500 public health nurses will help keep schools safe: This nurse explains what they'll do

Students in Ontario will return to school classrooms in just a few weeks, and that's prompted questions and concerns from parents, educators and the public.

It is unclear what education will really look like in the COVID-19 era — and what happens if an outbreak occurs in a school. The province has pledged to hire up to 500 extra school nurses to help prevent and deal with possible infections. 

Austin White is one of them. He's in Niagara, where he'll be serving 14 different elementary schools. He says there are still unanswered questions about the return, but he's confident they'll be able to adapt, even on a tight timeline. 

He spoke with the CBC's Justin Mowat about what his new role entails, how he feels about returning to a school environment amid the pandemic, and the importance of education in preventing further infections. 

Note: this interview has been condensed for clarity. 

JM: What do you know so far about what your role as a school health nurse will look like?

AW: I can't speak to specifics, because we haven't been told by the government minister what the exact details of the position will look like. But I can assume what it'll look like based on my role as a school health nurse within elementary schools and the current work that I'm doing now. 

A large part of what we do as public health nurses is education, and providing the support necessary for schools to really address health challenges within their schools. And it's really going to continue in the next few months, especially when it comes to contact tracing and case management — it's all about education.

JM: How will you be educating students about the virus, especially younger children?

AW: The job of a school health nurse has always been about that education piece. And it's always been about tailoring education to age-appropriate messages for students, so really ensuring that they understand why things are being put in place. 

I always say you can't go into a community, or a school community and expect them to follow through with policy changes — or just changes in general — without providing that thorough education and understanding about why things are the way they are. 

When it comes to students, really making sure they understand that physical distancing should always be the first line of defence. But when it isn't possible, then it really comes down to hand hygiene and proper cough and mask etiquette. 

So making sure that, let's say for students in grade four and older, they understand why they use a mask and how to use it properly. And ensuring that they understand that it's not only to protect themselves, but to protect their friends and family, and everyone around them. 

JM: Do you believe these measures will be well received by children, and that they will follow the rules?

AW: I think the important thing about educating younger students is that partnership between public health, the school staff and parents at home. The messages just can't come from public health and not just from schools, but it also has to come from home as well. 

It's very important that parents start to discuss the expectations of what school is going to look like. Students have been off for the past six months, and we don't know what kind of psychosocial effects and mental health impacts that can have on them. 

So it's really important that we — as public health staff and teachers, along with parents — start preparing them now. We have to start talking about what it's going to be like walking into class, tell them they're going to have to wear a mask if they're in grade four or above and that it's really important they're washing their hands. Similar to our comprehensive school health model, you really have to engage the entire school community and provide that education through a variety of different means. 

JM: You've been working as a contact tracer this summer, which will also take place in schools if an outbreak occurs. How does that process work?

AW: Typically with any case right now when we receive a positive result, we contact the individual and we really try to understand if they're experiencing symptoms. If they are, when was their onset and what might be their infectious period? And then from there we look at who they might have been exposed to and come in contact with. It's important to make sure we do contact them, inquire about symptoms and provide them with recommendations. 

With contact tracing comes thorough questions of what the environment looked like, if proper PPE was used, whether physical distancing was in effect...we look at all these aspects to determine whether it's a high-risk or low-risk contact. When it is a high-risk, we recommend a 14-day self-isolation. It's really about the research that shows the virus can take up to 14 days to incubate in the body. 

I can only imagine that contact tracing in schools will be about a lot of education around contact tracing and case management, and they understand what it means to properly self-isolate — or self monitor, if it's a low-risk contact. 

JM: There's still a lot of concern from parents about their children returning to school in September. Are you at all worried?

AW: Of course I have concerns, as any individual would. I'm not a parent, so I can only speak from my own experience, but I understand the concern with sending their kids back. There is always going to be a risk with sending kids back to school during a pandemic. My main concern is making sure that they have the supports necessary to ensure this is a safe transition. There are going to be challenges and there may be potential exposures. 

I think it really comes down to that education piece, making sure they feel equipped. We all fear what we don't know and there are so many unknowns about this situation. But as long as we're continuously working together and collaborating, and providing the necessary educational support, I think that it's really important for kids to go back to school. For their mental well being, I think it's really important for them. We have to consider the psychosocial aspects of it.

JM: With such a heavy focus on preventing COVID-19 in schools, do you see other issues (mental health, sexual health) falling to the wayside?

AW: Just because we're in a pandemic, it doesn't mean everything else stops. I still have concerns about all the other health issues that we typically address within school. Within our school health program, we focus on comprehensive school health. A lot of that is really engaging the schools, parents and the students themselves in identifying health needs, and coming up with tailored programs that meet those needs. 

Often it's issues like vaping, sexual health, mental health and physical well-being. We still have to think about those, so I'm curious to see how the next few months are going to play out. I know our team has really transitioned into providing support online. But, of course there's still a value of us in the schools and getting to know our students and their problems, and working with them to create solutions.