continue to work. You know, we need to kind of stand firm with that so that we can keep our schools open for our kids.
BURDGE: School closures are absolutely on everyone's minds. In addition, I also fear for our nurses and their safety and well-being - that we are going to get burnt out, that, you know, hopefully we can get through this again like we did last year.
SHAPIRO: Well, thanks to all three of you for being there for students and for talking with us about it, and good luck in the year ahead.
BURDGE: Thank you.
GAVIN: Thank you very much.
SPOSATO: Thank you so much.
SHAPIRO: That's Katherine Burdge of Tampa, Fla., Eileen Gavin of Monmouth County, N.J., and Rebecca Sposato of Denver Public Schools in Colorado.
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