Contact tracing adds to regular workload for school nurses
Michelle Thomas spends at least four to eight hours contact tracing when a student in her Columbus elementary school tests positive for COVID-19.
The school nurse launches an investigation that includes interviewing teachers and students, figuring out what classrooms the student was in, what extracurricular activities they are involved in, what bus they rode and who they sat next to at lunch.
“It’s like a ballooning, unfolding mystery to solve,” Thomas, 53, said. “If you have a positive case and you have to notify people that need to quarantine, that has to be done immediately.”
Columbus City Schools nurses are in charge of contact tracing in the state’s largest school district when a student tests positive for COVID-19.
“There’s no help from administration,” Thomas said. “When we tell them caseloads are unmanageable, they just say we stand with our nurses. It’s like throwing you a block of cement while you’re drowning in the water.”
As the sole school nurse at Valleyview Elementary School in the West Side, she said she is overwhelmed.
“This is a level of exhaustion, I don’t know if I’ve ever felt this,” she said. “I’m not getting any sleep. I’m stressed all the time. My whole day is consumed by COVID.”
Thomas said she usually works an additional six to seven hours a day on top of her regular 7.5-hour shift at school. She said she has been up charting cases at 4 a.m. and is only averaging about three hours of sleep on a good night.
On top of their contact tracing responsibilities, school nurses are continuing to deal with their regular caseload – including administering medicines, dealing with emergencies and helping diabetic and asthmatic students who need immediate attention.
And none of it can wait, they say, including the actions that follow after someone in a school is found to have COVID-19.
“It’s not something you can put down and come back to tomorrow because it’s a public health issue,” Thomas said.
School nurses are feeling as if they can’t safely take care of children in schools, said Kate King, president-elect of the National Association of School Nurses.
“We can’t do the same job that we used to do,” said King, who is also the school nurse at World Language Middle School in Columbus City Schools.
“It’s causing stress and a moral dilemma for nurses,” she said.
Thomas said she has not been paid for the extra hours she has worked, but said it’s not even about the money at this point.
“I just want to have my life back,” she said. “I don’t turn in all my hours because I don’t think anyone would believe how many hours I work.”
Columbus City Schools nurses are salaried and are able to get paid extended time at $35.68 an hour if they work past their contracted hours for contact tracing, said district spokeswoman Jacqueline Bryant.
The extended time was approved by the Columbus School Board on Sept. 21, but the school nurses say they have yet to see a dime of that money.
Extended work time is “not to exceed 111 hours per person for a total not to exceed 12,765 hours for the project. Payment is to be made from the Elementary/secondary School Emergency Relief Fund in the amount of $455,455.20,” according to a resolution that was approved by the school board.
But Bryant says it takes time for the payroll coding for disbursement of that extra money to be implemented.
Thomas said the maximum hours set per nurse is unrealistic.
“I don’t know how that would ever be fair because a lot of us have worked more than that in the past month, so I don’t know how they are going to not pay people for what they are doing,” she said.
“Once you reach your 111 hours, do you just stop notifying the public that you have to quarantine?”
Concerns about health and safety
Columbus City Schools, which has about 50,000 students, had 975 students and 191 staff members test positive for COVID-19 from Aug. 26 to Oct. 6, according to the district. During that same time, the district had 11,323 students and 413 staff members quarantine.
“It’s out of control,” Thomas said. “The spread in the school and the spread in the community. We just can’t handle it; we just don’t have the manpower.”
In the first month of school at Valleyview, Thomas said she has isolated or quarantined about half of the staff and students.
“I’m just really concerned about the health and safety of the kids,” she said.
Thomas admits she isn’t coping well with the workload. She tries to focus on her kindergarten son by reading books with him or hearing about what he learned at school, but working extra hours contact tracing eats away at that precious time.
“I just want to focus on my family, and it’s been hard,” she said.
Columbus Education Association, the district’s 4,200-member union which also represents school nurses, conducted a survey of more than 2,500 bargaining unit members from Sept. 1419.
The CEA said the survey found 73% of responding members don’t feel confident that the district’s health and safety protocols are keeping them safe, and 83% said they are not confident that their students and families understand the district’s health and safety protocols.
Nurses at Columbus City Schools declared a state of emergency in schools on Tuesday due to the COVID-19 pandemic. The CEA held a press conference prior to the regular school board meeting that day calling on the school board to adopt mandatory vaccinations or testing.
“Six weeks into the school year, nurses are sounding the alarm and asking for the help that we desperately need in order to keep students and staff safe,” Jackie Broderick Patton, a Columbus City Schools nurse, said at the press conference. “The workload of school nurses ... is not sustainable under the current conditions.”
Specifically, CEA is calling for the immediate implementation of:
h Vaccination or bi-weekly testing requirements for all Columbus City Schools district staff.
h Ohio Department of Health or equivalent home COVID-19 rapid testing kits for all students and families in all school buildings.
h A “Daily Pass” electronic symptoms screening checklist system to be completed every day by students before entering the building.
h COVID-19 compliance task force in each school building
h Air purifiers installed where MERV 13 filters can’t be used by a building HVAC system.
h Contact tracing supplement hours and training made available to all CEA bargaining unit members to help school nurses.
h Cabinet-level meetings where health decisions for the district are made with a medical professional from the district’s Health, Family & Community Services Department.
The Columbus Board of Education did not address the union’s demands or the news conference during Tuesday night’s meeting.
Superintendent Talisa Dixon touched briefly on the situation during the meeting, saying the district is finalizing a contract with an outside vendor to provide nursing staff to conduct contact tracing. The district shared no additional information.
In an email to families Thursday, Columbus City Schools also announced that the district has partnered with Columbus Public Health to offer a limited number of voluntary, at-home Binaxnow COVID-19 rapid test kits for any student or staff member in a school or transportation center who is symptomatic or a close contact of a positive case.
The free, convenient testing option will be available to students and staff beginning the week of Oct. 11.
“Even before students returned to classrooms five days a week, we worked closely with Columbus Public Health to be proactive and vigilant to slow the spread of COVID-19,” Dixon said in the email. “We recently announced vaccine clinics for students and staff, and these rapid test kits present the District with an additional layer of protection to detect infections early and get ahead of potential
outbreaks, including asymptomatic spread, keep schools open, and protect our entire community.”
Families of any student receiving an at-home rapid test will also be notified by their school, per district contact tracing protocols. Families can notify their school of their positive or negative status by submitting a printed copy of their Binaxnow test results, emailing a digital copy to the school (principal, nurse or teacher) or emailing detailed verifiable screenshot of the results
Nonetheless, the news gives Thomas a glimmer of hope.
“When you feel like there’s no end in sight, you feel helpless and that’s a hard hole to go down,” she said. “When there’s no end, you are just a gerbil running and you are never going to get off this wheel.”
More buildings than school nurses in Greater Columbus
In Greater Columbus and across the United States, there are usually more schools in a district than school nurses.
Westerville City Schools, for example, has 14 school nurses for 25 buildings.
Dublin has eight school nurses who travel between the district’s 24 schools. The district does have clinic aides at each school.
Whitehall, Grandview Heights, Hamilton and Licking Heights only have one school nurse in their districts to oversee all their school buildings and students.
In Columbus City Schools, there are actually more school nurses (119) than school buildings (112). Yet the large student population keeps them extremely busy, especially during a pandemic.
On Sept. 16, 115 of the 119 school nurses sent a letter to Dixon, Columbus Board of Education members and other district administrators saying they’re overwhelmed, tired and left doing it all when it comes to dealing with COVID exposures because of unclear directives.
“We cannot passively stand by and witness COVID-19 run rampant in our buildings,” the letter states, “while protocols are unclear or ignored, and staffing is not adequate to keep up with the work.” mhenry@dispatch.com @megankhenry