School Nursing

The Relentless School Nurse: How Sick is Too Sick to Come to School?

I often get ideas for blog posts from articles that cross my path. Today’s topic came from this headline that caught my eye:
 

The debate over when to keep children home from school due to illness reflects a broader concern about balancing public health with educational needs. During COVID, schools emphasized the importance of keeping any sick children at home to prevent the spread of the virus. However, as the immediate crisis has waned, there’s a shift towards encouraging attendance even when children exhibit mild symptoms of illness.

Attendance Works, a nonprofit focused on improving school attendance, advocates for sending children to school unless they are unable to participate in day-to-day activities or have severe symptoms. They argue that low-level sickness should not be barriers to attendance.

The American Academy of Pediatrics advises that children should stay home if they exhibit signs of significant illness, such as fever, vomiting, or diarrhea, or if they are not well enough to engage in class activities. Fever is specifically defined as a body temperature of 101º F. 
 
School districts across the United States have varying guidelines on when to keep children home. For example, the Fort Worth Independent School District recommends staying home for symptoms like cough, sore throat, or rash, and students should be “fever-free” for 24 hours without medication before returning. The Austin Independent School District lists additional symptoms like eye redness and undetermined rash as reasons to stay home. In contrast, New York City schools and Maryland’s Montgomery County schools have their specific criteria, including prohibiting attendance for children with lice or advising staying home for symptoms like stomach pain or thick yellow nasal discharge.

This inconsistency in guidelines reflects the diverse approaches of different schools and districts, influenced by their tolerance for illness and local health concerns.
California has recently adjusted its guidelines, allowing children with low-level signs of sickness to attend school, aiming to reduce the educational impact of absenteeism. This change is part of a broader discussion on how to balance the need for public health precautions with ensuring children receive consistent education.

The decision on when to keep a child home from school due to illness involves balancing the risk of spreading contagious diseases with the importance of regular school attendance for education and social development. Guidelines vary by location and are evolving in response to changing public health dynamics and educational priorities. 
 

Let’s hear from you, has your school district changed attendance guidance? If not, should your school health guidelines be updated? 

 
 
 

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2 thoughts on “The Relentless School Nurse: How Sick is Too Sick to Come to School?”

  1. My children’s school has definitely changed guidelines, or the school nurse has her own. My son got sick at school and went to the nurse’s office. He was told to lie down for fifteen minutes and sent back to class because he didn’t have a fever. He spent the rest of the day running back and forth to the bathroom because he had severe diarrhea. Four of those times, he didn’t quite make it in time and had to clean himself up. I am furious that I wasn’t called to make the decision to pick him up. Another student went to the nurse because of fever, vomiting, chills, etc. and was sent back to class. Meanwhile, my son has gotten sick twice since the beginning of the school year- fever, cough, vomiting, body aches, etc. and the school counselor told him that (even though he had doctor’s notes explained his absences) if he misses any more school they will have to contact child protective services. Now he is scared to get sick! Since when did it become a crime to keep or send sick students home? Maybe if more parents, and the school nurse, did this, then so many other students (like my son) wouldn’t get sick so frequently!

    1. Thank you for reaching out Amber, I hope you can discuss your concerns with the school nurse and administration. While our goal is to have our students present in school, there are certainly circumstances, like illness, where students do need to have excused absences. Chronic absenteeism is a huge issue across the country, but that is equivalent to missing 10% or more of school, so about 2 days per month. Your concerns are valid, and it is best if you discuss them with the staff involved.

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