With the reopening of Texas classrooms and the absence of the state mask mandate, school nurses have become crucial in the fight against the pandemic, but districts are not required to have them.

This article is published in association with TexasTribune.org.

WWorking as a school nurse is “not just ice and boos.”

This is how Marisa Thomison, an elementary school nurse in the Hutto Independent School District, explains her profession, which has become a crucial component of public health during the pandemic. At Veterans’ Hill Elementary School, he manages student health records, administers medications, provides health education, and tries to prevent COVID-19 from spreading widely among students and staff.

Among her tasks: keeping parents and teachers calm when she calls to tell them they were in contact with someone who tested positive for COVID-19. Thomison said she and her colleagues have been “cursed” and even physically threatened by parents who are scared and frustrated at having to keep their children at home for weeks.

“It’s the immediate, ‘My God, I have a job. How can I get someone to watch my child? What I am going to do? ‘”Thomison said.

Unlike their peers in the hospital’s COVID-19 units, school nurses have not had to care for dying patients. They are serving on the front lines of the pandemic in a different way: tracking who has been exposed to the virus, examining staff and students experiencing symptoms, and diagnosing signs of anxiety in traumatized students.

Thomison is one of 13 nurses in her school district, which makes her lucky. Texas law does not require public schools to have full-time nurses, and many do not. In 2019-2020, more than 8,000 Texas public schools employed about 6,100 full-time school nurses, according to state data.

State Representative Shawn Thierry, D-Houston, introduced a bill in this legislative session to require all districts to employ at least one full-time nurse per school and maintain a ratio of at least one full-time nurse for every 750 enrolled students. Hiring more nurses would cost districts or the state money, and Thierry said she wasn’t sure how much yet.

“These are essential workers, so it is a cost that we can no longer afford to cut. Even the life of a lost child would be tragic, ”he said.

Similar bills have failed in previous sessions, but the coronavirus pandemic has demonstrated the scope and importance of the jobs of school nurses. Without a trained healthcare professional to track how the virus has spread across campuses, schools are less able to prevent major outbreaks, said Becca Harkleroad, president of advocacy for the Texas School Nurses Organization and a nurse in Lake Travis ISD. .

“I cannot imagine what it is like during this time not to have a nurse. Many times it is up to the front office staff to take care of the children and send children home who may be sick, ”he said. The advocacy group is also asking the state to track how many schools have nurses and whether they are covering more than one campus – a current gap in available state data. And he’s defending a bill introduced by state Sen. Beverly Powell, D-Burleson, that would allow schools to use money previously allocated for school safety to pay for additional nurses.

Beverly Dutchover, the only school nurse for 320 Marfa ISD students, takes action after a parent or teacher reports a positive case of COVID-19. Ask who they had lunch with, track class schedules, and call dozens of parents. Sometimes if more than one person in a small classroom tests positive, he closes the entire room and requires everyone to stay home and self-quarantine for two weeks.

In the fall and early winter, tourists flocking to Marfa National Park and Big Bend fueled an increase in COVID-19 cases and overwhelmed the capacity of local hospitals. Cases among Marfa ISD students and teachers rose to approximately 15 in October before falling again. Now that Gov. Greg Abbott has repealed the state’s mask mandate, Dutchover fears cases will rise again.

“I get upset. It saddened me to think that especially with all these nurses and doctors working so hard to keep people alive in hospitals, and then he went and did this, ”Dutchover said of the governor’s decision.

This spring, the state gave school boards the power to opt out of requiring masks on their campuses, which could make the job of some school nurses even more challenging.

Related: A Texas City, Two School Districts, Conflicting Mask Politics: How Science and Politics Collide in New Braunfels Classrooms

Debates about what safety policies are necessary for in-person learning have fractured some school communities, with 56% of students learning in-person as of January. Marfa ISD will continue to require masks, but some school districts have already opted out. Dutchover knows that even if students and teachers wear masks on campus, they may not wear them while hanging out with friends or running errands, increasing the risk of transmission.

Masks inside are crucial to preventing the spread of the virus, experts say, and school nurses know this from experience. Tracy Ayers, a district nurse in rural Caldwell ISD, recalled the time when five players on the women’s soccer team tested positive for COVID-19. After tracing the contact, she learned that the outbreak was due to close contact on a school bus: the girls were eating without masks. By contrast, soccer coaches were adamant about having their players wear masks and sit widely apart on the bus, and the season saw few cases.

“When I see lax behavior in mask use in particular, that’s where I tend to see cases that will increase,” he said.

At the beginning of the school year, approximately half of Caldwell ISD students were learning in person. Now almost all of them are. The district’s school board is likely to hear public comments after spring break from community members advocating for dropping the mask order.

“Even on a trip to one of the local grocery stores, some will wear masks and some will not,” Ayers said. “I understand where parents come from in terms of wanting normality for their children. Where I come from as a health provider and seeing how well the masks work, I want their children to go to school and I want them healthy. “

The symptoms of the pandemic go beyond the purely physical. Thomison has noticed an increase in anxiety among staff members and students. Recently, a student came into her office for the second day in a row, concerned about her symptoms. Before the pandemic, Thomison would have sat on the cot next to the student, found them at eye level and convinced them to open. Now, he had to sit six feet away on a chair, fully equipped with goggles and a mask. The student eventually confessed to being terrified of contracting COVID-19 because a relative had it, and Thomison calmed them down.

She felt the tension of distance between her and the student. “We cannot do for our students as we normally would. Our work can only provide great comfort, but it will not allay anyone’s true fears, ”he said. “I cannot breastfeed as I am used to because we have security restrictions. … It has a great price. We are trying, but we are also feeling the effects. “

Aliyya Swaby is the public education reporter at the texas tribuneDigital First, the only non-partisan, member-supported media organization that informs Texans about public policy, government and state affairs.

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