In the summer of 2019, I was privileged to teach another cohort of Rutgers-Camden School Nurse Certificate students. That same summer I spoke at The Future of Nursing 2020-2030 Townhall in Philadelphia, and they came to support me. At the end of the formal presentations, audience members were invited to speak about their vision for the upcoming, much anticipated, consensus report. One of my students, Karen Vidal, bravely took the mic and spoke that day. She continues to use her voice to champion children’s health. Karen is now my colleague as she recently transitioned from a long career in pediatric oncology to school nursing in the midst of a global pandemic. Here is a letter that Karen wrote to the Board of Education in the town where she lives, and her children attend school. Nurses, we need to use our voices to educate and influence the public now more than ever!
July 16, 2021
An open letter to the Moorestown Township Public Schools Administration and Board of Education:
I would like to thank the MTPS Administration and BOE for waiting to decide on masks in MTPS schools until closer to September. The CDC has made recommendations for anyone who is not fully vaccinated against COVID, to wear a mask in schools. There is no health care organization at the federal, state, or local level who is advocating for unvaccinated people to have the ‘personal choice’ to wear a mask in a school building. Vaccination is a choice. With that choice comes the responsibility to wear a mask if you decide to not vaccinate (or are not eligible for the COVID vaccination due to medical reasons or age).
As I stated during the public comments portion at the BOE meeting, conspiracy theorists are spreading disinformation to the public. Although we are a community of good people, we are also exhausted, stressed, and concerned for the wellbeing of our children. This makes all of us vulnerable to disinformation and misinformation. The US Surgeon General, Dr. Vivek Murthy agrees, releasing a statement warning Americans about the “urgent threat of health misinformation.” We have the power and responsibility to confront health disinformation. As educators, MTPS should be living up to its reputation for academic excellence including basing decisions on the recommendations of the experts in this area including (but not limited to) the CDC, NJDOH, NJDOE, and the Children’s Hospital of Philadelphia. They, and countless others, agree that anyone who is not vaccinated should wear a mask in a school building.
There is no reason to go against CDC recommendations when we know the Delta Variant is the predominant strain of COVID infections in NJ. Nationwide COVID numbers have doubled. We must consider morbidity as well as mortality. It has been proven that children do suffer from long COVID. We can prevent COVID from spreading with proven mitigation factors, like masking.
In addition to listening to the outside medical experts, we should be utilizing our experts, our MTPS school nurses to help make these decisions. The National Association of School Nurses (NASN), “strongly encourages school districts to leverage the public health expertise of their school nurses when determining the appropriate COVID-19 prevention protocols as outlined by the CDC”. Our school nurses have the data to make informed decisions based on the specific population at each MTPS building. The two data points that we should be taking advantage of is COVID vaccination rates and number of chronic health conditions per building. ESSER II funds were released in March 2021 to assist schools in safely reopening. They can be used to compile this information, needed to guide policy directly related to student health and safety. Let’s start with vaccination rates.
New Jersey’s, The Road Forward: Health and Safety Guidance for the 2021-2022 School Year addresses vaccination in section 1.1: “Most K-12 schools will have a mixed population of fully vaccinated, partially vaccinated, and unvaccinated individuals at any given time, thereby requiring the layering of preventive measures to protect individuals who are not fully vaccinated. LEAs [local educational agencies] are encouraged to have a system in place to determine the vaccination status of students and staff, however, if an LEA is unable to determine the vaccination status of individual students or staff, those individuals should be considered not fully vaccinated.”
MTPS already has a system in place with our electronic record system (Genesis) and the New Jersey Information Immunization System (NJIIS). Our school nurses and/or administration can pull the data and present vaccination rates per building to the BOE, at a public meeting, without any identifying information. Instead of guessing or estimating the vaccination rate per building, utilize the data we have available to make informed decisions based on facts.
The other piece of crucial data is our students with chronic medical conditions. School nurses keep the number of students with asthma, allergies, diabetes, immunocompromised students, and students with other chronic health conditions at their fingertips. Students with chronic medical conditions cannot not be forced into homebound learning; it is not the least restrictive environment. We are a community and should do what is best to protect the most vulnerable in town. MTPS school nurses can report the number (or percent) of students with chronic health conditions per building while maintaining student privacy as required by HIPAA and FERPA. Once we have the data, a multi-disciplinary team can review and make the decision in the best interest of the specific population, at each building.
The precedent has been established by our MTPS school nurses to implement evidence-based practice to keep vulnerable children safe. The school nurse in an elementary building noticed an increase in the percentage of students with peanut/tree nut allergies. This prompted a change in policy based on data specific to the building. The same can be done to protect our vulnerable population from COVID.
Science is not a result; it is a process. Remove one mitigation factor at a time. When you remove multiple at once, you have no way to know which was working. MTPS is already removing 3 mitigation strategies at the beginning of the school year: 1) We are going back full day. 2) We are having lunch in school. 3) There is no remote learning option; all students will be in the buildings. Another mitigation factor is increasing the numbers of vaccinated students and staff. We expect approval for children under 12 years to be eligible for COVID vaccination sometime this fall. Once we have an increase in vaccination of students in our buildings, we can change our guidelines based on new data. Until then, we should keep the mitigation strategy of masks for anyone who is not vaccinated.
It has been proven that masking works and protects other people in addition to the person wearing the mask. Simply allowing for “optional” masks is not enough. We wear a mask to protect students with medical conditions and students who are not yet eligible for COVID vaccination.
MTPS has a district Social and Emotional Learning Goal to prepare students, “to contribute to and thrive in an inclusive, diverse and evolving global society.” We need to practice what we preach and show the community we are inclusive of students with chronic medical conditions. I would also encourage a community forum of pediatric specialists in the area, including those from the Children’s Hospital of Philadelphia, to educate the community on public health standards of practice, and COVID vaccines. I am available to volunteer my time and partner with the district to assist in any way necessary. I believe in a transparent process. Educate the community on public health & safety for the benefit of our children, our schools, and our town. I am asking MTPS to live up to our mission of E3 = Excellence, Equity, Engagement through Community Partnership. I look forward to seeing the data for COVID vaccination rate and chronic health conditions, for each school building in MTPS.
Karen A. Vidal, BSN, RN, NJ-CSN
Parent of 2 students in the district
Bio: Karen A. Vidal, BSN, RN, NJ-CSN has been a nurse for 23 years. She received her BS in Nursing from the Pennsylvania State University. In 2001 she started credits to her master’s degree. In December 2019 Vidal completed her NJ State School Nurses Certification program at the University of Rutgers, Camden. Vidal began working in NJ public schools in April 2020. During the pandemic, Vidal led a project to provide and accurate and timely report to District Administration that gave numbers of students with missing physicals and immunizations. Her work assisted the public school district to bring needed health care (physicals, immunizations) to a specific community, neighborhood, school, and age group in need, during the pandemic. Her project allowed the district to see a breakdown of data per school, per grade, and district wide per grade, for both missing immunizations and missing physicals. This report was updated and shared weekly. Vidal has a passion for providing quality care to students, and the necessary leadership skills to inspire other staff members to strive to provide above standard levels of service while implementing the most up to date evidence-based practice to guide day-to-day clinical practice. She has been recognized as a dedicated, ambitious, and reliable person who has the ability work proficiently among multidisciplinary teams. Prior to working as a school nurse, Vidal worked as a Registered Nurse in direct patient care on the inpatient Oncology, Blood and Bone Marrow Transplant units at The Children’s Hospital of Philadelphia for 16 years. During her last 10 years at CHOP, she volunteered as team captain for CHOP Cancer Crushers, bringing together over 200 staff members from the Cancer Center, family, and friends to participate in the Parkway Run and Walk every September. Prior to her career at CHOP, she worked at Alfred I DuPont Hospital for Children and Penn State Children’s Hospital at the Hershey Medical Center. Vidal has dedicated her life to pediatric nursing.
2 thoughts on “The Relentless School Nurse: The Power of Nurse’s Voices”
Thank you for sharing Karen Vidal’s brilliant and inspired letter to her board of education. She provides a compelling argument in favor maintaining mitigation strategies based on vaccination rates. I’m looking for speakers for my County school nurses organization for the fall, and would love to assist our members to express such important information so eloquently.
Thank you for your comments Carolyn, I shared your message with Karen!