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School nurses are on the front lines, in school and out

They have offered their services in many different settings, while continuing their role as a health adviser to students.

This article was originally published in The Notebook. In August 2020, The Notebook became Chalkbeat Philadelphia.

When patients pulled up to the medical tent at Citizens Bank Park’s drive-through COVID-19 testing site, which was operated from March 20 to April 10 by Philadelphia’s Medical Reserve Corps and volunteers, they may have found themselves being treated by school nurse Christine Lynch.

For the last four years at Thomas Holme Elementary School in Philadelphia, Lynch, 51, has been prepared to treat anything that students might bring into her office. Volunteering at the testing site, she was prepared for whatever the next car might bring.

“As soon as this happened, I was like, I need to volunteer, I need to help,” Lynch said. “I can’t just sit at home now that schools are out.”

The testing site, which could accommodate up to 250 tests a day, consisted of a screening tent, a data collection tent, and the medical tent, which allowed patients to be tested without leaving their cars.

“It was extremely well-run,” she said. “It flowed so beautifully. Everyone had a job and did it. As far as me, I did the actual swabbing.”

At the medical tent, Lynch and about a dozen other volunteers, including medical students and residents whose clinical rotations had been cancelled, were outfitted with protective equipment. It was provided by the Medical Reserve Corps and the Federal Emergency Management Agency, and it included N95 and regular face masks, face shields, gowns, aprons, two pairs of gloves, and boots.

Test recipients rolled down their windows six inches, were swabbed, and were sent on their way as their samples were organized to be sent to the lab. With these precautions, Lynch said, “the risk to me was very, very low. It was nice to be able to give back and to help.”

Now, Lynch is volunteering a few days a week at the Liacouras Center, Temple’s sporting and concert venue that has been converted into a temporary hospital to admit COVID-19 patients overflowing from surrounding Philadelphia hospitals.

Lynch’s parents and her husband were worried when she announced her intention to volunteer.

“I just kept reminding them that you take precautions,” she said. “You wear protective gear. You wash your hands. You take precautions. That’s how we stay safe.”

Despite their worries, she said, her daughters Abigail, a senior in high school, and Michaela, a freshman at Temple, were “really proud of me. They were glad I did it.”

Before going into nursing school in 1998, Lynch worked in the Temple hospital system in medical-surgical nursing, orthopedic trauma, and wound care. She believes her hospital training provided the preparation she needed to work as a school nurse.

“I always thought it was like an independent clinic,” she said. “You never know what’s going to walk into that office. I can’t imagine a school nurse going into it right after college. … It’s hard – you can’t rely on anybody or ask anybody any questions. It’s just you.”

However, Lynch added, “It’s very rewarding. I like being in community nursing. It’s very preventative. There are a lot of teaching opportunities. And the kids are adorable.”

Lynch is one of many school nurses doing their part to keep their schools and communities informed and safe during this pandemic.

Colleen Quinn, a school nurse at Philadelphia High School for Creative & Performing Arts, echoes Lynch’s description of their vital role in the school community.

Colleen Quinn

“I love the kids, their questions, health complaints, and outlook on life!” Quinn said by email. “Most days I feel like I’m in a busy emergency room triaging from the parking lot until dismissal. For the most part, I am the only medical interaction they have, they rely on me for medical advice and direction.”

Quinn has continued to serve her school community remotely as part of the school’s leadership committee.

“I have been working with the principal and counselors to identify ‘at risk’ students, both academically and medically,” she said.

The committee compiled a document of students at risk who have learning plans (IEPs) under the Individuals with Disabilities Education Act (IDEA), 504 plans under civil rights law preventing discrimination, or other health issues that require attention in school.

“The expectation for teachers is to fill in the comments as to how students are doing, are they showing up, turning in work, conveying any challenges or problems, etc.,” she said. “We are attempting to capture all students in the school and help them through this unprecedented time.”

The committee meets twice weekly to review the teachers’ comments and reach out to students in need.

Quinn also individually contacted parents of students who had medication at school and organized times to pick it up that coordinated with CAPA’s laptop-distribution program.

“It has also been put out to our parents if anyone has lost their job and health benefits to contact the school nurse, and I will help them navigate CHIP (Children’s Health Insurance Program),” she said. “To date, I have had a handful of parents reach out to me, and they are now working with PCCY to get their child health benefits.”

Natanya Gornstein

In addition to working weekdays for the District, Quinn is also awaiting clearance to head to the front lines.

“I am on the FEMA emergency list and have been called to work the pop-up hospital at the Atlantic City Convention Center as I also have an N.J. nursing license. As of now, I am awaiting instructions, and if needed will do 12-hour shifts on the weekend.”

Similarly, Natanya Gornstein, 28, is balancing her remote role as the school nurse at Penn Alexander School in West Philly with her part-time job as a staff nurse at the University of Pennsylvania Student Health Services, where she reported by email, “We have seen our fair share of cases of COVID-19.”

She said that Penn Alexander’s response to the pandemic has been “nothing short of incredible,” and the school has clearly outlined her role for the rest of the year.

“I am in touch with students and families every single day via the virtual health office I set up on Google Classroom and the new Google Voice phone number that is set up due to not being able to answer calls in my office,” she said. “Although it is difficult to perform all my nursing duties from behind a screen, I can still get some things done.”

In addition to her role as a school nurse, Gornstein said, “During this time specifically, I am the 6th-grade staff contact for teachers, parents, and students. All of the above are aware they can contact me with anything and everything, and I will try to help!”

Gornstein and Quinn both reported that although they believe the District is doing its best, they would have liked to have had more guidance and communication earlier on.

Gornstein said, “I do believe the School District absolutely could have responded quicker to this crisis by closing schools earlier.”

Similarly, Quinn said, “I feel they could have had a better plan to let the nurse get back in their building sooner to gather important documents needed to work from home and to return medications to parents.”

However, both mentioned planned virtual meetings that will hopefully help outline the expectations for school nurses going forward.

At a school level, Gornstein said “Parents and staff respect my medical decisions in general. However, they have expressed gratitude with the amount of communication that is happening on a community level with all staff and students. We are all working as a team.”

The COVID-19 outbreak is changing our daily reality

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