A Kentucky School Nurse Faces The Pandemic As Her 'Hotspot' District Reopens

Aug 31, 2020

Tina Ryan stands by her supplies at East Calloway Elementary in west Kentucky.
Credit Liam Niemeyer | Ohio Valley ReSource

Tina Ryan knows the hallways of East Calloway Elementary better than most. Besides working as a school nurse here for 20 years, Ryan, who is 55, was also a student here herself. 

“I’m probably one of the older ones here as far as staff and things. Or maybe the oldest one here,” she said with a laugh. “I was happy to know I was coming to East Elementary when I got the job. Because I was an alumni here.”

A pencil-shaped sign that reads “Nurse’s Office” hangs in the hallway next to her door, with all the classic supplies of a veteran nurse inside: tongue depressors, a blood pressure cuff, itch cream — “bug bites all the time” — and loads of bandages and band-aids.

 


 

Kids walk through her office for vision screenings, headaches, and the kids she calls “frequent flyers,” otherwise known as students who may be visiting just to get out of class. But a new tool also sits on her desk — an infrared, touchless thermometer to check for fever, a COVID-19 symptom. 

“Somebody’s gonna test positive. But we have what we’re going to do if that happens,” Ryan said behind her red and white mask. “I mean, it’s just inevitable it’s gonna happen.”

Calloway County Schools is one of a minority of school districts in Kentucky to offer in-person classes alongside a remote learning option. The school district’s decision went against Governor Andy Beshear’s recommendation to delay in-person school openings until late September due to COVID-19 concerns.

Beshear last week advised against in-person classes for counties considered to be COVID-19 “hotspots,” those counties that had coronavirus test positivity rates of more than 10%. According to a recent White House report Calloway County was among those “hotspot” counties. The test positivity rate for tests conducted at Murray-Calloway County Hospital, the county’s only testing site, was 7.51% as of August 20. A district spokesperson said the district expected about 60% of their more than 2,500 students to be back in classrooms.

Tina Ryan stands among classroom desks in the altered cafeteria at East Calloway Elementary.
Credit Liam Niemeyer | Ohio Valley ReSource

This pandemic is unlike anything Ryan has seen during her decades in these hallways. Yet Ryan and the school district are putting their faith in a detailed reopening plan

Teachers and staff have to self-assess symptoms before entering schools. Each student gets a temperature check and hand sanitizer when entering schools. Masks are required when social distancing can’t be maintained, the cafeteria is cleaned between lunch periods and the classrooms cleaned daily. In East Calloway Elementary, the cafeteria has more than 50 classroom desks spread out across the large area.

“That is just one of the things that was so strange to me when I walked through the cafeteria for the first time,” said Ryan. “There’s just no long cafeteria tables. That’s just what I grew up with —  big, long picnic tables.”

And when a student appears with COVID-19 symptoms, the person teachers will often look to is the school nurse. But Ryan said tracking the coronavirus in schools can be difficult because kids have potential symptoms for a lot of reasons, especially as school enters into flu season.

“Well, it’s allergy season. It’s hot outside. Everybody’s coughing, so we’re not gonna send them home just for a cough,” Ryan said. “It’s supposed to be a new cough that just started, and there are other guidelines I’m going to be looking at.”

Yet, worries follow her, including the implications of recent research showing that children may be more likely to be asymptomatic carriers of the virus. Research from hospitals in Massachusetts shows that kids, even without symptoms, can have higher levels of coronavirus than do patients in the intensive care unit. 

She worries about parents and families not following COVID-19 guidelines and then sending their kids to her school. She worries about her students with chronic illnesses who could be more vulnerable, across the hundreds of students she cares for in multiple schools. 

“If one person ends up getting really, really sick or possibly even dying, that would be devastating. That would be so devastating,” Ryan said. “But I wouldn’t think it was the school’s fault, because I know what we’ve done, know how hard we have worked, to do things. But it would still be hard.”

If a student is sick with COVID-19 symptoms, she’ll have to call parents to have them pick up their child, which leads to more potential issues with parents sometimes hard to contact. She worries students may feel afraid to say they feel sick while sitting in a classroom. But Ryan also knows some parents may not have much of a choice about sending their child to school.

East Calloway Elementary in west Kentucky.
Credit Liam Niemeyer | Ohio Valley ReSource

Sometimes, a student doesn’t have health care access other than visits to the school nurse. Families may struggle with finding child care options if they have to have kids learning remotely at home. Ryan’s daughter could have sent her child to kindergarten this year, but decided to wait another year due to COVID-19 uncertainty. 

Ryan’s not alone in facing these challenges, as a variety of school reopening plans are being implemented across the Ohio Valley. West Virginia leaders are using a color-coded system to determine reopenings with a plan for school entry in early September, while Ohio school districts have a variety of school reopening plans in action over the upcoming weeks. A rural school district in central Kentucky had to switch from in-person learning to virtual after COVID-19 cases spiked in the region.

In Calloway County there have been four confirmed COVID-19 cases so far associated with the district going into the school year, but the district said in a report that no exposure has happened at schools. 

Even with that anxiety and warnings from the state, Ryan is optimistic the district’s plan will work. In a follow-up call she said the first week has gone well, even with having more kids than she expected in classes. And she believes students should have the option to come back to school for several reasons, including to check in on students the district hasn’t seen since the pandemic took hold in March.

“I just feel like that kids, physically, mentally, socially, they need to be back in school. It’s time to be back,” Ryan said. “They want to be back. And again, if they don’t, if the parents choose not to, that’s their option.”

Yet the virus is still around. Regardless of what happens, Ryan said she’s always happy to see kids back.