School nurses work to keep students healthy, safe


As a nurse for 26 years and school nurse at Chatham County Schools for 14, Melissa Lassen has seen a lot of health crises in the country during her tenure: the 2009 swine flu, Salmonella and even clusters of mumps.

Still, nothing could’ve prepared her for the reality of living during the coronavirus pandemic.

“The amount of planning that has gone into this is unlike anything I have ever experienced as a nurse for 26 years, and I have never experienced anything like the planning that has gone into COVID,” said Lassen, who is the lead school nurse for CCS. “I don’t think anyone has any idea of the amount of fine details that we have detailed out to keep our students and staff safe.”

Just two weeks ago, more than 2,000 students returned to in-person learning on Oct. 19 for the first time in almost seven months, under Plan B. This followed the CCS Board of Education’s unanimous Sept. 29 decision to send Extended Content Standard E.C. students, Pre-K students and K-2 students back to school under hybrid learning starting Oct. 19; for now, all other students will be in Plan C until Jan. 15.

The preparation required to make that transition possible was immense, Lassen emphasized, adding that Chatham’s nursing staff had played an important role in all the logistical planning and execution required to ensure students can return to in-person learning safely.

Normally, school nurses do a lot behind the scenes to manage student health needs: overseeing handling of medication, educating teachers on how illness can impact academics and ensuring school vaccinations are up to date — in addition to the widely recognized role of treating student injuries or illness. During a pandemic, school nurses are still doing all of that, with the added responsibility of helping with student symptom screenings, serving as a resource regarding COVID-19 school protocol and assisting with contact tracing now that students are back in the school buildings.

“It added a couple of extra layers to what we normally do and made things a little more challenging for us,” Lassen said of the remote learning plan, which made communication with students and families more of a challenge in some cases.

As the lead school nurse, Lassen serves as a constant resource for the school administrators and the county’s eight other full-time nurses, who float among Chatham’s 19 schools.

Tracy Fowler, the executive director of student services and support programs for Chatham County Schools, said phasing in the return to in-person learning with a smaller number of students first has benefited nurses, as they are having to adjust to doing all their normal duties along with their new COVID-19-related responsibilities.

“They are liaisons between the health department and the school system,” Fowler said of the district’s nurses.

Many health officials and workers have felt the added strain from working during a public health crisis, and that’s especially noticeable among school nurses, who are often understaffed. The nationally recommended ratio is one nurse per every 750 students, but in North Carolina, 54% of school districts fail to meet this ratio, according to July findings from a public policy research group at UNC-Chapel Hill.

Chatham has just over 9,000 students, according to the National Center for Education Statistics, meaning the district would need three more nurses to meet the recommended ratio. It’s a ratio that is much better than in many surrounding counties, but eventually, Lassen said she’d love to see a full-time nurse in each of the district’s schools.

“I can tell you from just the number of years that I’ve done this, that the more you have a nurse in the school, the healthier your students will be and the better able they are to manage their academic with like their health issues,” Lassen said.

Still, she said each of the county’s nurses have been with the school system for a long time and have built strong rapport with the schools they serve. This sense of trust between nurses and their schools have helped make the implementation of so many new policies and protocols smoother, Lassen said.

There are no vacancies in the district’s nursing positions, which Lassen said is a big relief as the nursing team prepares for the eventual return of more students to school. While she does anticipate the pandemic will continue to increase their workload, she said picking up extra work is something each of the school nurses is used to doing every year — not just during COVID-19.

“I mean, I think the biggest challenge is probably being available to every school that needs us,” she said. “It’s easier because we don’t have every school in session right now, and we all know that. One of the ways we worked through it is I’m available to all the nurses … we also are meeting weekly with the nurses.”

CCS public relations coordinator John McCann praised Lassen’s leadership, emphasizing that all the nurses’ COVID-19 efforts reflect their larger goal of managing and maintaining student health.

“Just like feeding them is important, keeping them healthy is important, too,” he said. “It all works together.”

“It all works together,” Lassen echoed.

Since Aug. 17, 16 positive COVID-19 cases among staff members and four student cases have been reported, according to the district’s COVID-19 tracking page. It's unclear how many of those cases have been reported since the district partially reopened under Plan B, as the spreadsheet was posted last month. These cases have been spread out among the county’s schools and there are no reported clusters.

Combined with evidence of students and teachers wearing masks and socially distancing, Lassen thinks this demonstrates the school’s safety protocols are working. She was admittedly apprehensive about returning to in-person learning, but after the first day back, she became convinced the return could be and was being done safely.

“It’s good to see that our processes are working, that everything we put in place is working,” she added. “I mean, you can have great plans in place, but until you actually live it and walk through it, you don’t know, but it’s good to see that our plans are working.”

On Oct. 20, the second day of learning under Plan B for some students, Lassen was sitting in her office listening to a principal reading to one of the classrooms when she heard it — the sound of kids laughing.

“I thought, I am tired, I am worn out,” she said. “But at the end of the day, it was worth it all just to know that these kids have a little bit more of a normal environment. I mean, it made me feel like, OK, everything that we’ve done since March with all this planning, it’s worth it just to hear that 30 seconds of laughter in the classroom.”

Reporter Hannah McClellan can be reached at