On an average day, Carson High School might have about 45 to 65 students absent. Carson Middle or Eagle Valley middle schools could see between 50 and 60 kids missing from classes. Any of Carson City School District’s elementary campuses generally will have about 40 to 50 students out of classes.
And every count matters when it comes to chronic absenteeism.
“I truly feel that we do have more students staying home,” Carson City head nurse Sheila Story said. “We do have more parents keeping them home and tell they're feeling better, you know, just because of COVID and the flu and that type of stuff. And I think we, as a society, we're just more educated. We understand just because of COVID, we understand so much more about illness and infection and preventive measures.”
Many students in recent years are missing school for health reasons even when it’s not flu season. When there is an outbreak, student absences could fluctuate, Story says. But to keep students safe and in the seat, the message often starts with encouragement about personal health.
“I really think it comes down to parent education, following through, making sure you get them treated correctly and trying to keep them healthy, which is then preventative measures: good rest, good nutrition, handwashing, all those things, along with communicating with the school of what's going on,” Story said. “And then how can we help? As the school nurses in each of our schools, we can help with that educational piece.”
In the post-COVID climate, communities are having to worry increasingly about the ill effects of prolonged, easily transmitted or perhaps unexplained conditions.
“We have an increased number of students with a diagnosis of asthma, seizures, severe allergies,” Story said. “We just have a lot more chronic illness in our population, our diabetic population is going up, and I think it’s just our environment is changing and more and more individuals are coming down with these chronic conditions.”
In the event of an outbreak, Story said, school officials will report it once they observe about 10% or more of a classroom that suddenly becomes ill and will call Carson City Health and Human Services and the local epidemiologists to ensure a plan is put into place for assessment and mitigation. It could involve a deep cleaning of the school, educating parents or other tactics, she said.
The National Center for Health Statistics reports in 2022, 5.8% of children experienced chronic absenteeism due to health in the past 12 months. Children with disabilities, about 14.8%, were about three times more likely to be chronically absent than those without disabilities, or 4.4%.
But if students are absent, it’s important to work with students and families with a constructive, patient approach since not all families can make a doctor’s visit without transportation, Story said.
“The school nurses really try, number one, to ask do they know what the chronic illness is, do they have a provider, and if not, help get a provider, make up a first appointment for them and then follow up — ‘How did your appointment go?’ ” she said.
Cecilia Leong, vice president of programs for Attendance Works, a national nonprofit working with school districts, states and organizations to offer resources, advance policies and build awareness of the challenges of chronic absenteeism, told the Appeal some studies that have been conducted show nurses who help with outreach to students can increase participation in school.
“It makes common sense,” Leong said. “It could be an unmet health need or a parent not understanding, ‘Is my child really too sick to come to school?’ I’ve seen districts where school nurses are part of a more proactive effort to prevent health teaching and comprehensive washing. Having that repeated for students to avoid transmission of diseases, nutrition and exercises is important.”
Leong said an important aspect in the months ahead is updating students families on consistent innoculations and flu vaccines and helping to reduce absences for diseases or viral infections such as the measles or rubella.
Story said Carson City School District is only one of two in the state, with Elko County being the other, to have a distinct advantage of offering a school nurse every school, to help assess a child’s health, reinforce preventative measures, encourage students to wear masks if necessary and give guidance on attending school.
“There’s a lot going on,” Story said. “There are so many different variables playing into why kids stay home and why kids come to school. … So we really try to hone in our assessment skills and really truly only send the children home that need to be sent home or to the doctors or to the hospital.
“I think that's another reason why it's so important to have a nurse in each school because we then can truly do a full assessment because it's within our scope of practice,” Story said. “We can't diagnose but we can do a full assessment, advise, recommend and encourage the parents on their next steps.”