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A School Nurse’s Guide to Surviving the “Fear” of the Coronavirus

Folks Have Lost Their Minds

No, this is not a guide to keeping the Corona virus out of your school. We already have that guide:

Step 1) Wash Your Hands
Step 2) Don’t Touch Your Face
Step 3) Stay home if you feel sick

Yes, yes, there is more to it than just that. However, the truth of the matter is that folks usually fail on Step #2 (try not to itch that itch) and, sadly, many fail on Step #1 as well. First of all, I don’t know enough about the coronavirus to tell you what’s what. As a matter of fact, as of this article, the world’s top scientists don’t know enough to tell you what’s what with 100% accuracy. 

What Can We Do To Stop The Spread of the Coronavirus 

“Nurse Kevin, what can we do to stop this thing from spreading?” My check-out lady at my favorite grocery store asked me this past Saturday. She is the grumpiest, no-nonsense, in-your-face check-out lady in the entire world…and I love going through her lane. I’ll wait for an extra two buggies just to go through her lane and have a chat.

Now picture the scene here. She’s asking me how we can stop the spread of the coronavirus and just 2 feet away is a daddy loading his “supplies” on the conveyor belt behind me while his two children play on the floor…kneeling and bare-handed as they play with the candy…kneeling and bare-handed ON THE FLOOR where many have walked after stepping in a wad of what Big Bad Bubba had spat on the pavement in the parking lot from deep in his oral and nasal mucosa.

My advice to my check-out lady was loud and clear, “First, don’t touch your face. Second, avoid having your children place their little hands on the nasty grocery store floor where hundreds of shoes have tread spreading stepped-in substances from chewed bubble gum, wet and sticky spit and loogies, and residue from a poured-out-half-drank soda (what about the “wetness” at the base of a male, public urinal?).”

During my loud, “educational” rant, the father realized that I was talking about his children and his utter failure. There he was prepping for a possible home quarantine and his children were “mopping up” every cootie that were still viable from the past 48 hours with their little moist hands and touching the wrappers of multiple candies as they begged daddy, “Can we have this one? Can we have this one? What about this one?” The check-out lady and I just stared at him until he got the point. Then he scolded his children, “Get up and off that floor; you two are getting on my last nerve.” The two children stood as they were directed…and… started touching candy wrappers at chest level, “Ohhh, this one daddy! Can we have this one?”

As a side note: Don’t wear shoes in your house

There’s Something Going Around the Classroom

I’m writing this article and prepping for the pending school-shutdown. I hear the office lady, “Yes. He’s here. Hang on.” My hand reaches for my phone in anticipation and I wait for the second ring (there’s a story there). “Hello Mr. Nurse Kevin. [NAME] is feeling sick and has body aches but he still wants to go to school. I know there’s something going around there in his classroom…”

I interrupted, “Madam, there’s something going around on the entire globe; keep him home.”

Yeah for his school spirit!… I guess. But, yes! Stay home. 

It’s crazy how folks think. They want others to wash their hands and stay home when they are sick. And at the same time, they truly believe that “I’m not going to get the coronavirus.” But that’s the life of a nurse, right? Tell me that you’ve not had 1000 conversations like this:

Layperson “Nurse, I have these symptoms. Should I worry?”

Nurse, “Yes, go see the doctor.”

Layperson, “Well, I may just wait and see.”

Nurse (thinking to herself), “So, what did you worry me for if you were going to do what you were going to do anyway?”

Stay home if you feel sick. It’s a freebie! Most districts aren’t even counting absences right now…as a student or as an employee. And I am sure your district is being as “forgiving” as our district is being. 

STAY HOME if you feel sick or do not feel good.

What’s More Important

I’ve been saying this for a hundred years and even before the “officials” started preaching this: “Don’t touch your face.” But, what’s more important: Don’t touch your face or wash your hands? Personally, I think that washing your hands takes a second place to this rule…a very close second place…but a second place nonetheless. Yes, yes…washing your hands is important. And, yes, we “all” wash our hands after using the bathroom. But, truth be known, it’s “game-over” once you touch your phone. Or the door handle. Or the keypad on the door. Or your office phone. Or your car’s steering wheel. Or…well…you get the point. 

I had heard that the coronavirus does not spread through the bladder or bowel. However, that rumor may not be true. There’s information now that suggests otherwise. And, I’m not sure you’re aware…and I only heard this from the grapevine…but…folks play on their phones while they are using the bathroom. Not you…but folks I know. Anyway…as the story goes…the “urge” hits, the bathroom is visited, phone-time during this private-time happens while Mr. or Ms. So-And-So does his or her “business,” handwashing follows and the bathroom is exited WITH PHONE IN HAND. Fact: Your cell phone is dirtier than your toilet.

So, don’t touch your face. Relying on your hands being clean is not a good idea. Just sayin’

What Deal Are We Closing

So, I ain’t sure any of y’all know yet but we just got finished building a house and have been moving for the past week. Yes, it’s been a lot of fun and good times (tongue in cheek). A week ago Thursday we closed on this house. If you’ve ever bought a house before you know the ocean of paperwork that has to be signed at the title company.

I am not sure why people do this…it grosses me out every time I see someone does it and I just grin-and-bare-it the whole time. Why do people lick their fingers and turn the pages or…grosser yet…lick their fingers to get the next plastic sack to fill with groceries (my grumpy check-out lady does NOT do this)? It happens so much that folks don’t notice themselves doing it nor does the one who receives the slobber-laced paper. My wife is more “germ-aware” than I am (some call us germaphobes…but they ain’t laughing now) and she didn’t even notice the finger-licking. 

Don’t forget about that dollar bill you got back in change from your favorite bistro, cafeteria, beer joint, chophouse, or tearoom. That dollar may have hundreds of people’s mucosal residue soaked into the fabric (US bank notes (dollars) are more fabric than paper).

For the love of all that is healthy, be aware of licking your fingers and, as uncomfortable as it will be, call out someone (in kindness) who tries to hand you something that they have licked. Let’s pause on letting this one slide (though I am in favor of making this as socially inappropriate as a kid spitting on the school hall floors). 

In Walks the School Nurse

When do we send the children home? How do we know if they have the coronavirus or not? What is our policy? How are the other school nurses doing things? How do I know if I am making the right decision? Truth-be-known, there are a million questions just like these and every single one of them have the same exact answer: “Who Knows?”

According to the World Health Organization:

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don’t feel unwell. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing. Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.

How many children will you see today (if your school is still in session) with tiredness and dry cough? What about aches and pains? I know I have a lot of aches and pains; we’ve been moving all weekend. What about a runny nose? It’s the middle of March! Allergy season is upon us. And as the school nurse, how do you pick out the ones who “become infected but don’t develop any symptoms and don’t feel unwell.” YOU CAN’T. 

What you have as an awesome school nurse is your “nursey-senses.” You go with your gut! If you think a child is sick and if there is a remote possibility of that child having this virus, go ahead and send that child home. You do not want to send that child back to class and get an excuse a day or two later from the doctor excusing that child for the next month because that child tested positive for COVID-19. Can you imagine the “why” questions that would follow?

The Inevitable Why Questions Are Coming

There are two possible truths right now. First, is this coronavirus a little thing and people are overreacting? Or, is this coronavirus a big thing that people are responding to appropriately? Now, when I say words like “little” and “overreacting,” I don’t mean to belittle those who have died or have lost loved ones. For those people, this is a HUGE thing. Again, not to down-play this pandemic, but folks don’t respond this way to the influenza, Bordetella pertussis or measles. You get my point…moving on…

People are wondering how toilet paper has anything to do with a respiratory illness. Why toilet paper and not tissue? Consider the fact that this has happened before. Go back to 1973. Americans were hoarding gas and toilet paper. Not because of a toilet paper shortage, it was because the popular late-night talk show host, Johnny Carson mentioned (as a joke) a “toilet paper shortage.” If they are accustomed to seeing a shelf full of toilet paper and the next time they go in for some TP there are only two packs left, it’s likely they will grab both. Maybe the truck is on the loading dock dropping off 10,000 more rolls. One the 2-pack TP guy shows a picture on his Facebook of a bare grocery store shelf, the run on potty paper starts!

Trust me. I am not immune from this silliness either. When folks ask themselves in all seriousness, “What WOULD I do if I could not wipe with toilet paper,” it scares the poop out of them (pun intended). What would you do if you reached for a roll and there was none? 

When we ask the two questions: Are we overreacting to something little or reacting appropriately to something big, we have to also be prepared for the why questions that will follow. If it turns out to be a big deal, the “Why didn’t you respond to the pandemic sooner?” Or, “Why didn’t you respond to it differently?” will come up.  If it’s a little deal, then, “Why did you close schools so prematurely?” Or, “Why did the government impede on our right to gather?” No matter what the outcome of this all, the “why” questions will come. 

There will be “why” questions for Trump, district superintendents, mayors, and even to the local grocery store when the fella with 136 rolls of toilet paper asks for a refund on what he overbought and now lacks enough money to pay his rent. There will be a school nurse somewhere in the USA that will send a child with mild COVID-19 symptoms back to class and there will be another child infected because of that decision. There may be a “why” question for her. But ain’t none of us school nurses sending all children home who say, “I feel sick.” All we can do is what we do and what we do is OUR BEST!

Your school is likely going to shut down. It’s likely either happened or is in the works to happen. What can we school nurses do if there is a shut down? In a way, your work-related COVID-19 potentials are home with their mamma and daddy or their guardians. All those little souls that you care for each day are absent from your workday and, hopefully (sometimes doubtfully) being taken care of. So, what do you do each day? 

A call home of some of the children who had missed those last few days before the shut down may appreciate a call to check in and see how things are going. Maybe reach out to your asthmatics and other children who are immunocompromised. What about the children who often come to your office for a snack or those that try to sneak a 2nd lunch to make sure they are getting enough to eat?

And don’t forget that COVID-19 isn’t the only thing that makes these children sick. With 8 +/- hours on your hands without children, what about:

  1. Updating or Creating Care Plans
  2. Reviewing Allergies
  3. “Flagging” Children’s Records
  4. Reviewing Immunizations
  5. High Schools collaborating with the school nurse at the Middle School about health concerns showing up next fall (school starts back in only 5 months)
  6. Middle Schools collaborating with the school nurse at the elementary school about health concerns showing up next fall. 
  7. And, if time allows, organize your office, inventory your supplies, wipe down your office and all the other things that you just can’t seem to finish. 

Afterall, the children don’t interrupt our work; they are our work. But if the kids are not at school…

Can you add to my list? Comment below and let all us school nurses know what you will be doing when you are faced with a day where the kids are at home.

Finally, Nurse Kevin Suggests:

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