Many cling to daily coronavirus numbers — infected, tested, recovered, dead — to understand the complexity of the pandemic and its path. But on a recent Friday, other figures loomed over Liz Pray, a school nurse.

120 phone calls. Seven hours. One infected employee.

When a school staff member in the Moses Lake School District tested positive for COVID-19, Pray was suddenly called to the frontlines. The local health department in the district about 180 miles east of Seattle has few staff, and needed help reaching the 100-120 people the employee had contact with: the staffer was contagious on the final day before schools closed. With a list of about 40 phone numbers in hand, Pray started dialing.

On the other end: “There were a couple of parents who were really upset and others who were like, ‘OK, thanks for letting us know.'”

Said Pray: “Given [my] experience as a nurse, you are kind of prepared for anything.”

With school buildings closed through the summer, school nurses are busy tracing contacts. Staffing COVID-19 call centers. Giving medical advice to people with coronavirus-like symptoms. Some are taking the temperatures of children at day care centers, and essential school staff who make and distribute bagged lunches.

This is the new reality for Washington’s at least 400 school nurses, and for those across much of the United States. Nationwide, about 95,000 nurses work at schools, said Laurie Combe, president of the National Association of School Nurses.


These critical public health employees typically spend their days on school grounds, administering medications, taking care of those who feel ill and making important decisions about the safety of students and staff. But these medical staff are beginning to fill urgently needed roles elsewhere.

In the days after schools closed here, many nurses say they rushed to collect and distribute students’ prescription medications stored at school, to ease the transition for families with children who might need refills. Then came calls for other forms of help. Some local hospitals and clinics asked school nurses to pick up shifts, said Amy Norton, president of the School Nurse Organization of Washington (SNOW). “We can use our license anywhere,” she said.

Krissa Cramer and her colleagues now screen every person who steps in Arlington School District buildings. Cramer is a nurse in the district between Seattle and Bellingham, which serves about 6,000 students. School nurses check for fevers and ask questions about symptoms; about 100 to 150 people are still visiting schools to provide child care, pack lunches or pick up teaching materials, Cramer said. Those who pass a health screen get a sticker or mark on a punch card. Everyone else is told to go home. “They are turned around,” she said. “It’s happened on several occasions over the past few weeks.”

Pray, president-elect of SNOW, is on call if the public health department needs her. She wishes she could do shift work, but is trying to limit time she spends outside her home. Pray and her son, a sixth-grader, live with and care for Pray’s grandmother, a colon cancer survivor who may be at risk for COVID-19 complications.

She uses her skills in other ways. One day, a father reached out when his child had a minor seizure at home. He didn’t know how to administer the seizure medication, so Pray made him a training video for future reference.

Elsewhere, school nurses are being asked to consult for child care centers. Alyssa Johnson, a nurse in the Bellingham Public School district, said she’s taken the temperatures of day care children, and helped train child care center staff to conduct health screenings.


Johnson and her nursing colleagues were also charged with scouring school health rooms, science classrooms and custodial supplies for masks, goggles and gloves. The district donated about 300 boxes of gloves, 500 sets of eye protection, bottles of hand sanitizer and some N95 and surgical masks to public health officials. They kept the district’s thermometers, and have loaned several out to child care centers. Some centers “just didn’t have one at all,” Johnson said.

Some school nurses are the first to alert county health departments about new COVID-19 cases. Nurses in the Edmonds School District, for instance, say they’ve reported positive cases in the district to public health officials, and helped with contact tracing.

Washington’s school nurses aren’t alone. As case counts have shot up across the U.S., school nurses in states from Texas to New Jersey have volunteered to pitch in.

A few days a week, Deana Bunting, a school nurse in the Vidor Independent School District in southeast Texas, drives 8 miles to a COVID-19 call center. During her 10-hour shifts, she assesses people over the phone and helps them schedule COVID-19 test appointments.

“What an amazing tool that state departments and health departments have in their school nurses,” she said.

About 1,500 miles away, Barbara Maher works three days a week at a drive-thru coronavirus testing clinic in New Jersey. She suits up (“We look like hazmat people,” she said) and takes nasal swabs; last Wednesday, the site tested more than 770 people, she said.


“Many of them look like they were very haggard, couldn’t complete a sentence, short of breath, looked feverish,” Maher, a school nurse in Rahway Public Schools, said of people she’s tested. “They were thanking us, and we’re like, ‘Heck, this is nothing.’”

As school districts begin to discuss reopening in the fall, school nurses are contemplating serious questions. What if a member of the school community dies, or has died, from coronavirus? How can they ensure the health and safety of the school community? What will become of students or staff who are immune-deficient, or have conditions that keep them from returning to school?

“That is going to be a really, really big part of what is going to be our work moving forward,” Johnson said. “Reentry is going to look very different.”