A year ago, the two nurses at the biggest high school in Georgia saw about 100 students a day, dispensing prescriptions, giving out feminine hygiene products, applying bandages, checking blood sugar levels and occasionally calling 911.

“This year, it is not that way,” Candy Fleming, one of two nurses at Mill Creek High School in Gwinnett County, said recently. “We are doing COVID-19 tracing pretty much all day long.”

Fleming is among more than 1,000 other school nurses in Georgia thrust onto the front lines this year as the public face of schools’ responses to the pandemic. They are taking on new leadership roles, helping districts strategize for pandemic safety and educating parents and staff about COVID-19.

“We always consider ourselves the hidden health care system across the country,” said Lynne Meadows, coordinator of student health services in Fulton County Schools and a leader of the Georgia Association of School Nurses. “School nurses are putting on the capes.”

The association is pushing Gov. Brian Kemp to fund 200 more school nurse positions statewide.

Mill Creek High School Nurse Candy Fleming talks about how her routine as a school nurse has changed since COVID-19. Video by Alyssa Pointer

Many Georgia school buildings have reopened to some extent, giving families the choice between digital and in-person learning. In districts that remain fully virtual, the nurses stay busy with virtual student appointments and monitoring staffers working on campus.

Registered nurses, licensed practical nurses and some certified medical assistants are training to give the coronavirus vaccine.

Health care aides, supervised by licensed nurses, run most of the clinics in Gwinnett County Public Schools, said Jennifer Poole Ross, the district’s lead nurse. The aides are trained in CPR, defibrillation, first aid and, this year, COVID-19 safety protocols. Some have emergency medical technician, medical assistant or nursing assistant certifications, Poole Ross said.

ExploreGeorgia schools prepare for vaccinations of teachers, other staff

Fleming is a registered nurse. Kathy Catapano, also of Mill Creek, held a license from New York that didn’t transfer to Georgia.

With nearly 2,000 students on campus this year — and 1,700 learning from home — the Mill Creek nurses are treating students for all the same health problems as before, in addition to their pandemic-era responsibilities.

Fleming’s day is supposed to begin at 7 a.m. but she arrives an hour earlier, getting ahead of the school buses that start rolling in at 6:30 a.m. Catapano used to work part time, from 9 a.m. to 1 p.m., but switched to full time in the pandemic.

“I was staying here ‘till five o’ clock anyway,” she said.

They spend long hours answering parents’ questions about their children who are sick or have been in contact with someone diagnosed with the coronavirus. By midday one recent Friday, they received nearly two dozen e-mails from parents asking how to handle various situations.

Someone’s father tested positive for the coronavirus. Another father was identified as a close contact of a positive case and wondered whether his child had to quarantine. A student had symptoms but tested negative.

ExploreMore stories about Gwinnett County Public Schools

No parents that day reported students testing positive. When that happens, the nurses go around with measuring sticks to investigate whether any classmates had been sitting within 6 feet. With so many on Mill Creek’s campus, social distancing in classrooms has not always been possible.

They research bus seating charts and attendance records and consult with athletic coaches to draw up a list of close contacts, then check it against an immunity list of students who’ve had the virus in the past 90 days. Then they start calling the parents of the students who must be quarantined.

“We did a little more hands-on nursing before,” Catapano said. “Now we’re just at the computer a lot.”

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They get help from an assistant principal and a clerk who round out the school’s Health Response Team.

The clinic has fewer beds this year. Students with headaches, stomachaches or cramps used to rest for an hour or so before deciding whether to return to class.

“Not this year,” Catapano said. “You have a headache and a sore throat? You’re going home.”

The school resource officer had an office in the suite but was displaced to create an isolation room where students with COVID-19 symptoms wait for their parents. The room is bare except for a cot and about 20 stacked boxes containing the school’s stockpile of feminine hygiene products.

The Gwinnett district has reported more than 4,000 school cases of COVID-19 among employees and students since August, when school buildings reopened. More than 12,500 cases have been reported this school year across eight metro Atlanta districts.

ExploreCOVID-19 cases reported at metro Atlanta public schools

Before the pandemic, children at Taylor Elementary School in Gwinnett routinely sought out the nurse for bandages, cotton swabs, bags of ice or petroleum jelly for chapped lips. The nurse, Molly Gautreaux, gave them “treasure boxes” when they lost teeth. But this year, she distributed all those supplies to teachers and coaches to prevent healthy children from catching infectious diseases in the clinic.

Gautreaux had been thinking about supplying teachers before the coronavirus pandemic so fewer students would miss class for clinic visits.

“It’s really rethinking how to proceed through the day,” she said.

Vanessa McCray and Leon Stafford contributed to this report.

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