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Meriwether Lewis school nurse reflects on pandemic job changes

Lisa Bittner’s clinic at Meriwether Lewis Elementary once was filled with cough drops, jars of cotton balls and a lot fewer masks.

Now, two years into the COVID-19 pandemic, boxes of different types of masks furnish the counter, a six-foot ruler stands near the doorway, and cough drops no longer sit out for the taking.

“We’re not allowed to give cough drops anymore,” said Bittner. “We don’t give Tylenol to students or staff anymore unless it’s like a tooth pain or a known migraine history. We used to be like Dr. Feelgood. The kids loved cough drops, but now we don’t have any.”

In the early days of the pandemic, the school division directed school nurses to stop administering acetaminophen or ibuprofen to students or staff in most cases, as the drugs could mask a fever. The COVID-19 safety plan also included social distancing, improved ventilation and daily temperature checks for students, staff and visitors. This school year, officials stopped requiring the temperature checks.

As school systems and the community at large have had to rethink everything during the pandemic, so have school nurses. On top of all their other responsibilities, they’ve become infection control officers, helping to identify any close contacts when there’s a positive case in the school. They monitor students and staff for COVID-19 symptoms. They coordinate testing for staff. They’ve helped to administer the COVID-19 vaccine.

“That was super fun,” she said about helping with vaccinations. “I was like, ‘I want to do that because I want to tell my grandchildren one day that I did everything that had to do with the pandemic.’”

Bittner has worked at Meriwether Lewis since 2018. Her background was as a critical care nurse. After being a stay-at-home mom, she wanted to get back into nursing. She had always wanted to go into the Peace Corps and be the only medical person in a village; now, the school is her village.

Before the pandemic, Bittner said her job was focused on students, though she would help if a staff member were sick or injured. But in the last two years, she’s spent more time worried about teachers and staff.

“I will always have that in my heart now because if a child is sick with anything, either the flu or something else, it’ll dawn on me even more that the teachers are vulnerable because they’re really on the frontline,” she said.

She’s also worked more with other staff members, from the custodians to the bus drivers, to coordinate cleaning a classroom after a positive or help with identifying students who would need to quarantine. As a team, they worked hard to limit transmission, she said.

“I think with all the rules the county set in place, and they’ve been pretty good about sticking to them, that we’ve limited the number of outbreaks that could have happened,” she said.

So far this school year, Meriwether Lewis has 37 reported cases among students and staff, according to the division’s dashboard.

Bittner sees about 30 students a day who are either ill or injured. This year, Meriwether Lewis has about 320 students. During the pandemic, the number of visitors to her office hasn’t increased, but she has seen increased reluctance in students who come through her clinic.

That’s because if a student had one of the 10 COVID-19 symptoms, they would be sent home and could only return if they had a negative COVID test, under policies in place for much of the last two school years. Starting Friday, the school system will suspend contact tracing for individual cases and modify the requirements for students who are symptomatic at school.

School nurses have been in demand this school year with both the Charlottesville and Albemarle school divisions offering stipends or bonuses to boost recruitment and retention and recognize the additional responsibilities brought by the pandemic. Charlottesville school nurses received $5,000 while those in Albemarle County received $2,500.

As of July 1, 2021, the average salary for school nurses in Albemarle County was about $35,000, according to county data. That’s for about 10 months of work, though some schools do hire their nurse over the summer, which would be recorded separately from their annual pay.

Each school in Albemarle County has one nurse, though the division is planning to spend $140,777 next fiscal year to hire one more nurse for Albemarle High School and a coordinator for health services. That’s the first phase in a broader plan to hire one nurse for every 750 students, officials have said.

‘Learned a lot’

As Albemarle and other school divisions start the process of dismantling the many COVID mitigation measures, Bittner doesn’t want them all to go away. She’d like to keep the isolation room, which is where students go to wait if they are showing symptoms.

The room has a desk, tables and chair, a cot, an iPad, an Etch a Sketch and an assortment of books.

Having a place to send students who are sick would help, especially during flu season, she said. In January 2020, Bittner said the school had a difficult flu season with half of one of the classes out sick.

Bittner also thinks she’ll continue to wear a mask to protect herself from other colds and viruses that tend to circulate around a school.

But Bittner is happy to leave the daily temperature checks in the past.

“It was a huge manpower effort that never resulted in a single positive case,” she said. “We were so into keeping the schools open, and were like, if this is what we have to do, we’ll do it. We learned a lot.”

With case numbers dropping in the county, Bittner is planning to update the bulletin board in her clinic. A COVID case meter was on the board previously along with other information about the virus. But now, she wants to do something more cheerful.

“I really do feel honored to have this job because the kids are great,” she said. “That’s one thing that hasn’t changed.”


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