Pinellas school nurses adapt to battle the pandemic

“We do so much more than boo-boos and Band-Aids.”
Sara O'Toole, head of school nursing for Pinellas County.
Sara O'Toole, head of school nursing for Pinellas County. [ Courtesy of Sara O'Toole ]
Published Sep. 12, 2020

Pinellas County has been pushing to have a nurse in every public school for years. Last month, for the first time, that finally happened.

“COVID really ramped us up,” said Sara O’Toole, who oversees the county’s School Health Services.

In the past, some nurses oversaw as many as eight schools at a time. Even before the pandemic, O’Toole said, more kids were coming to school with chronic conditions, needing nurses to help with insulin, feeding tubes and catheters.

This year, nurses' primary responsibility is keeping the coronavirus from spreading through their schools.

A dozen Pinellas County school nurses decided not to come back this fall, because of the virus. O’Toole hired 18 new nurses. When the 125 schools opened at the end of August, she still had 17 slots to fill. Those vacancies, she said, are being covered by nurses hired from temp agencies, people she hopes might want to stick around.

The Tampa Bay Times asked O’Toole what nurses are doing to keep everyone safe.

How has the job of being a school nurse changed since last school year?

Nurses are going to be much more mobile than in previous years. Students won’t come to their clinic, the nurse will come to them. We have to keep students in their separate areas, so they don’t cross-contaminate.

We’re asking teachers to do any minor first-aid: Band-Aids and bug bite bleeds. But if someone needs their daily meds, or a diabetes check, or a tube feed, we’ll come to them and take them to a private space close to class to do that procedure.

If a teacher has a concern about a student showing symptoms, they’ll call the nurse, who will pull the kid out of class to do an assessment. If there’s a fever, or cough, vomiting or diarrhea, those are nonnegotiable symptoms, and we have to send them home.

Every school has a designated space, an “isolation room” where the student can stay until their parent comes to get them. Those rooms are converted classrooms.

What new training are nurses getting?

Before school opened, whole-staff meetings were held via Microsoft Teams for two hours each day. We discussed new protocols and changes to the nurses' jobs related to COVID, and we ended every session with a Q&A where nurses could submit questions, and I would answer them.

What types of new supplies/equipment are nurses getting?

Every school received a COVID box with additional gloves, masks, hand sanitizers, face shields, and additional signage. Every nurse was provided a “to-go” bag to use when they have to respond to a classroom to assess a student.

Is Pinellas working with other counties or state agencies to come up with protocols? Or is it all up to the county?

Soon after the governor ordered schools to close in the spring, the superintendent formed a task force of medical experts and community and district leaders. The group has been responsible for guiding the district on best practices for implementing CDC guidelines to help keep students and staff safe and healthy.

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Medical experts representing the Department of Health-Pinellas, John Hopkins All Children’s Hospital, BayCare and Community Health Centers of Pinellas, along with district leadership, did one last walking tour of our schools before they opened.

Will nurses be checking students' temperatures before they are allowed into the building?

No, only if they are showing symptoms, or their teacher has a concern.

Will nurses be conducting COVID tests if a student or staff member shows symptoms?


If someone tests positive, who else has to isolate? The whole class? Just students near that person?

The Department of Health is responsible for contact tracing, determining who isolates/quarantines, and notification of those directly impacted. The district sends those individuals a follow-up communication and sends the school a message stating there has been a positive case at their school.

If someone tests positive, how long before they can come back to school?

Employees and students can return when they meet the criteria laid out by the CDC for self-isolation: At least 10 days since symptoms appeared or since positive test date, and at least 24 hours fever-free without the use of medications, and once their symptoms have improved.

Once the student meets the criteria, they can return provided their cohort has also returned — because the cohort also will have been quarantined.

Employees also need written medical clearance from a healthcare provider before they can return to school.

Are you concerned about your nurses' safety?

I am concerned. My staff will be exposed to 800, even 2,500 kids every day. But we’re all trained to do this. Nurses are the best equipped of anyone to wear personal protection equipment properly. They’ll be wearing face shields, surgical masks and gloves. They’ll be helping to enforce that all the kids are wearing masks.