Unphased and true to its core principles, values and practice, school nursing has risen above and beyond the challenges posed by Covid-19 lockdown with the majority of children at home and out of school.
Like many, our workforce rapidly redesigned its service offer. Whilst many other health services had to start from scratch, school nursing was, in many areas, already well-established in the use of technology, therefore, able to respond swifter.
Text services have been commissioned and successfully implemented in 50% more school nursing services during Covid. ChatHealth text messaging service has also advanced its offer to parents of under 5’s, peri-natal mental health and family nurse partnership services, which has increased confidential access for many children and young people with school nursing services able to respond offering early help, intervention, support, advocacy, signpost and, as necessary referral. We know of at least one case where a young man, in the throes of committing suicide, was prevented by rapid intervention triggered by his school nurse during a text conversation.
Traditional school/community based ‘drop-ins’, have been offered as ‘e-clinics’, through remote contact and, as preferred, including face-to-face via tech platforms enabling new self and other referrals and continuity of care. This includes helping our students in addressing issues such as loneliness, abuse, eating disorders, anxiety, sexual health and much more.
Recognising the immense toll that lockdown and isolation can and has taken on children and young people’s mental health, services have also been offering remote 1:1 interventions and group courses on emotional health and well-being, to parents/carers, children, young people, schools and stakeholders. ‘Walk and talk’ sessions – held while walking outside – have enabled much needed face-to-face for some young people whilst also the added bonus of exercise and positive impact of nature on wellbeing. These initiatives have been received positively and are receiving excellent feedback and outputs.
School nurses have used social media and websites to great effect to promote their availability, to share health messages and to encourage service users to access theirs and others health services eg sexual health.
‘E-consent’ has also rapidly extended across many more school nursing services, ridding the need of excess bureaucracy, paper, resources and precious admin time whilst at the same time improving safety, governance and facilitating speedier services. This has been key in the immunisation catch-up programmes where they’ve worked tirelessly to ensure those immunisations missed due to school closure, self-isolation, illness etc, are protected from other diseases as part of the childhood immunisation programme.
Drive-thru clinics, first introduced by school nursing services on the Isle of Wight, have now been replicated globally as a safe initiative to administer coronavirus immunisations as well as deliver other health services such as vital asthma check.
Tragically, during lockdown, we have seen an exponential rise in the number of children, young people and families experiencing abuse, neglect and some becoming victims of the impact of poverty, including digital poverty. Therefore, a blended offer has been offered by school nursing services including hard copy information via post and/or face-to-face (where compelling need identified).
Safeguarding meetings have also been successfully conducted using digital platforms. Some families have welcomed and responded well to this approach, including reported improved engagement with school nursing services as part of child protection plans and interventions.
School nurses have vitally increased their contact and ‘presence’ with schools throughout the pandemic, using their specialist public health nursing skills and experience to support schools’ infection prevention and control, track and trace, research swabbing testing and more. This has been done through ‘virtual’ assemblies, health education sessions, ‘meetings’ and face to face as essential. This has not gone unnoticed with schools and school unions calling for urgent investment into services.
There is so much we can and must learn from this pandemic including the stark inequalities. We know that our children and families have suffered trauma of one kind or another and that their mental health and child protection issues will need more support than ever. School nurses have proven their worth on this, especially during Covid-19. In the forthcoming comprehensive spending review, surely our Government must recognise and invest if we are indeed to Build Back Better.