School nurses have been on the front lines of New Hampshire schools’ daily battle against COVID-19, with a goal of keeping case numbers low enough that schools can stay open for in-person learning.
At Bow Elementary School, that nurse is Shannon Donahue. Her workday often begins before she’s even inside the building in the morning, as fellow staff members wave her down in the parking lot to ask her advice on exposure and safety protocols. From that point on, she’s busy making phone calls and responding to emails from parents and teachers, answering questions, giving advice and updating them on exposures and student quarantine status. She’s also checking students for symptoms, sending them home if they’re sick and notifying staff, parents and the Department of Health and Human Services if they test positive.
“I really consider myself a holistic nurse. If somebody comes to me with a health concern, I focus on everything about them,” Donahue said, about her nursing approach. “How’s your sleep? How’s your diet? How’s your stress? I don’t just try to focus on this one problem that you have, I try to come at everything from a holistic standpoint.”
Donahue became a school nurse 11 years ago, after starting her career as an accountant. An interest in health and wellness, which started as a hobby, became a full-time job when she went back to school and decided to pursue nursing in earnest.
“She has worked tirelessly since the beginning of COVID to keep our school and children of our community safe,” wrote Miranda Belmont, kindergarten paraprofessional and one of two people who nominated Donahue as a Hometown Hero. “She always has a smile on her face. She is a wonderful and caring member of our community and I don’t know if we would have made it through all of this at school without her support and help.”
School nurses’ approach to care has changed slightly in last two years. While before, school nursing was all about helping children mitigate their symptoms enough to return to class, the pandemic has necessitated removing symptomatic students from class to mitigate the risk for others.
Karen Audet is the school nurse at Boscawen Elementary School. She says this switch has been a major one, both for her and for families.
“My job before was keeping kids in school. Now I’m sending them home with a runny nose because that could be a symptom of COVID,” Audet said. “And we do see kids with runny noses that test positive. I know sending these kids home affects the families and their work and things like that, so that’s what makes it stressful.”
Audet has been a nurse for 21 years, and has previously worked at Merrimack Valley High School, St. Paul’s School, Dartmouth-Hitchcock and Concord Hospital. In addition to her day spent tending to students and evaluating them for symptoms, Audet attends regular meetings with state health officials like epidemiologist Dr. Ben Chan and other school nurses from around the state. Like Donahue, she spends much of the day on the phone and in her email, answering parent questions about symptoms and quarantine requirements.
“We feel so fortunate to have Karen leading us through this pandemic,” wrote first grade teacher Sally Fisher, who nominated Audet as a Hometown Hero. “She provides timely information without being overwhelming. She understands many points of view. She is empathetic toward all. She has kept her sense of humor and a smile. She is fair, considerate and respectful. She keeps in touch with staff and families even over weekends and breaks so that everyone has the knowledge they need to move forward safely.”
Audet loves working with kids and says she misses they days when they came to visit for reasons other than COVID symptoms. She said it can be difficult to explain the low bar for sending a child home from school – a child only needs to display one symptom of COVID-19 to be sent home – to parents who haven’t been closely following COVID guidelines at home.
“Our school follows the New Hampshire Department of Health guidelines, and a lot of places don’t,” Audet said. “So a lot of people just don’t realize that, because they might not be following the strict guidelines that the Department of Health wants us to follow.”
For Donahue, the most difficult part of her job – one she’s had to do a lot this month – is telling families they have to quarantine over the holidays.
“I’ve had to do it over Thanksgiving, I’ve had to do it this week for the Christmas holidays, and it’s hard,” Donahue said. “I’ve had moms start crying on the phone. Everyone’s trying to spend time with their family, get together with their children or grandparents who they haven’t seen for eight or 10 months and they’ve made plans and they can’t do it now. I am unfortunately the one who has to break that news to them.”
Donahue said one of her biggest successes this year was a vaccination clinic she organized at Bow Elementary, where 113 students got their COVID-19 vaccine and and 36 adults got a booster shot. Donahue called organizing event a “labor of love.”
School nurses across the state have been working more days and longer hours the past two school years than ever before in their careers. Audet said the paperwork alone that’s required for charting the positives and negative cases can make for extra-long work days. Donahue said she worked seven days a week throughout the 2020-21 school year and the summer, alongside other school staff, to come up with the safety protocols and prepare for the in-person return in the fall.
“I want these kids to be safe. These kids are like my kids, they’re like my work family, I want to take care of them,” Donahue said. “So you say to yourself, ‘okay, I’m doing this because I want to keep these kids safe, that’s all that matters. Nothing else matters at that point, you know? Yes, I’d like to be sitting on the beach, but this is a little more important.”
When discussing their work, both Donahue and Audet emphasize their roles as part of teams, saying they wouldn’t be anywhere without the help of their coworkers, the support of their administrators and the solidarity of other school nurses statewide.
“I get a lot of support from my administration, which is so important right now with COVID,” Donahue said. “People are always asking me if they can help and they’re always just being nice and telling me I’m doing a good job. I don’t know if I would still be able to do this if that wasn’t happening.”