School nurses stepping to the plate.

In early 2010, the Georgia Association of School Nurses (GASN) was invited to participate in the Georgia School Based Flu Stakeholders meeting at the Georgia Department of Education (DOE). Lisa Byrns, RN, our past president, sent Karen Bell, RN, school nurse, and I to the meeting as GASN representatives. Attendees represented many community partners including the Associate State Superintendent of Policy for the Georgia DOE, Director of Infectious Disease and Immunizations/Acting State Epidemiologist Department of Community Health (DCH), Center for Disease Control (CDC) Epidemiologist, Emory School of Nursing and others. I remember leaving the meeting thinking, "Wow, what an opportunity for school nurses to influence healthy behaviors in our school communities!"

During the 2009 H1N1 Pandemic, National Association of School Nurses (NASN) President Sandi Delack RN, M Ed, sent the following message to members: "School Nurses are in a position of public trust in both normal and crisis times. Parents, policy makers and other members of the community expect us to be there to assess 'problems du jour' and to address them in a competent manner. They don't understand the scope of our work, and most likely, it's not of concern to them. We are expected to perform at the highest level, resulting in saving lives and helping children learn."

Delack's message that the H1N1 pandemic raised awareness of school nurses like no other time we could recall brought many to question if there were enough school nurses. School-based flu programs are administered on school grounds before, during and/or after school hours. Our objective is to help meet the recent universal vaccination recommendations while reducing absenteeism and increasing immunity. Research by the Georgia DOE shows that each day that a student is absent from school contributes to a 3 percent decrease in CRCT scores. In Georgia, some school nurses were allowed to administer flu vaccines while others were allowed to facilitate the site for public health nurses to administer the flu vaccines at their schools. One role all school nurses shared was surveillance for flu. Most of us taught hand washing and cough etiquette. Again, we were the flu patrol, assessing health conditions; reporting cases to parents, administrators and health departments to enforce infection control practices.

Participants in the stakeholders meetings have identified and provided a foundation for identifying best practices, as well as ways to sustain the program moving forward. We experienced many challenges in the implementation of the program, as grant funding was not awarded in the amount needed to provide adequate resources (product and staff) and reimbursement for immunizations. DOE and DCH will collaborate in a research project to determine the reduction in absenteeism of both students and staff; and any correlations between immunization rates and greater academic measures. School nurses look forward to seeing these results, we would like to see increased funding for sustainable school-based flu vaccination programs statewide, as we see schools as a critical component of the response to pandemics and other emergencies. We have stepped up to the plate to help keep our students in school and parents at work, while increasing opportunities for increasing flu vaccination rates.

By Carol Darsey, RN, President, Georgia Association of School Nurses

Carol Darsey, RN, is GASN president and a practicing lead school nurse in Liberty County. Visit www.gasn.org for more information about the Georgia Association of School Nurses.