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Tips From School Nurses on Keeping Students Healthy

We recently asked school nurses, “What’s the most important thing teachers can do to help keep students healthy during the school year?

Here’s how 271 school nurses responded to our online survey:

  • 73% said teachers should encourage proper hygiene and hand washing, and keep desks and classrooms clean
  • 12% said teachers should be role models to their students for healthy behaviors
  • 3% said teachers should send students home or to the nurse’s office as soon as students say they feel sick or show signs of illness
  • 3% said teachers need to watch for signs of stress

Nearly 60 million school days are lost each year due to colds or the influenza virus, according to the Centers for Disease Control and Prevention (CDC). Infections spread in schools so easily because students are in close contact and share supplies and equipment.

A Chilhowee, Missouri, school nurse said teachers can help students stay healthy by encouraging them to “cover coughs and sneezes; wash hands frequently; keep their hands away from their faces; and keep hands, pens, and pencils out of their mouths.”

Prevention methods for teachers include:

  • Promoting hand washing. Washing their hands well and often will protect students from getting infected by — and spreading — bacteria and viruses.

    “Educate the students and take the time to do the necessary infection controls, such as washing hands and coughing into elbows, and reinforcing those lessons on a daily basis so that the repetitive behavior will become automatic and will greatly reduce the infection rates in school,” said a school nurse from New York City. Important times to wash hands at school are after using the bathroom, before eating lunch or snacks, after outdoor activities, and when hands get dirty from classroom activities.

  • Making sure classroom materials and surfaces are disinfected. A lot of learning in schools is hands-on with shared resources. “Maintain a clean classroom, wash desktops and commonly shared classroom tools,” advised a school nurse from Pittsfield, Massachusetts.
  • Encouraging sick students (and school staff) to stay home. Students who have a fever, feel nauseated, are vomiting, or have diarrhea should stay home. Students who lose their appetite, are lethargic, or complain of pain also should take a sick day. Teachers should “watch out for students who are not acting like themselves, or who don’t look right, and send them to the nurse,” a Piermont, New York, school nurse said.
  • Teaching and modeling hygienic coughing, sneezing, and nose-blowing. Respiratory infections can spread from student to student in airborne droplets from coughs and sneezes. Teachers can model how to cough or sneeze into a tissue or an elbow — not into hands. In addition to coughing and sneezing, nose-blowing is a culprit for spreading germs.

    cough illustration “Demonstrate how to blow your nose and throw the tissue out in trash immediately,” said a Linwood, New Jersey, school nurse.

  • Making infection prevention part of the school-day routine. “Teachers need to allow students time in the day for hand washing … If a kid has a cold, keep his desk area clean and have him wash his hands more than usual,” a Fayette, Alabama, school nurse said.

Additionally, the CDC says educators can help prevent flu infections by encouraging parents to get flu shots for their kids and teens. Before flu season starts in October, schools can remind parents through school newsletters and other communications.

Reviewed by: Steven Dowshen, MD
Date reviewed: August 2014