Whole Community Health Leads to Safer Return to In-Person Learning in Lawrence

Lawrence in a Pandemic:

Lawrence, Massachusetts is approximately 35 minutes north of Boston, and adjacent to the communities of Methuen, Andover, and North Andover. Covering only 7.5 square miles with a population of around 80,000, Lawrence is a relatively small city. As of 2019, 21% of their residents live in poverty and 25% of their population is under the age of 18. The majority of Lawrence residents fall into minority groups, including Hispanic or Latino populations, who are already facing adversity.

Lawrence has been hit incredibly hard by COVID-19 and is facing many major resulting challenges. Since the onset of the pandemic, the city has consistently been in the top three for the highest number of COVID-19 cases in the entire state of Massachusetts and has been firmly in the red zone of the MA COVID risk color-coding system (highest risk). As of April 1st, 2021 there have been 250 COVID-19-related deaths in the city, and over 20,000 positive cases. One in 20 Lawrence residents has contracted COVID-19.

Role of Schools:

Schools in Lawrence not only provide quality education to the children within the community, but also provide meals and a safe space. When students transitioned to remote learning in March of 2020, it was clear that Lawrence families were going to need increased help supporting their health and learning from home.

The Role of School Nursing in Lawrence:

Nancy Walsh, BSN, RN, NCSN, Director of Health Services for Lawrence Public Schools, highlighted the important role school nurses are playing in supporting families. As outlined in the Framework for 21^st Century School Nursing Practice^TM, school nurses are supporting student health and academic success by contributing to a healthy and safe school environment. Their efforts include delivering skilled nursing care to children with chronic conditions, infectious disease surveillance, conducting health screenings, and teaching skills to promote health. Further, school nurses are also connecting families to community resources. The Lawrence school community relies heavily on the important work these school nurses are doing to ensure access to care for all and overall health promotion.

School Nurse Response to COVID-19:

In addition to the typical school nurse duties that have remained in place, even amidst the COVID-19 pandemic, school nurses in Lawrence have also added tasks to their workload centered on addressing disease prevention and public outreach. They assumed the responsibility of making sure students are safe and healthy at home. They have distributed lunches to families. They supported students and staff, by holding virtual office hours, and connected with families to ensure they received the health care they needed. The school nursing team in Lawrence has also educated families about the importance of the flu vaccine, and organized clinics at the schools that were distributing lunches so students would have easy access. School nurses also continued to formulate care plans and update health records, so they would be prepared when schools re-opened.

In addition to all of these efforts, all 40 of the school nurses in Lawrence shifted a large percent of their time and energy toward contact tracing for the city. Collectively, since March, the school nursing team has put over 30,000 hours toward detecting every single COVID-19 case in Lawrence.

Acting Fast:

As an emergency response to the continuously climbing COVID-19 infection rate, in January 2021, the city of Lawrence opened a vaccination clinic at South Lawrence East Elementary. The city again turned to the school nurses to manage the clinic, and the nurses were eager to get started. They knew that focusing on vaccinations would improve the health of the community and make it safer for children to return to school.

Following the phased timeline recommended by the state, the clinic initially immunized approximately 400 people a day. Today, the clinic is now administering roughly 1,200 vaccinations per day.

Appreciative Public:

Despite every seat being filled at the vaccination clinic since it opened, Lawrence continues to experience an especially high prevalence of COVID-19. Nancy is excited that, in March 2021, the state opened a second clinic to help assist the city with their efforts to get the infection rate under control.

Comprehensive School Health:

Grounded in their belief that all students should achieve and maintain optimal health to attain their full academic ability, Lawrence school nurses strive every day to ensure community health. As schools have brought high-needs students back to in-person learning, many of Lawrence’s school nurses have returned to their schools, while also continuing to contact trace and work at the vaccination clinics. Lawrence has a goal of returning to in-person learning in April, starting with elementary students.​​​​​​​

​​​​​​​Nancy mentioned that one of the most challenging parts of the pandemic has been staying current on the constantly changing guidance surrounding COVID-19 safety. She credits the Massachusetts Department of Public Health (MA-DPH) for running weekly webinars. She regularly applies the information she gains in these webinars to the schools and community. School nurses have been continually pivoting their practice to keep up with the latest guidance, and to disseminate accurate information to the school community.

A Thank You:

School nurses work at the intersection of education, public health, and skilled nursing services. It is for this reason that they are uniquely prepared to respond to public health crises. The school nursing team in Lawrence has applied their specialized knowledge and skills to ensuring access to care through providing food and health services to the community. They have focused on disease prevention through their contact tracing work, and health promotion through their efforts at the vaccination clinics. Their whole community approach keeps students in the center, always aiming to ensure they are safe, healthy, ready to learn, and able to return to school.

The community would like to sincerely thank each and every one of the Lawrence school nurses for their time, efforts, and smiles.

Written by Hannah Burgess