Schools struggle to monitor COVID-19 cases as nurses resign, retire, recruited overseas

PRIMARY and secondary schools are facing a shortage of nurses as they grapple with monitoring cases of novel coronavirus infections among students since face-to-face classes resumed on January 3.

Information received from the education ministry indicated that, up to September 2021, there were only 152 public health nurses assigned to some 227 secondary schools islandwide. Primary schools, which account for about 77 per cent or 756 of the island's 983 primary and secondary institutions, also sometimes depend on these nurses.

However, of the 152 public health nurses which the education ministry's audit accounted for in September 2021, the ministry says some may have resigned, or retired, and others recruited overseas.

The ministry, however, said all secondary and tertiary institutions have established school nurse posts, and that where nurses retire or resign, the boards of the institutions recruit or replace them accordingly. Despite the shortage of school nurses, institutions have been asked to keep a close eye on possible cases of COVID-19 infections among students amid the return to face-to-face classes since the start of this month.

Primary schools have long indicated an urgent need for nurses on site, in anticipation of students returning to the classroom during the novel coronavirus pandemic, with desperate calls in August 2020 for nurses to fill available positions islandwide.

Former head of the Jamaica Teachers' Association (JTA), Owen Speid told the Jamaica Observer at the time that since 2016, schools had been pleading for nurses to be stationed at primary and secondary schools, to no avail. At the time, he said while only some high schools have nurses, primary schools are only able to engage nurses if they can pay out of pocket.

“We've been saying that to the Government for years, that we need the primary schools to have school nurses. We are calling on the Government every time. We carried it in the last negotiation and the Government flatly rejected it, and we think it is a big mistake that they have made,” he said. One St Andrew-based primary school teacher explained that it is difficult to monitor students as not all schools have test kits, and with the absence of a school nurse they have had to solicit donations from students and pay for the services of one.

“When you have to watch small children to ensure they keep on masks, wash and sanitise their hands, social distance, plus also teach's difficult to also monitor them for signs of the virus. So unless a child is roasting with fever and eyes turning over, you might miss it. My school has had to ask each child to contribute $200 for us to pay a nurse as we don't get one from the ministry,” she said.

Conroy Griffiths, principal of Eltham Park Primary School in St Catherine, told the Observer that he has a school population of 541 students. However, there is no nurse to attend to said students.

“We have gotten to as far as about 450. There are 32 teachers, with additional ancillary staff and about four 'admins'. We do not have a school nurse. In terms of the protocols, we have all the things in place… students temperatures are checked and they either wash their hands or [are] sanitised before entering the school building,” he said.

Griffiths added that the school is outfitted with a “well-equipped” isolation room for students who are believed to be ill.

“But I am not a medical practitioner. So, once somebody has any flu-like symptoms — meaning if they are coughing too often, if it appears that their eyes are running, if they complain about fatigue, and if we see a temperature — they do not enter the school compound,” he said, noting that if the symptoms develop while they are on the school compound they are taken to the isolation room and the necessary reports are made to the parents.

At Mahoe Hill Primary and Infant School in Mahoe Hill, Broadgate, St Mary, there is no school nurse post.

“We do temperature checks every morning, sanitising, and ensure that everyone entering the compound is wearing a mask. If a child or teacher has a cold or running nose, the child is sent home or the adult stays home,” she said.

Further, Annie-Kay Foster-Wallace, guidance counsellor at Ferris Primary School in Westmoreland, said they have a similar issue. There is no nurse to monitor some 76 students who turn up to school daily, on average.

“The major issue we have is probably manning the gate. We don't have a security guard so persons will come on the compound. And if someone is not there to quickly see them, they might end up coming to the office without being checked at the same time, so somebody — a teacher or the secretary — would have to run and check the temperature before they get to the principal or the classroom,” she said.

She said the presence of a school nurse would make things easier because: “Instead of sending home a child because of a sneeze or cough, a nurse would check for underlying issues, or so forth, so that a child may not be sent home for a long period of time because of a simple runny nose. Our children are way behind so we need them to be at school.”

However, Foster-Wallace said they make do with that they have.

“Right away, once we see that the temperature is high, it's either they go to the waiting area or we send them straight to the isolation room and the parents are called. And parents normally pick them up immediately. If they have a high temperature we don't isolate them right away… we send them to waiting area.”

Efforts to ascertain the status or outcomes of any current appeal from the JTA were unsuccessful.

The education ministry, however, said the primary schools are supported by the health practitioners from the nearest health centres or the nurses in the high schools, upon request.

“The principals are expected, as part of the COVID-19 response plan, to isolate, record and report...students with elevated temperatures [suspected cases] to the parish health officers, who provide quick-response guidance which may include immediate visitation to the school,” the ministry advised the Observer this week.

Meanwhile, Health Minister Dr Christopher Tufton stressed that beyond having a clinician on site, critical staff are aware of the safety protocols so that children who show symptoms of any kind are referred for testing.

“It doesn't mean that you have to have a nurse in order to identify some of the issues,” he said, adding, “What I can speak to is the strong partnership that we have with them, which includes us in all aspects of the COVID response and resilience at the level of the schools — and up to this point it has been going well.”

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