With New York City public school students back in classrooms, school nurses are doing far more than bandaging bloodied knees and dispensing Tylenol. Daily temperature checks are now one of their main responsibilities amid the pandemic.

But a month since in-person learning resumed for nearly 1 million New York City public school students, who make up the largest school district in the country, school nurses are concerned that there are not enough healthcare providers to adequately support students and staff this year.

Despite the Department of Education’s website that explains health and safety guidelines in schools, some nurses say pandemic protocols are not standardized within the buildings, and the city’s health screening tool does not provide reliable information.

“There’s still things you can’t avoid 100%,” said Jillian Burgess, a contracted nurse who is currently working at the School of the Future, a secondary school for grades six through 12, in Midtown East. “You have to do your own assessment.”

Burgess is employed by a healthcare staffing agency, like many school nurses who were hired after Mayor de Blasio declared that there would be a designated nurse in every public school. The announcement came last year after New York City public schools adopted a hybrid-learning model. Now some nurses are responsible for hundreds to thousands of students, more than any one nurse can accommodate.

“I haven’t stood in a school for a full year,” said Burgess, who bounces between different elementary and high schools with varying numbers of students and conditions. “Once, I worked at another school and they had never had a nurse there. They turned a broom closet into a nurse’s office,” she said. Another school required Burgess to provide her own personal protective equipment. 

In May, school nurses published an open letter to Mayor de Blasio requesting higher pay and more funding for Fiscal Year 2022. But the new budget, which was voted on in June, does not include increased salaries and resources for school nurses. The mayor’s office did not respond to requests for comment.

“For the country as a whole, it is very concerning that almost half of our public schools don’t have a full-time nurse. Many school nurses support more than a thousand students and more than one school building—sometimes serving as the only nurse for an entire district,” said a spokesperson for the National Association of School Nurses, in an emailed statement, adding that, “Every American school child deserves a school with a full-time nurse—both to help navigate through the pandemic and support students physical and mental health AND their academic readiness.”

Schools are facing shortages of public health assistants and advisors too, said Christopher Trivell, a nurse at Simon Baruch Junior High School on East 21st Street. “These titles are supposed to assist nurses in their jobs, and there are so very, very, few of these staff people.”

Despite the lack of providers, Trivell said he works hard to check off the boxes on his to-do list, but sometimes feels that what he’s doing isn’t enough. The only way he could fulfill every expectation of his job, he added, is by working almost 70-hour weeks. Yet, long hours and excessive amounts of overtime aren’t what concerns Trivell the most.

The COVID-19 protocols are too broad, he said. The wording, as is, states that students presenting any possible symptoms of COVID-19, such as coughing or shortness of breath, are subject to removal from classrooms. “He or she can’t come back into the building unless there’s a negative Covid test or a period of quarantine,” said Trivell, who believes the requirement is excessive and exclusionary. 

But some school healthcare providers agree with the measure.

Ibrahima Diallo, a nurse at Manhattan High School on West 52nd Street, said he relies on the protocols outlined by the Department of Education and the Center for Disease Control and Prevention to protect students and staff. “We have to follow the overall guidelines,” he said. “The policies are there and we have to follow them.”

Diallo also doesn’t find working under staffing shortages stressful. “As a nurse, no matter where you work, it’s going to be overwhelming,” he said, adding that his first week was rough, but steadily improved.

Burgess, like Diallo, sees some progress around school nursing, despite her concerns about inadequate resources. “With the return, it’s getting a little bit better. We have a better idea of the organization with social distancing,” she said, though adding that she still is worried about the number of students in schools. “I personally would rather everyone be remote.”

“There’s a trend in the right direction,” said Trivell. “We could do better, should do better.”