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JHWMS Nurse's Corner

School Nurse Clip Art - Royalty Free - GoGraph

Elizabeth Stoffers MHSc BSN CSN-NJ RN

estoffers@nutleyschools.org

973-661-8873

 

Latest update to Nutley Public Schools Covid Protocol 

January 11, 2022

 

Persons who test positive for COVID-19 and ARE symptomatic or persons WITH COVID-19 SYMPTOMS who were not tested or who are waiting for test results

 

• Stay home and Isolate from other people for at least 5 full days (day 0 is the first day of symptoms). 

a. If symptoms resolve (fever-free for 24 hours and other symptoms improve, Isolation can end after 5 full days (i.e., on Day 6). 

b. If symptoms persist (fever or if other symptoms have not improved), continue to Isolate until fever-free for 24 hours and other symptoms have improved*. 

 


 

Persons who test positive for COVID-19 but have NO SYMPTOMS

 

• Stay home and Isolate from other people for at least 5 full days (day 0 is the day of the positive viral test). 

a. If no symptoms develop, Isolation can end after 5 full days (i.e., on Day 6). 

b. If symptoms develop within one week of the positive test, the 5-day Isolation period starts over with day 0 being the first day of symptoms. 

 

Follow recommendations for ending Isolation for persons who have COVID-19 symptoms*. 


 

Additional precautions during/after Isolation (EVERYONE) 

 

MASK: Continue to wear a well-fitted mask when around others at home and in public through Day 10. For those ending Isolation on Day 5, this would be during days 6 through 10. Persons who are unable to wear a mask when around others should stay home and Isolate from other people for a full 10 days. 

 

TRAVEL: Avoid travel until a full 10 days after your first day of symptoms or if asymptomatic, after the date of the positive test. If travel is necessary on days 6-10, wear a well-fitting mask when around others for the entire duration of travel. Persons unable to wear a mask should not travel during the 10 days. 

 

AVOID HIGH-RISK ACTIVITIES: Avoid people who are immunocompromised or at high risk for severe disease, including nursing homes and other high-risk settings; do not go to places where you are unable to wear a mask, such as restaurants and some gyms, and avoid eating around others at home and at work until a full 10 days

 

1. These timeframes do not apply to people with severe COVID-19 or with weakened immune systems (immunocompromised). Follow guidance from your healthcare provider.

2. Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation.

3. The day of the positive test is the day tested, not the day the positive test result was received.

 


CLOSE CONTACT

 

 

Who does not need to Quarantine?

Individuals in the following groups who had close contact with someone with COVID-19 do NOT need to Quarantine but should wear a well-fitting mask around others for 10 days and get tested at least 5 days after the last close contact* .

If the test is positive or if COVID-19 symptoms develop, follow Isolation recommendations [listed above].

• Adults ≥ 18 years old who completed a primary series of COVID-19 vaccine AND have received all recommended vaccine doses, including boosters* and additional primary shots for some immunocompromised people.

• Children and adolescents 5-17 years old who completed the primary series of COVID-19 vaccine [2 weeks after 2nd dose].

• Persons who had confirmed COVID-19 within the last 90 days (positive viral test) [Contact your family health care provider for guidance]

 

Who should Quarantine?

Individuals in the following groups who had close contact with someone with COVID-19 DO need to Quarantine and should take additional precautions during and after Quarantine:

• Adults ≥ 18 years old who completed a primary series of COVID-19 vaccine but have NOT received a recommended booster shot when eligible.

• Persons who are not fully vaccinated (haven’t completed a primary vaccine series).

 

During Quarantine

• Stay home and away from other people for at least 5 days (day 0 through day 5) after the last close contact with a person who has COVID-19. The date of the exposure is considered day 0.

• If COVID-19 symptoms develop, get tested and follow isolation recommendations. [listed above]

• If asymptomatic, get tested at least 5 days after the last close contact * .

  • If the test is positive, follow Isolation recommendations.
  •  If the test is negative, you can end Quarantine after day 5.
  •  If testing is not available, you can end quarantine after day 5 (as long as there were no COVID-19 symptoms throughout the 5-day period).

 

* Exception: persons who recently recovered from COVID-19 (tested positive and recovered in the past 90 days) do not need to be tested.

* For the purpose of quarantine, someone is considered “boosted” upon receipt of the booster dose.



Please continue to monitor for symptoms, stay home if you feel unwell (contacting your family health care provider for medical guidance), and test for COVID.

If you have tested positive in the last 90 days and you have symptoms please contact your family health care provider for guidance.

 


 

Household settings

 

Isolation and Quarantine can be challenging in households, particularly when caregiving is involved. Persons with COVID-19 should stay home and Isolate away from other people for at least 5 full days and wear a well-fitted mask around others in the home (and in public) for 5 additional days. Those who are unable to consistently wear a mask at home should Isolate from household members for a full 10 days. Household contacts who can’t Isolate away from the household member with COVID-19 should start their Quarantine period on the day after the household member would have completed their 10-day Isolation period, UNLESS the household member is able to consistently wear a well fitted mask in the household through day 10, in which case the Quarantine period would start on the day after the household member completes their 5-day isolation period.

 


 

 

Everyone 5+ who lives, works, or studies in New Jersey is now eligible for a COVID-19 vaccine. Get vaccinated

 

https://www.state.nj.us/health/cd/documents/topics/NCOV/covid19_vaccine_info_chart.pdf

 

 

Make Your Vaccination Plan

You can choose what is most convenient for you:

Every vaccine is a step closer to getting back to what you love – but it starts with you. Make your plan to get vaccinated today.


Help is Available

Know someone who needs to get vaccinated? Share this message with your friends or family members.

 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html    

 

Due to the large number of Americans who remain unvaccinated and the current state of the pandemic, CDC recommends that fully vaccinated people continue to take COVID-19 precautions, such as wearing a mask, social distancing, washing hands frequently and avoiding crowds when in public, when visiting with unvaccinated people from multiple other households, and when around unvaccinated people who are at high risk of getting severely ill from COVID-19.

 

 

Guidelines for Illnesses (updated COVID-19 guidelines)

 

In the latest communication from the State of NJ Department of Health schools have been instructed that any child with COVID-19 compatible symptoms should not return to school until they have either received a negative viral test (molecular, PCR) for SARS-CoV-2 or they have completed an isolation period of at least 10 days since the symptom onset and at least 24 hours after resolution of fever without fever-reducing medications with symptom improvement. A purely clinical alternative diagnosis would no longer be accepted.

The NJ Department of Health further clarified students with COVID-19 compatible symptoms are defined in NJDOH K-12 school guidance using CSTE/CDC case criteria definition as those [students] who have:

  • At least two of the following symptoms:  fever (measured or subjective), chills, rigors (shivers), myalgia (muscle aches), headache, sore throat, nausea or vomiting, diarrhea, fatigue, congestion or runny nose; 

OR

  • At least one of the following symptoms: cough, shortness of breath, difficulty breathing, new olfactory disorder [loss of smell], new taste disorder.

 

The NJ Department of Health continues with “COVID-19 testing is not required for students who do not meet either of the above criteria to return to school. Additionally, for students with chronic illness, only new symptoms, or symptoms worse than baseline should be used to fulfill these criteria".

 

Unvaccinated siblings/spouses/live-ins, etc... of symptomatic students and staff need to be sent home until we get a negative PCR test result. 

 

https://www.nj.gov/health/cd/documents/topics/NCOV/COVID-19_symptoms_illness_comparison_cdc.pdf

 

Everyone (vaccinated or not) who has symptoms described above needs to get  PCR/molecular tested and Quarantine until they get their results.

 

Where to get tested locally

https://www.nutleynj.org/news/category/382/

 

Important COVID-19 information can be found at:

 

https://www.nutleynj.org/news/category/382/ - COVID-19 information from the Nutley Department of Health

 

https://essexCOVID.org/ - information on COVID-19 from Essex county with testing and vaccination sites. From personal experience Essex County is doing an incredible job getting shots into arms.

 

https://covid19.nj.gov/ - State of NJ website with information on COVID-19, includes symptom checker and state testing sites and vaccine scheduler

 

https://covid19.nj.gov/pages/finder - find a Covid-19 vaccine appointment 

 

https://www.nj.gov/health/cd/statistics/covid/ - NJ weekly Covid-19 Activity Level (CALI) report by region

 

https://covid.cdc.gov/covid-data-tracker/#county-view - CDC Covid-19 data tracker by county

 

https://www.cdc.gov/coronavirus/2019-ncov/index.html - State of NJ gets it’s guidelines from the CDC. However, at times the State of NJ’s guidelines are stricter than the CDC guidelines.

 

https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html

 

 


Domestic Travel

It is recommended to delay domestic travel until you are fully vaccinated. Some states require proof of vaccination to enter, so please check your destination prior to travel.

 

International Travel

It is recommended to delay international travel until you are fully vaccinated. If you have proof of vaccination, take it with you. Some destinations require proof of vaccination to enter, so please check your destination prior to travel. You can upload your vaccination card to your phone via the secure Docket App

  • Effective November 8, 2021, non-U.S citizens who are not immigrants to the United States will be required to be fully vaccinated and provide proof of vaccination status to fly to the United States.
  • Effective December 6, 2021, all air passengers, regardless of vaccination status, must show a negative COVID-19 test taken no more than 1 day before travel to the United States.
    • If you have recently recovered from an infection within the last 90 days, be prepared to show documentation of recovery.
  • After returning to New Jersey:
    • Fully vaccinated: Travelers who are fully vaccinated should get tested with a PCR or antigen test 3-5 days after travel and self-monitor for symptoms.
    • Not fully vaccinated:
       
      • U.S. Citizens, U.S. Nationals, U.S. Lawful Permanent Residents, and Immigrants: These travelers should get tested with a PCR or antigen test 3-5 days after travel and self-quarantine for a full 5 days upon returning even with a negative test result. 
      • Non-U.S. Citizens and Non-U.S. Immigrants: These travelers should get tested with a PCR or antigen test 3-5 days after travel and self-quarantine for a full 7 days upon returning even with a negative test result, unless able to provide documentation of COVID-19 recovery within the last 90 days. 

 

Learn how you can shop for a health plan through Get Covered New Jersey:

https://nj.gov/getcoverednj/?utm_campaign=20210226_nwsltr&utm_medium=email&utm_source=govdelivery 

 

 

 

Nutley Public Schools Physical Formhttps://www.nutleyschools.org/news/2019-08-22/nursemedical-forms-available

 

 

Elizabeth Stoffers RN photo

I have just started my 40th year in Nursing! I am looking more like the above caricature every day. I graduated from Nutley High School and attended Rutgers University, graduating with a Bachelor of Science degree in Nursing. I worked as an OB/GYN Nurse at  Saint Barnabas Medical Center in Livingston since graduation until January 2020. I have had the greatest pleasure of meeting some of my “special deliveries” 12 years after their actual “birth”day as students in the middle school.

 

I was “recruited” into school nursing by John Walker when my three children attended Yantacaw School and he was their principal. Mr. Walker convinced me to obtain my School Nurse certification and arranged for me to do my student teaching in the Nutley school district. I was mentored by the best: Mrs. Flannery the School Nurse at Yantacaw School and Mr. Chern while teaching Health at the Middle School. I have since completed my graduate degree in Health Science along with post-graduate studies in supervision and special services.

 

I have been the School Nurse here at JHWMS for 18 years. I do yearly screening on all the students for Height, Weight, and Blood Pressure and screen all the 7th graders for Hearing and Scoliosis and the 8th graders for Vision. If parents do not want their child screened they can send a letter to the school and just ask their child to remind me on the day of screening. I keep and update physical forms on all students including their immunizations so that the district is compliant with state mandates. I also see the students on a daily basis caring for anything from paper cuts to the occasional trauma. If your child has medical concerns give me a call and I will make sure they have the accommodations they need.

Send me a picture or copy of your child's Covid vaccine completion and I will add it to their health record (estoffers@nutleyschools.org).

 

Medical forms:

https://www.nutleyschools.org/news/2019-08-22/nursemedical-forms-available

 

 

 

 

Guidelines for Illnesses photo

General guidelines for illnesses (pre-Covid):

• Call the Main Office if your child is going to be absent 973-661-8871.

• Send in copies of medical/dental notes.

Many parents ask, “When is my child sick enough to stay home from school?” This is not always an easy question to answer! I hope that these tips can help! A child who is sick will not be able to perform well in school and is likely to spread the illness to other children and staff. We suggest making a plan for childcare ahead of time so you will not be caught without a comforting place for your child to stay if he/she is ill.

 

Most school policies state that you should not send your child to school if he/she has:

o Fever in the past 24 hours and/or Vomiting in the past 24 hours

o Diarrhea in the past 24 hours

o Chills and/or Sore throat

o Strep Throat (must have been taking an antibiotic for at least 24 hours before returning to school)

o Bad cold, with a very runny nose or bad cough, especially if it has kept the child awake at night

o Head lice – until your child has been treated according to the nurse or doctor’s instructions.

If your child becomes ill at school and the school nurse feels the child is too sick to benefit from school or is contagious to other children, you will be called to come and take him/her home from school. It is essential that the school have a phone number where you can be contacted during the day and an emergency number in the event you cannot be reached. Please be sure that arrangements can be made to transport your child home from school and that childcare is available in case of illness. If your daytime or emergency phone number changes during the year, please notify the school immediately.

Please call the school’s Nurse's Office if you have any questions or concerns 973-661-8873 or email me at estoffers@nutleyschools.org during regular school hours.

 

 

 

IMMUNIZATIONS photoIMMUNIZATIONS NEEDED FOR MIDDLE SCHOOL


DTP (3 doses) including Tdap after 10th birthday

Polio (3 doses)

Measles (2 dose) Mumps (1 dose) Rubella (1 dose) OR MMR (2 doses)

Varicella (1 dose)

Hepatitis B (3 child doses OR 2 adult doses - age 11-15)

Meningococcal (1 dose) upon entering Grade 6 and 11 years old (must be after 10 years of age)

Mantoux is ONLY required for new students entering from outside the country from certain countries that have a high incidence of tuberculosis.

 

 

 

HPV Vaccine 

More than 9 of every 10 cases of cervical cancer are caused by HPV. Cervical cancer can be largely prevented by HPV vaccination.

Illustration showing 3 circles with data within each. First circle: 300,000 cervical precancer cases. Second circle: 11,000 cervical cancer cases. Third circle: 4,000 deaths.

Every year in the United States:

  • Nearly 200,000 women are estimated to be diagnosed with a cervical precancer, or abnormal cells on the cervix that can lead to cancer.
  • 11,000 cases of cervical cancer are caused by HPV.
  • Over 4,000 women die from the disease.

Cervical cancer was once the leading cause of cancer deaths among women in the United States. HPV vaccine and cervical cancer screening have made it one of the most preventable cancers. Even women who have received HPV vaccine should still get regular cervical cancer screening starting at age 21 years. (https://www.cdc.gov/hpv/parents/cancer.html


The HPV vaccine is most effective when given to girls who are not yet sexually active; therefore, it is important to get vaccinated at the recommended age, ideally 11-12 years old. However, it is sometimes given to girls as young as 9 and women through age 26.
People receiving the HPV vaccine get a series of three shots over several months. For full protection, all three injections must be received.

https://www.nj.gov/health/cd/topics/hpv.shtml

https://www.cdc.gov/hpv/

 

 

 

FOOD ALLERGIES in SCHOOL

 

The middle school has a “no food in the classroom” policy. This policy is in effect the entire school year and is reinforced at monthly faculty meetings.

We have “peanut-free” tables in the cafeteria. Any student sitting at this table will have the ingredients of their lunch checked by a lunch aide. The food tables are wiped down after every lunch period.

Our school district utilizes an electronic Student Information System (S.I.S.). Once we receive medical documentation of a life threatening allergy from your child’s doctor the information is added to the S.I.S. All of your child’s teachers then have access to this as well as to a Health Care Plan document. The Health Care Plan document has information on the student’s allergy, the signs and symptoms of exposure to the allergen, what to do if symptoms develop, and the names of delegates who have been trained in the administration of an epinephrine auto-injector. A copy of the Health Care Plan document is available to administrators, cafeteria and office staff, as well as substitute teachers and nurses.

We encourage students to carry their own epinephrine auto-injector but it can also be kept in the Nurse’s Office. If in the Nurse’s Office, it is kept in a locked cabinet; the building administrator has a key. There are also epinephrine auto-injectors located in the Main Office and throughout the building that are readily accessible.

All school-sponsored functions that your child will attend, will have an epinephrine auto-injector trained delegate in attendance. The student must have up-to-date medical documentation that must be submitted every academic year. Please make sure emergency contact information is correct in the portal and accurate information is included on permission forms when your child is attending field trips and/or after school functions.

Please include your child in the management of their food/environmental allergy.

Some specific topics to discuss are:

• avoidance strategies - not sharing food, not eating food prepared by persons who may not be familiar with cross-contamination

• symptoms of allergic reactions – mouth/throat, respiratory, stomach/intestinal cramping, rashes

• actions – the importance of when and how to tell others you are having an allergic reaction or think you may have been exposed to an allergen

• reading food labels

 

Food Allergy Emergency Care Plan form can be found at:

https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/food-allergy-anaphylaxis-emergency-care-plan

 

 

 

Asthma / Reactive Airway Disease

Asthma photo

 

Asthma is a leading chronic illness among children and adolescents in the United States. It is also one of the leading causes of school absenteeism. On average, in a classroom of 30 children, about 3 are likely to have asthma

Effective asthma management can lead to the following positive results:

• A supportive learning environment for students with asthma.

• Reduced absences—students have fewer episodes and symptoms are treated earlier.

• Reduced disruption in the classroom— students have fewer symptoms when they adhere to their asthma treatment plan.

• Appropriate emergency care—school staff members know how to respond to emergencies.

• Full student participation in physical activities— physical education (PE) instructors and coaches know how to prevent exercise induced asthma.

 

Allergy Treatment Plan form can be found at:

http://pacnj.org/pacnj-asthma-treatment-plan/

 

 

Diabetes Management in School

For a student using insulin, diabetes must be managed 24/7, including the many hours spent at school, on field trips and in extra-curricular activities.

Diabetes Management in School photo

I have had many students with diabetes, some with pumps, some doing injections. Most need some assistance with calculations in 7th grade but by December they are pretty independent. I try to make them look at the whole picture and not just the numbers on their glucometers/sensors and in their calculations/pumps. If they are running high or low - what could the reason(s) be and how should it be treated taking into account how long from or until their next meal, how long from or until physical activity, or even how old  the insulin is that they are using or the battery in their pump.

I will send a copy of an individualized health plan to all of your child’s teachers explaining to them that your child has diabetes, your child will be able to check his blood sugar in class and treat with insulin or a snack as needed, that he/she gets unlimited access to the bathroom and the water fountain. I also include a list of symptoms of hypo- and hyper- glycemia and the actions a teacher should take if they see any symptoms. A copy of the health care plan is kept on file with the class roster in case the teacher is absent and there is a substitute teacher. A copy also goes to guidance, administration, and the cafeteria. Most students come to me at lunch time to check their glucose and calculate. Whatever your child, you, and your doctor decide is best for him/her will be fine. I will need doctor's orders (as I am sure you are aware), just make sure they state "independent". I will be here as a resource and will call a parent if I have any concerns, just supply the number of the person easily accessible.

We have a Student Information System (S.I.S) that generates a red + when I input a student’s medical concern into the system and will print out on the teacher's class rosters as well as be seen by teachers (password protected) on the computer screen. The teacher clicks on the + and the medical concern is there along with the health plan document. This information will also be available through guidance in the 504 that all teachers must sign off on. In summary, all of your child’s teachers will get a written health care plan, there will be a notation red + in our password-protected S.I.S., and teachers will sign off on the 504 from Guidance (504 also appears in the S.I.S.).

Many students come in 7th grade and want to leave their glucometers, insulin pens, and snacks in my office. I strongly encourage students to carry their glucometers and Insulin pens (if applicable) and a snack with them at all times. I do this to encourage independence but also in the event we have an emergency that necessitates an evacuation, lockdown, or secure in place. I welcome extra supplies (batteries, pump tubing/site changes, ketone sticks, snacks, bottled water, insulin pen, spare glucometer) and will keep them secure in my office.

I am sure you have many more questions, please feel free to call or email. I try to get the students with diabetes an earlier lunch but many (most) times it does not work out with their schedule. Guidance may be able to help you with their lunch schedule. Your child can always snack in the morning if a late lunch will disrupt their routine.

 

 

 

Medications in School

 

The administration of prescription and over-the-counter medications during school hours is a complex issue. However, in order for many students with chronic health conditions and disabilities to remain in school, medication may have to be administered during school hours.

Herbal remedies and nutritional supplements are not considered medications and should not be administered in school.

Parents/guardians should be encouraged to administer medications at home whenever possible. Medications should be administered in school only when necessary for the health and safety of students.

Before any medication may be administered, the Board policy requires written permission from the parent/guardian and a written order from the prescribing physician.

The written order from the prescribing physician must include:

a) the purpose of the medication
b) the dosage
c) the time to administer or special circumstances under which medication should be administered
d) the length of time medication is prescribed
e) possible side effects of the medication

 

Authorization for medication in school - https://www.nutleyschools.org/news/2019-08-22/nursemedical-forms-available

 

Seizures

 

When a seizure occurs, the main goal is to protect the person from injury. Try to prevent a fall. Lay the person on the ground in a safe area. Clear the area of furniture or other sharp objects.

 

When to contact medical personnel:

Call 911 if:

• This is the first time the person has had a seizure.

• A seizure lasts more than 2 to 5 minutes.

• The person does not awaken or have normal behavior after a seizure.

• Another seizure starts soon after a seizure ends.

• The person had a seizure in water.

• The person is pregnant, injured, or has diabetes.

• The person does not have a medical ID bracelet (instructions explaining what to do).

• There is anything different about this seizure compared to the person's usual seizures.

Report all seizures to the person's health care provider. The doctor may need to adjust or change the person's medications.

 

reference - National Institutes of Health    http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm

 

Seizure Action Plan form can be found at:

https://www.epilepsy.com/sites/core/files/atoms/files/GENERAL%20Seizure%20Action%20Plan%202020-April7_FILLABLE.pdf

 

 

WORKING  PAPERS

 

Working Paper forms and instructions:  http://lwd.dol.state.nj.us/labor/forms_pdfs/wagehour/A300.pdf

 

  • Before working  papers can be issued, student must have promise of a job, a current physical, and show proof of age, such as passport or birth certificate (other proof acceptable noted on form). 
  • Once the form is completely filled out it can be brought to the NHS Nurse's Office (973-661-8828) -  working papers are issued by the NHS Nurse's Office before school, after school until 3:30pm, or on a student's lunch period.

 

**During the summer months working papers may be obtained through the Guidance Department (promoted 8th grade student files will be at NHS).**

 

Hand Washing

EVERYONE should make a point of washing their hands regularly to prevent the spread of disease. The Centers for Disease Control and Prevention (CDC) recommends that hand washing should be done:

Before, during, and after food preparation

Before eating

Before and after looking after someone who is ill

Before and after treating a cut or a wound

After using the washroom

After changing diapers or cleaning up a child who has used the bathroom

After coughing, sneezing or blowing one's nose

After petting, playing with or touching an animal

After handling pet food or treats

After touching garbage

If soap and water is not available, an alcohol-based hand sanitizer may be used to clean the hands. Recommended hand sanitizers should contain at least 60 percent alcohol to be effective

 

______________________________________________________________________________

 

 

 

BBP -  https://docs.google.com/presentation/d/14durJ0eUyD345swBLZW9AQnjdxSLdqFMFk0LZK1xoNw/edit?usp=sharing

 

 

 

About

The Nutley School District serves approximately 4,100 students in Kindergarten through grade 12. The five elementary schools serve students K-6 and include Lincoln School, Radcliffe School, Spring Garden School, Washington School and Yantacaw School. John H. Walker Middle School serves students in grades 7-8 while Nutley High School addresses the needs of students in grades 9-12.