School nurses play a pivotal role in school communities during COVID-19 and will remain critical after the pandemic ends. In addition to their regular duties, many school nurses are currently providing COVID-19 information to students, staff, and families; spearheading virus testing and contact tracing efforts at the school and district levels; caring for symptomatic students and staff; and serving as the school or district liaison to local health departments. Many states offer detailed guidance on the roles and responsibilities of school nurses at the district and school levels during the pandemic, including considerations for safely providing school health spaces and personal protective equipment (PPE). However, it is also critical that states consider ways school nurses’ expertise can be proactively leveraged to develop and enhance state and district plans for school reopening, as well as future plans for pandemic response and emergency management. To address these issues, states have provided the following recommendations: 

Include school nurses on state- and district-level emergency planning and response teams.

• New Mexico encourages districts to allow school nurses to lead pandemic planning and response teams so they can be responsible for monitoring community health information and communicating about health standards and protocols to the state education department.
• Oregon recommends that districts enlist school nurses to create or further enhance emergency planning teams. In districts without school nurses, Oregon recommends contacting the state School Nurses Association for support and expertise.
• West Virginia recommends including school nurses on crisis response teams that are responsible for updating and revising crisis prevention and response plans.

Prioritize the expertise of school nurses when designing and implementing school reopening plans.

• Connecticut recommends that any decisions about school closures or reopenings during COVID-19 are made in collaboration with, and at the discretion of, school health staff and school nurse supervisors.
• Georgia recommends prioritizing the perspectives of school nurses during the planning and implementation of school reopening strategies, including the assessment of available resources and staff, communication of and adherence to updated health guidance, and the provision of ongoing training to staff around health and safety procedures and guidelines.
• Massachusetts encourages districts to use school nurses’ expertise when planning for the end of the school year and throughout the summer, particularly when planning for student supports related to mental health and trauma, special education and related services, and students and staff with medical conditions.

Leverage school nurse leadership when reviewing and updating broad school health policies.

• Oklahoma encourages districts to include school nurses in discussions about the needs of the district, based on pandemic-related experiences over the past two school years, and consult school nurses when revising or adopting new health and emergency-related school policies. 
• For future pandemics, Wisconsin recommends that school nurses review and update district policies, particularly those regarding communicable disease outbreak and emergency preparedness, as well as district strategies to protect student and staff health information and privacy.
• Wisconsin also encourages nurses to use quality improvement processes to understand which school nurse activities and school health policies had the greatest impact on student health outcomes during the pandemic, and to reflect on processes that would improve communication and efficiency in future pandemic planning sessions.

While school nurses already played an integral role in school communities prior to COVID-19, their roles and responsibilities have been stretched even further during the pandemic.  States can leverage new funding from the American Rescue Plan to provide districts with resources to ensure that every school has access to a school nurse

Related resources from the Centers for Disease Control and Prevention and others:

• CDC: Strategies for Protecting K-12 School Staff from COVID-19
• CDC: Information for School Nurses and Other Healthcare Personnel Working in Schools and Child Care Settings
• National Association of School Nurses: Role of the School Nurse in Return to School Planning