O2027: Impact of COVID-19 on School Nurses and School Health Services,

Background: School nurses are charged with advancing student well-being and academic achievement. The COVID-19 pandemic brought many changes to the school nurse role and responsibilities. The uncertainties of the pandemic and rising conflict may have led to school nurses exhibiting moral distress, which occurs when someone knows the ethically correct thing to do but something or someone restricts their ability to pursue the right course of action. In this study, we explored how California school nurses mitigated the impact of COVID-19 on the health and academic challenges of students and school nurses’ experiences with moral distress during the pandemic.

Methods: This is a mixed-methods study with content analysis of data from the narratives of 19 credentialed frontline California school nurses. Participants completed a demographics questionnaire, the Moral Distress Thermometer, and 14 items measuring school nurse moral dilemmas.

Results: Key themes identified included 1) skills and roles unique to RNs, 2) policy and procedure development, 3) communication with school administration, 4) disruption to usual care/burden of COVID-19, and 5) coping with one’s own health. All school nurses experienced some degree of moral distress (M=5.8; uncomfortable to distressing). The common dilemmas were “unable to provide care due to workload,” “unable to provide care due to lack of time,” “unable to provide preventive care,” and “unable to provide case management due to workload.”

Conclusion: Our study provides preliminary data on school nurse perspectives of the impact of COVID-19 on school nurse health services, the unique skills of school nurses essential to mitigation strategies, and the types of moral dilemmas school nurses encounter that may be related to moral distress.