For months, Flood Brook School has been trying to hire a nurse.
The Londonderry K-8 school’s current full-time nurse is on a yearlong sabbatical, and administrators started looking for a replacement before school let out last spring — with little luck.
“We’re struggling with positions in all of our schools,” said Randi Lowe, the superintendent of the Bennington-Rutland Supervisory Union, which includes Flood Brook. And the school nurse job “is a challenging and difficult position.”
In an Aug. 10 memo, the Vermont Agency of Education told local school administrators that nurses would take the lead in handling Covid-19 safety on campus.
Instead of structured Covid-19 safety programs used in the past years — such as contact tracing and testing regimens — schools will rely on nurses’ “clinical decision-making” to ensure students’ safety, state officials wrote.
But amid a longstanding shortage of nurses in schools and medical facilities, some Vermont schools are making plans for handling Covid-19 without a full-time nurse.
Vermont has about 330 schools, and the equivalent of roughly 290 full-time school nurses, according to Clayton Wetzel, the Vermont director of the National Association of School Nurses. Because some larger schools may employ multiple nurses, he estimated that around 50 schools in the state have no nurse on staff.
The likely outcome is sharing nurses across districts or, worst case, students missing more school.
“If there’s no nurse in the school, a sick child is going home,” said Soph Hall, the lead nurse at the Kingdom East School District and the past president of the Vermont State School Nurses Association. “That’s what they should be doing. Because they don’t have a nurse to help decide whether the child could stay in school or should go home.”
Without a nurse in the building, children with Covid-like symptoms may not have access to someone who is familiar with their medical history. That, Wetzel and Hall said, could mean that kids with conditions like hay fever, allergies or asthma get sent home more frequently out of an abundance of caution.
“It’s more dismissals, and it might be more absences,” Wetzel said. “Because there’s not someone in the building with the medical knowledge to be able to help the parents, the administrator and the other staff understand all the nuances of what’s going on there.”
Challenges finding coverage
In an interview earlier this month, Wetzel, who is also the school nurse at Waitsfield Elementary School, said that many nurses got burned out during Covid-19.
Even schools that have hired full-time nurses have struggled to find substitutes for when a nurse takes time off, a predicament that can exacerbate burnout, he said.
“I think the biggest concern is that we’re not going to have either all of our positions filled before the school year starts, or we’re not going to have any substitutes,” Wetzel said.
Lowe, the superintendent of the Bennington-Rutland Supervisory Union, said that, after being unable to find a nurse, administrators have started searching for a nursing assistant for Flood Brook.
That person would provide “medical triage” services, Lowe said, and would be able to consult the supervisory union’s full-time nurses if needed.
But if no candidate is found for Flood Brook, Lowe said, the schools might be forced to shuffle nurses around across the district. The supervisory union’s six schools have five full-time nurses among them, she said, and she is considering a system in which nurses would be shared among smaller schools.
That is the system that was in place prior to the pandemic, she said, and one that Lowe is “very reluctant” to return to.
“If nothing we have in the works pans out, then that’s ultimately what I would do,” she said.
At Oxbow Union High School, administrators are looking to hire a new nurse after the previous one left for a job closer to home. That nurse is still on staff for a few more weeks, said Ken Cadow, the school’s co-principal, but administrators have not yet found a replacement.
Last year, when he was an administrator at Randolph Union High School, the Covid situation was “staggering,” Cadow recalled. “The school nurses, they were critical,” he said. “They were the center of pretty much everything.”
But this year, Cadow said he is less worried about Covid-19 in Oxbow Union. The school has received some applications for the nurse position, and he said he is more concerned with a potential candidate’s ability to bond with the community there.
“From the Covid side of things — I may eat my words — but I’m less worried about that than I am about finding the right person who puts relationships way, way up the list,” he said.
Asked what would happen if they don’t find a nurse soon, he said that Oxbow Union would simply coordinate with its neighbors and other schools in the district. Oxbow Union is located next to the River Bend Career & Technical Center, which has a full-time nurse, and staff can call other schools in the Orange East Supervisory Union for medical help.
“And, you know, we’ll arm our folks with Band-Aids,” he said.
Where no nurse is normal
Other schools are used to making do with no full-time nurse.
Woodford Hollow Elementary, in Woodford, has no staff nurse by design. At the tiny school, whose student body is currently 23, a nurse “would be very bored, for lack of a better word,” said Melissa Chancey, a K-2 teacher at the school.
As one of the school’s three full-time teachers, Chancey is used to filling different roles: in addition to teaching, she acts as the school’s supervisor, performs basic nursing duties and was the point person for the school’s Covid-19 testing program.
“I joke often, if I had a hat for every job I did, it would be 10 feet tall,” Chancey said.
She estimated that medical-related duties usually take up about a half-hour of her time every day. The school can handle “the run of the mill: bloody noses, scraped knees, all the little stuff” on its own, she said, but for more serious medical problems, administrators call one of the district’s other nurses, who is based at Shaftsbury Elementary School.
At Woodford, Chancey said, the new guidelines seem unlikely to dramatically change the school’s medical status quo.
“You always have to make a judgment call in Woodford as to what’s going on,” Chancey said. “That’s the way it’s always been.”
