This site is intended for health professionals only

Read the latest issue online
Overwhelmed and undervalued


School nurses sometimes feel like they are wading through treacle


School nurse


Children are returning to school following closures during the peak of the Covid outbreak, in a welcome but challenging step towards normality for school nurses, writes Sharon White.

It is heartening to see most children return to school. The majority of them report feeling happy to return and especially welcome being back with friends and teachers

There are new routines, systems and behaviours that need to be followed, but the majority are not finding this too much of a challenge. As ever, children are very adaptable given the right guidance and support.

In Covid readiness, schools and school nurses have worked tirelessly together on risk assessments, implementing required Department for Education ‘systems of control’, health protection, wellbeing of staff and much more. One way routes, hand sanitising stations, staggered arrival/departures, lunch and play times, limitations on playgrounds and PE all make for significant upheaval; change for some is naturally challenging and is needing careful and considerate additional support, particularly for those with additional needs.

School nursing services have also redesigned their usual offer to support school readiness, primary to high school transition and even puberty lessons through amazing innovative digital offers. Extra focus has necessarily been given to promoting and supporting emotional health and wellbeing through unique and brilliant innovations too, which have been well received and appreciated by children and young people, schools and parents alike. Sadly due to repeated budget cuts and slashed school nursing services, this has not been a universal offer across the country; a travesty and inequality in itself.

Tragically, but as expected, schools, school nursing and children’s social care are now already swamped with complex safeguarding and mental health issues requiring urgent support and intervention. Many of our children have suffered sustained abuse and neglect whilst in lockdown whilst others’ mental health issues have been magnified or have developed as a result. (However, it should also be noted for some it has also removed many anxieties and worries, which have in fact improved their emotional health and wellbeing).

Within a very short space of time, schools are now witnessing Covid positive outbreaks resulting in a suggested circa 25% of children being sent home to self-isolate, this alongside the emerging travesty of lockdown now being imposed on so many university students too.

It was always expected that there would be local outbreaks however I doubt not on this scale. Schools and school nurses are doing their damndest to manage, comply and play their key role in breaking the chain of Covid infection, however, the demand on local public health teams and test and trace services means they’re often wading through treacle and against the clock.

Parents, frazzled at having had to keep their children at home for six months, home educate whilst often working themselves, are finding this all very frustrating. Whilst the majority are understanding when children are sent home from school, nerves are frayed and frustrations are now frequently being targeted at schools.

Many head teachers and school nurses are spending evenings, weekends tracing and contacting parents, staff and local communities to alert and inform. This is unsustainable with staff reporting feeling very stressed and worn out already so early in the term.

School nurses have recourse to both safeguarding and clinical supervision which, whilst it doesn’t remove the relentless pressure, does go some way in helping to ‘sort and sift’, prioritise and gain much-needed support and deliver safe, quality care. This is not the case for our teaching colleagues with minimal supervision in place. Some school nursing services, as an additional buy-in from schools, do and can offer this and self-care support to school staff with great success. This would seem an absolute must, especially right now, if we are to prevent the workforce collapsing under a strain which, I fear, will remain for the foreseeable future

SAPHNA have built strong relationships with teachers unions including NAHT and ASCL who, as part of the Governments Comprehensive Spending Review, have jointly called for a minimum 3,000+ urgent increase in the school nursing workforce, so we can provide much needed support to schools and deliver on our invaluable preventative public health role.

Meantime, we celebrate the strengthened partnership working between all agencies and, indeed, many parents, that has developed during Covid-19 and work together to facilitate safe school attendance for as many children as possible, mindful of the sage advice from Russell Viner, RCPCH, that our children may not be physically effected by Covid-19 ‘but the collateral damage of not attending school will be huge’.