What is it Like to be a School Nurse During COVID-19?

Her entry into St. Michael's College School (SMCS) has been fast and furious.

After all, she is the first nurse the school has had in recent memory. Her tenure at SMCS began in the throes of a global pandemic. And, this is the first time in her career she has worked in a school.

"I've been an intensive care nurse for 12 years," says Natalie Hnidec, Registered Nurse at SMCS. "I've been lucky to dabble in outpost nursing in Nunavut and camp nursing with Pioneer Clubs and the Salvation Army."

Her arrival came not a moment too soon.

Natalie Hnidec, School Nurse at SMCS.

Natalie Hnidec is the first school nurse in many years at St. Michael's College School.

"Natalie has been instrumental in our COVID-19 management plan," says Sarah D'Angelo, who led the interdisciplinary Safe at School Committee put in place this past summer and is also a member of the school's Joint Health and Safety Committee in addition to her role as Human Resources Manager. "She brings a cautious approach to our processes and procedures, and provides a lens and expertise that no one else has in the building. We’ve come to realize throughout this pandemic that so much of what we do needs to be reviewed, and she has helped guide us through those changes."

Of the newly-introduced position, D'Angelo says, "It was a role the school has considered over the years, but this pandemic convinced administration it was time to implement it."

So, what is involved in leading the health management of a community of 1,200 people on a daily basis during COVID-19?

Hnidec provides a glimpse into a day in her life at SMCS:

Natalie Hnidec, School Nurse at SMCS and Marianne Ottavino, attendance assistant

Natalie Hnidec and the Attendance Assistant, Mrs. Ottavino, meet every morning to review student absences.

What staple elements make up a typical morning in the SMCS environment?

The morning starts before students begin to arrive for school. I work closely with Mrs. [Marianne] Ottavino [Attendance Assistant] to assess absences reported by parents. We developed a comprehensive illness tracking system which allows me to visualize trends among certain grades or cohorts. Every COVID-19-like ailment or potential exposure cues a call to action. Parents then receive emails or phone calls so I can assist in creating a safe return to school plan for their son which may require students to quarantine, have a COVID-19 test, or return after their son feels better after 24 hours. Each situation is different and requires its own keen eye for safety.

What does an average afternoon at SMCS look like in your role?

My afternoons are primarily used to continue developing our COVID-19 defense plan. I'm usually consulting with educators and administration regarding enrichment activities which make the SMCS experience memorable for students. Safety must be at the forefront of all decisions so minimizing risk exposure is a team effort. When planning events, all aspects must be ironed out prior to implementing an activity, from utilizing designated spaces so there is no mixing of grades, assessing the availability of Safe Officers, adding additional cleaning requirements to our housekeeping staff, and limiting unnecessary exposures.
Sprinkled into the mix is my interaction with the students! Sometimes I am helping a student who is unwell or walking through common spaces and reminding everyone to physically distance, sanitize their hands, and utilize their masks appropriately.

Natalie Hnidec, School Nurse at SMCS.

What has been your biggest challenge so far?

My role is about safety, and with safety I'm often putting the brakes on activities or wrapping them in red tape until I often take the fun out of them. It would be nice if I didn’t have to wear a mask all the time—because people never see my smile. I often feel trapped in an ‘enforcement’ role due to my mask. Even when a student is unwell or has an injury, the assurance and welcome a smile can deliver is no longer a resource. All school staff have to work hard at showing care with their eyes, how they stand, and utilize their laughter to provide a positive learning environment.

What is unique about working in a school environment?

It is extremely positive. I'm usually exposed to the other end of the health spectrum —when people have multiple disease pathologies and you are fixing the situation. Here, I am working with healthy people and keeping them safe. It's uplifting to visualize the joy and fun students are having and know I get to play a role in providing a safe school environment where they can continue to engage with one another.
What is your main message to staff in this pandemic environment?

It's never easy to hand over the keys to your health to anyone. The administration at this school is unbelievably supportive. From the top of this organization, people are concerned about the health and well-being of the staff. There is never a time when I feel my concerns are not validated—this is the type of work environment that values people and their lives.

Your key message to parents in this pandemic environment?

I notice trends regarding exposures. Most exposures seem to happen through carpooling and at recreational sports activities. SMCS loves its sports, but there is a season for everything and I want families to be able to enjoy life together when the pandemic is over.

The SMCS security team speaking with students

How would you describe compliance, overall, in the school environment?

Staff and students are doing surprisingly well considering all the changes. Constant vocal reminders and visual cues are necessary when you are working with this age group. Overall, I'm extremely proud and feel safe where I work. 

What has surprised you most about the current COVID-19 climate?

In the ICU (intensive care unit), I saw patients daily who were fighting for their lives—there was a real urgency and blatancy that COVID-19 existed. Now, at SMCS, you don’t see the faces of individual cases. The decisions we make to keep each other safe are often laborious, annoying, or limiting. If I did not have my previous work exposure, I would think COVID-19 doesn't exist because I don’t have a direct family member or friend who has been diagnosed with it. I understand why some people are having difficulties with compliance of strict protocols.
What concerns you the most in both the short and long term?

Mental health and physical fitness have been placed on the back-burner. For many, life is difficult without the added pressures of job insecurity, co-morbidities from sickness, and loss of loved ones. I worry about those who are feeling lonely or experiencing hopelessness and are unable to access the resources like gyms and friends/family to elevate their mood. Less daylight and colder weather make for difficult times. I would like this to be over so the mental strain of COVID-19 doesn’t compound the winter blues.

SMCS grand staircase and main entrance

A fast and furious introduction to two new worlds at the same time has made visibility and responsiveness key elements of the school nurse role.

"Natalie has been excellent at creating a presence within the school – she makes herself available to students and staff alike to answer questions," says D'Angelo. "She has spoken with a number of parents as they navigate their sons’ health during this time as well."

Apart from COVID-19-related requests, Hnidec is also part of the school's Health Team.

"Life in our school continues, and other illnesses are still a part of school life," says D'Angelo. "We are blessed to have staff who are first responders, and can provide first aid, but to have someone on staff who can help us with transmissible disease management is extremely helpful."