“I’ve been a school nurse for about—quick do the math—for about 25, 26 years. I worked in a pediatric intensive care unit before that in Chicago and found my calling in school nursing. Really just love it,” says Cam Traut, MS, BSN, RN, PEL-IL, NCSN.
She’s the lead nurse at Libertyville High School, a school of 1800 students in the northern suburbs of Chicago. Cam is the only certified nurse in her building, but her team includes an RN and recently hired CNA for support during the pandemic.
Cam knows that misconceptions about school nurses still exist. “It is a highly skilled, highly stressful—stressful in a different way—autonomous position that we take on that has a lot of moving pieces and parts. Some still don’t realize and acknowledge and give it the respect that it’s due,” she says.
Bringing Healthcare Expertise to the School Community
With a role that spans from big-picture planning to emergency care, she could be working on a safety plan for students in wheelchairs one minute. The next she could be rushing to a colleague who’s collapsed.
“You never truly know what’s going to walk through that door or what you’ll be called to. You just have to be ready. Again, you’re it. That comes with a huge responsibility and pressure in the sense of ‘we’re it.’ They’re looking at me in an emergency: ‘what do you need, what do you want, what do we do?’
“You have a community here that you feel very responsible for. And this community is your friends. Not just your colleagues. And the students. You get to know the students very well and the parents because you’re with them—thankfully in my high school—it’s four years. So I get to know these kids over the years and you do become more emotionally attached than you might have an opportunity to do in other settings.”
Sudden Changes with the Pandemic
Cam’s days were busy with supporting students and staff, providing urgent care, planning for emergencies, and ensuring school safety plans were in place. Then everything changed.
“Right as it started in February 2020…we started to hear more and I’m thinking ‘this has got legs. This is something I need to pay attention to.’ Again, school nurse, you’re listening to what’s going on in the world and you hear this thing and kids were starting to get a little upset, a little nervous.
“Myself and our principal at the time were ‘well, there’s only 12 cases right now.’ I remember that so well. Within a few weeks, we were shutting down the school. We really didn’t know what we were dealing with, except as of March 13 every school in Illinois was shut down.
“The beginning was a shift to alright, I’m not doing direct care, but what am I doing to ensure the kids’ [safety]? I have emergency plans for the classroom—seizure care. What in the world does this look like when a teacher sees a kid on Zoom have a seizure? How do I help the teacher respond to that? I would make calls to parents, I would talk to our school resource officer and the local dispatcher, and we came up with a pretty good plan for teachers. That’s a great example of: how can I shift with the teachers and how can I support them in their space?”
Back to School Still in Crisis Mode
Cam spent the summer planning and creating protocols with a team based on health department guidance and supporting students and staff doing hybrid learning. When the new school year started, she was not only back to caring for students and staff as she was before the pandemic but also managing all the protocols and testing related to Covid-19.
“It never ended. It just kept going. And now we’re shifting gears to where we’re all coming back to full-time school and yet we all have to wear masks. First we didn’t. Then we did. Now we need to do this and that, protocols changing/updating all the time… There was Point of Care testing, and screening testing in the school. I had to apply for a CLIA waiver last year. What am I doing? I’m not a CLIA director. I guess I am for this particular Point of Care testing. There’s a lot of paperwork that goes into every test you administer.
“Now we’re testing unvaccinated kids three or four times when they’ve been exposed during the course of their [incubation or quarantine] time so they can stay in the school. It’s great, as long as we have tests. When that runs out, kids are going to have to quarantine, and they’re not going to be happy. We have defensive parents and angry ones.
“Each time you get a case it is contact tracing, and we are taking more and more of that on. When we contact trace it’s a whole day affair. You have to go back two days from when symptoms start. We need seating charts. We go to measure classrooms. We have to track down teachers to give us that information.
“They want to eat in the lunchroom. They’re supposed to be six feet apart but ours are only four feet [due to spacing challenges]. Okay, but you have to kind of make concessions and be okay with that. I keep reminding myself that now we have over 80% of our students vaccinated, and the majority of our staff is vaccinated. Last spring it took me a while to get to that place, and it really wore on me.
“This year, I can only do what I can do so I have a different mentality to survive. We’re in survival mode right now. This is crisis mode. Survival mode. Whatever we need to do, do the best that we can and at the end of the day that’s all you can do. That’s been my mantra. Some days it really works. Some days it’s really hard to accept and be at peace with that.”
Managing Intense Community Dynamics
“You’ve heard it in the news. The school board meetings. Well, that’s definitely ramped up, and it hasn’t settled. We’ve had difficult situations with excluding kids from school due to exposures or illness as we follow the health department protocols. It’s affected student academic performance, sports teams, theater performances, 18th birthday celebrations, holidays, family events, other school events, and important milestones., We’ve got all these protocols and they’re yelling at us or angry at us. These stories wear on my heart every time.
“As nurses, we’re not used to being yelled at. We want to help people and support them. That has been hard. In one word, I can’t even.
“Every day I think about my colleagues in the ICUs, in the horrible life and death situations, where they’re just as angry and just as frustra ted as I am—for a different but similar reason. We have a different level of stress. I feel a different weight. I feel the weight of an entire community on my shoulders.
“I’ve had to tell colleagues they tested positive, and they just sobbed. I felt like I was telling them they had cancer. They were just so upset. You’re doing all of this at the same time and you feel a horrible weight—I just can’t make it better for everybody. And there’s going to be somebody who’s just going to be mad. At me. Because they don’t know where else to direct it at this point.
“Many school nurses would say that they just feel that weight of the community and wanting to care for them and care for them well. The community is literally the community. It’s not just the kids. It’s their families and the staff.
“So it’s taken a toll. It’s taking a toll on all of us that are in this position in different ways.”
Support From the Nursing Community
Cam appreciates the resources from ANA and attended helpful, educational webinars related to the pandemic.
“We all need that information, and we need that support. I do appreciate knowing they’re out there and they’re that support system for us. I think I said that to our school nurses’ organization that we need that connectedness. Because as school nurses we’re pretty isolated.
“The acknowledgement of our colleagues goes a long way as nurses. That’s what I want the most. Just that respect and collegiality across disciplines. I want us to respect each other and what we bring to the table and doing what we do for the betterment of this patient and their family.”
Now, more than ever, it’s become very clear that we’re all in this together.