When I moved to the high school this year, not only did my caseload almost triple making that move, because I'm the only nurse in the high school, but we haven't seen a good majority of those kids in the building for 18 months," said Pray, who also serves as president of the School Nurse Organization of Washington. "So, we're dealing with all of their chronic health conditions like diabetes, asthma, allergies, and then on top of that, toss in all of the mental health pieces. The anxiety about walking in the door that first time. Depression because they've been at home without any socialization with their peers," Pray said. You can't really say anything in general about the role of the school nurse during the epidemic, because of the variability from one district to another," Linda McCauley, dean of the Nell Hodgson Woodruff School of Nursing at Emory University, told CNN. Nationwide, some schools mandate that students and staff wear masks to reduce the spread of the virus that causes Covid-19. Others don't. Some schools require anyone exposed to the coronavirus to quarantine to reduce the risk of spreading the pathogen to others if they are infected. Others don't. Some schools require staff to be fully vaccinated against Covid-19 in order to protect young students who are not yet eligible to be vaccinated. Others don't. Because Covid-19 policies vary across school districts, the responsibilities of the school nurse can vary as well. And in some schools where mitigation measures to reduce the spread of the coronavirus are not followed or enforced, that can increase a school nurse's risk of exposure to the virus. When you get into a rural setting, you've got school districts, pre-pandemic, that saw a nurse once a week or once a month depending on where they were, and they share nurses with multiple districts that could be an hour away from each other -- and then you get in the middle of a pandemic, and the nurses are needed, and we've never been leaned on in that way," said Pray, whose Moses Lake School District is considered to be in a rural area. To address the nation's school nursing shortage and also improve the number of school nurses in rural regions, funding is needed, Laura Searcy, a pediatric nurse practitioner who is a past president of the National Association of Pediatric Nurse Practitioners and a fellow of the American Association of Nurse Practitioners, wrote in an email to CNN. "Funding is a key issue. There is an inconsistent mishmash of state and local funding that puts small rural school districts with inadequate tax bases at a disadvantage," she said in the email. "And those areas also are likely to have a shortage of primary care pediatric health care providers as well.
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