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Nurses at reopening schools brace for ‘uphill fight’ to keep students safe from COVID-19

School nurses have a message for parents: Expect your kids to be sent home more quickly this year if they seem even a little ill.

“There have been a lot of kids I’ve sent back to class with a headache, and now I might send them home. That will be different for sure,” said Nicole Cable, the nurse at Roosevelt High School in Des Moines, Iowa.

In normal times, a student with a headache, fatigue or slight cough would not raise alarms in a school nurse’s office. But these are not normal times.

Cable and about 600 other Iowa school nurses — along with their peers across the country — will face immense challenges in trying to keep children and staff safe as classes resume amid the continuing coronavirus pandemic. “It’s an uphill fight,” said Cable, who is leading a Des Moines school district committee working on the issue. “It’s one thing to say you have to physically distance in the classroom. It’s another thing to actually do it.”

School nurses will be on the lookout for signs of COVID-19, the disease the virus causes. It could be especially tough to sort out those cases as late-summer allergy season brings a wave of coughs and sneezes. Then schools will see outbreaks of colds and flu, which cause many of the same symptoms that COVID-19 brings. School nurses always perform crucial public health tasks, from bandaging playground scrapes and ensuring kids are vaccinated to responding to teens who are considering suicide. “It was a really complex role anyhow, and now you add COVID on top of that and it gets a whole lot more complicated,” said Sharon Guthrie, executive director of the Iowa School Nurse Organization.

School nurses are armed with flow charts to help discern the difference between everyday maladies and COVID-19. But they will have to employ a relatively quick hook this fall, sending kids home if there’s any doubt.

Once a coronavirus case is identified, school nurses and local public health officials will have to figure out which students, teachers and other school staff might have been exposed at length to the infected person. That could lead to extensive testing and quarantining. The challenges could be particularly daunting for nurses in rural school districts. Many of them work in more than one building, and some ride a circuit of several towns. Urban districts’ nurses have backup in case they become overwhelmed or ill. Many rural school nurses lack that support.

Heather Sloma-Weber is the only full-time school nurse in eastern Iowa’s Tipton school district. She monitors the health of about 700 elementary and middle-school students. A part-time nurse covers the high school.

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