Charleston County School District (CCSD) will now have a full-time school nurse in every elementary, middle, and high school.
According to Ellen Nitz, Director of Nursing Services, CCSD employs 104 nurses, some of whom are part-time and serve in larger schools as an addition to the full-time nurse. She said the district’s commitment to the health and safety of students and staff is evidenced in not only the hiring of so many full and part-time nurses but in the most recent updates of every school clinic.
Because of new protocols around COVID-19, Plexiglas has been installed in front of each nurse's station and floor markers or chairs will be spaced to provide six foot distancing.
“The district has done a fantastic job preparing our clinics and school buildings for the return of children,” said Nitz. “Our plans are well thought out so that as many safety and health precautions as possible could be implemented. Nurses took contact tracing courses to be versed in the procedures and can answer questions from parents and administration. We extended our contact tracing team to include additional resources, and we are fully equipped to provide the quickest guidance and education to anyone who has been diagnosed or been in close contact with a COVID patient. We also had a team of 16 school nurses that worked more than 800 hours alongside DHEC during the school closure to provide contact tracing for the lowcountry region.”
Nitz explained that the final touches were still taking place but that each clinic has an isolation area or bay with a cot and a curtain that can be wrapped around to act as a protective barrier. Nitz said the goal is to keep students isolated when they are present in the clinic with COVID like symptoms. All clinics have a HEPA-rated/UV air scrubber as well. To mitigate risk of COVID-19 transmission, the clinics will be fogged nightly.
“All of these things put us at a great advantage to care for children showing symptoms,” said Nitz.
Kathryn Bouziane, a nurse at R.B. Stall High School, said she is very much looking forward to going back to the school building.
“Students should be in school, especially considering the diverse populations we serve in Charleston County,” said Bouziane. “CCSD should serve as an example to others across the nation as far as a Safe Restart. Our model can be replicated in so many places in the United States.”
“I have to brag about the district because in years past, we only had one nurse for every 750 kids,” said Nitz. “Due to the district’s insight, we now have one nurse for every 600 students.”
Bouzianne explained that nurses are ambassadors to healthcare delivery.
“Nurses are very important and COVID-19 is demonstrative of that,” said Bouziane. “In the case of the school nurses, we are prepared to recognize symptoms in staff and students and educate on how to manage COVID-19. It’s not just the clinical skill nurses bring to the table but the education piece which is important now more than ever.”
School nurses are very much the frontline when it comes to the health and safety of those in a school building. According to Nitz there is a sense of security knowing there is a healthcare professional in each clinic.
“Nurses this year will play a major role in listening to their staff and hearing their concerns and fears about returning,” said Nitz. “They will be called on to use their clinical background and current training to help put people at ease. We need our staff to feel comfortable to return which in turn makes students feel comfortable coming back into the building. It is very much a domino effect. Nurses are really good at listening and making people feel better, and that is our responsibility to keep everyone safe and healthy physically and mentally.”
“Each school is prepared and ready for students on September 8, 2020,” said Nitz.
Kathy Nash is the nurse at Belle Hall Elementary School. She serves hundreds of students at her school and on her busiest days, she can see up to 80 children.
That was before COVID-19. She foresees the return to school being a challenge for medical professionals across the district, especially when flu and allergy season arrives.
For Nash and the other nurses across the district, a typical day is never typical.
“You never know what you’re going to get,” said Nash. “Medicines have to be administered, we must check on our special needs students, speak with parents about various situations, and treat sick children. I suspect symptoms will be very difficult to distinguish when it comes to strep throat and the flu verses COVID-19.”
“Seasonal symptoms are similar to COVID-19,” said Nitz. “Nurses will utilize DHEC guidelines and follow the school exclusion list in regards to sending kids home.”
“It is clear that COVID-19 is still very present in our community,” said Nash. “It is also clear that children need to get back to school and back to regular life. We have to, of course, do it very carefully. Having licensed nurses able to put eyes on these students is imperative.”
She explained that nurses do far more than put Band-Aids on scrapes. They also serve as counselors. That is just one of many reasons bringing the kids back face to face for school is so necessary, she added.
Elementary school nurses traditionally weave in the importance of keeping hands clean as part of the curriculum they teach. Nash said that this will be more important now than ever before. The addition of proper mask wearing and handling will also become part of that curriculum, she added.
Nurse Wendy Dunigan works at Angel Oak Elementary School. She describes school nurses as an integral part of the education system.
“We play a large role in ensuring the basic health needs of these children are met,” said Dunigan. “We’re often helping families integrate healthy routines into their home. We serve hundreds of children with chronic conditions such as asthma. We notice and respond to those students when we see their condition has changed as well.”
Every school has multiple repeat visitors to the clinic. Dunigan explained that nurses get to know those students quite well and can tell instantly if they are in need of something, which then allows them to alert the parent or the teacher to help assist.
“Nurses are able to take a holistic approach to meeting the needs of a child,” said Dunigan. “At the elementary level, ice, and a Band Aid are considered magical. But nurses offer so much more than that. We have good insight into our students and provide a level of mental health services that most people don’t realize. I can tell if one of my students is bothered and I often serve as a sounding board when they are scared or want to talk.”
Dunigan said that students returning tfor face to face instruction will receive instruction on the new COVID-19 protocols such as clarification on the right way to wear a mask and how playing with friends at recess will change. She will also work to ease any fears the students or staff may have about returning.
“Wearing masks can become something we do out of habit because we learn habits,” said Dunigan. “Elementary school students are here to learn and parents and students can expect these habits to be taught along with all the other things we teach our students. Kids love to help and show off things they’ve learned.
When it is all said and done, the students will have learned these new habits and can be proud of themselves.”
Dunigan is a former emergency room nurse where she faced many unknowns when it came to her patients.
“I’m here to do what I have to do,” said Dunigan. “We are all well-trained professionals and have experience in all types of ways. We know the seriousness of the situation and we will strictly follow the guidelines to allay parent fears. As front line personnel, we’re going to work hard at keeping the kids calm. We’ll offer some hand holding where needed and do all we can to make sure people feel safe while in the building.”
Bouziane and Nash share the same confidence as Dunigan in regards to feeling safe about returning to the school building.
“The clinics are equipped to handle any spectrum of severity that walks through the door whether it is to diagnose COVID-19 symptoms or apply a Band-Aid,” said Bouziane. “We have the same PPE that you would expect in a hospital. We are experienced and equipped to manage anything that walks through the door.”
“It is important for the community to understand that we employ some of the top nurses,” said Nitz. “We have risen in the ranks by hiring professionals such as nurse practitioners, neonatal nurses, emergency room nurses, orthopedic nurses and more. They all come from a vast array of specialties and bring a lot of professionalism to our group. They truly are a wealth of knowledge.”
Bouziane is a sixth generation family member to work in the school system.
“I feel very fortunate to work for CCSD because as I speak with so many of my peers in other school districts and hear their concerns about the unknowns,” said Bouziane. “I am reminded that I have a strong idea of what our Safe Restart looks like because I know the system. I know that our district leaders have been working tirelessly to put it in place.”
Bouziane said the planning involved a lot of communication.
“The communication between students, staff and healthcare professionals in the building, including our therapy professionals and our partners at MUSC Telehealth will continue,” said Bouziane. “That's how the system functions optimally. We all know the rules and responsibilities of our peers. I am looking forward to that high level of communication with staff and students.”
For more information contact the Office of Strategy and Communications at (843) 937-6303.