School Nursing

The Relentless School Nurse: A Tale of Health Inequity


Sometimes there are moments that jar me into deeper levels of understanding how difficult our health system is to navigate for people who do not speak English. It’s obviously not just our broken health system that makes life hard for people new to our country, but when it is, it can be a matter of life and death. This could not be more true than in the midst of a pandemic, with a variant that is impacting children.

I am a school nurse for preschoolers in an urban rich community. I like to describe my city as urban rich because it is filled with art, culture, diversity, and people from many parts of the world who have found their way to Camden, New Jersey. Ever present is poverty and structural inequities that impact the social determinants of health. I have a colleage who called them social determinants of death, she was not wrong…

Many days at school, needs are high and resources are depleted, especially now as COVID and specifically, the Delta variant is swirling around us. I feel like we are playing “Whack a Mole” with this virus that holds no prisoners and devastates families. Many of my families live in shared spaces, creating more chances for transmissibility of the virus. 

In one of these shared apartment spaces, one of the adults was COVID positive. A parent, out of an abundance of caution for her young child, took them for a COVID test. She went to an Urgent Care and waited for the test results. The parent did not send the child to school while waiting for the COVID test, a rarity this school year. The parent is Spanish speaking and presented to the Urgent Care needing a translator. The problem became in obtaining the test results in the language the family speaks. 

School nurses are care coordinators, one of the many skills we bring to our practice. After four days, when the parent did not know her child’s test status, she reached out to the school for help. When I found out that the student was COVID positive and had to share this information with the parent, it struck me how broken our healthcare communication system has become. While the parent took the news calmly, I wanted to know more about why she was not made aware of the results. It turned out the Urgent Care did call, according to their office notes, and left a voicemail two days prior, but the message was left in English. We must do better. 





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