El Camino Real Academy nurse Gloribel Fierro spends her early mornings preparing for an onslaught of kids, germs, problems — and joy.
She assembles bandages and ice packs for students’ inevitable bumps and scrapes. She readies their medications and asthma treatments and tracks their vaccinations. She manages public health projects, including dental, hearing and visions checkups, plus vaccination clinics.
All the while, she positions herself as a trusted adult for the nearly 800 students at El Camino Real Academy.
There is always something going on in the nurse’s office — a hive of activity at El Camino Real and schools throughout the district.
Fierro is part of a vast network of nurses, nurse aids and nursing leadership at Santa Fe Public Schools — a group that has survived difficult times as the coronavirus pandemic created a sea change in how education is delivered and students’ health is protected. Negotiating that crisis has been nearly as difficult for the caregivers as the young recipients.
The district’s nurse supervisor, Anita Hett, said school nurses have adapted to ever-changing challenges related to the pandemic while managing the typical duties of the nurse’s office and the recent formidable spate of flu and RSV cases.
But their work, said Superintendent Hilario “Larry” Chavez, has not gone unappreciated, because nurses were critical to maintaining a school’s sense of normalcy in addition to helping create a healthy environment.
“They really are one of those departments or staff members that is really more behind the scenes but so vital for a school to be healthy, prosperous. … They’re as important as the building principal, as the classroom teacher,” Chavez said.
Their duties extend outside of school, Hett said. School nurses are responsible for promoting healthy practices — from handwashing to vaccinations, vision exams to recognizing the symptoms of certain diseases — throughout the community.
It was a school nurse in New York City who first identified an outbreak of swine flu in 2009. And during the early and uncertain days of COVID-19, district nurses were often the first point of contact for families with questions about best health practices, Hett said.
As public health guidelines changed numerous times in the first year of the pandemic, school nurses were there to answer families’ questions.
“I truly believe that the work that the school nurses did contributed to a healthier community because they were doing such a great job” following Public Education Department and state Health Department guidelines, Hett said.
During the height of the pandemic, Hett said school nurses acted as educational gatekeepers in addition to their typical duties. It was their job to keep sick people out of school facilities and educate families on how and when to isolate or quarantine.
Sometimes, parents of sick kids or staff — facing up to 14 days of quarantine time — took out their frustrations on school nurses.
Nurses, Hett said, had to figure out how to manage that.
“Usually people think of school nurses as kind of like a mom. But they were having to tell people to go get tested, having to tell parents that their kids couldn’t come to school for up to 14 days. That was very, very difficult work for them,” Hett said.
This year, school nursing looks more similar to pre-pandemic normalcy in many ways, Hett said. But as the COVID-19 pandemic continues, common viruses, including the flu and RSV, or respiratory syncytial virus, have regained full force, resulting in some challenges with respiratory illnesses this winter.
Some have referred to the combination of the three ailments as the “tripledemic.”
Although she’s new to the school nurse specialty — she previously worked as a hospice nurse and a nurse at Christus
St. Vincent Regional Medical Center — Fierro has noticed the influx of sick students in her office at El Camino Real.
“I’ve noticed that this winter it’s been very prominent. … Lots of kids are getting sick right now. It’s a busy office,” she said.
Hiring school health workers also remains challenging; the school district is searching for nurses and nurses aids to fill vacant positions, Chavez said. This district’s recruitment website lists six open positions for school nurses and three for nurse aides.
But Hett said the vacancies aren’t any worse than before the pandemic.
Still, she notes the post-pandemic era is fraught with challenges. As in other industries, Hett has worked to maintain morale for school health workers who have felt dispirited by the pandemic.
She made meetings — which occurred weekly at the height of the pandemic — a place to both dissect problems and celebrate wins, asking staff to share “something great” that happened each week.
The meetings also end with a game of Plinko — the pachinko-inspired game from the TV game show The Price is Right — in which one school health worker wins a prize.
Nurses say they feel the support, from Hett’s efforts to boost morale to staffing virtual nurses office. Fierro said she was grateful for Hett and other nursing supervisors’ guidance throughout her first few months at El Camino Real.
Hett said the pandemic also created a new staple of Santa Fe Public Schools nursing: the virtual nurse’s office.
The online meeting allows nurses to triage students requiring care and avoid inundating the nurse on duty at any school site.
For Fierro, the virtual office means advice from another nurse is just a click away.
“Although you’re the only nurse at the school, you’re never alone,” she said.
Hett said she is proud of the way her staff of school health workers have weathered nearly three years of challenges.
She admired their ability to adapt, as school nursing grows into its own nursing specialty and its practitioners take on additional responsibilities.
“We are public health. That’s what we are right now,” Hett said. “… I can’t say enough about the work that they’ve done.”
In an article published in the September 2021 issue of the National Association of School Nurses journal, Santa Fe Public Schools’ nurse leadership team acknowledged the additional responsibilities school health workers had taken on during the pandemic and committed to continuing their efforts.
“The COVID-19 pandemic is far from over, and while we, in our ever expanding school nursing roles, have persevered through many adaptations to mitigate this public health crisis within our community, we will continue to ‘strive for excellence’ (our district’s motto) until the job is done,” wrote Myrna Barbee-Lee, the article’s first author.
Fierro, for one, feels confident in her choice to become a school nurse. It’s the best job she’s had as a nurse so far, she said.
“It’s very uplifting to work with kids,” Fierro said. “… They find joy in the little things, and that’s contagious.”