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School nurses play critical role in school systems

Johnston County Public Schools (JCPS) School Health Coordinator Allison Marshall knows first-hand that school nurses are vital to a student’s success. She gets to experience making an impact and seeing that impact each and every day. 

She joined the JCPS family as a school nurse in January of 2021, with a robust resume and experience in various roles including school nurse, hospital ICU unit nurse, a skilled nursing manager, ICU nurse manager, case management/discharge planning, a home health nurse, and legal nurse consulting.

Before moving to Johnston County, Marshall lived in different parts of North Carolina and even spent some time in Virginia. Born in Greenville, North Carolina, her family moved to Harnett County when she was two years old.  Marshall’s roots run deep there. Her mom was a secretary/bookkeeper at her elementary and high schools.  Her father was the principal at Angier High, Western Harnett High, and eventually became the superintendent of Harnett County Schools.

For that reason, Marshall didn’t just go to school each day, it was her second home.  She attended every school event, extracurricular activity, and spent summers at school as well while her parents worked. “School settings are my home,” Marshall said.

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“School settings are my home.” 

With her eyes set on a career in the medical field, Marshall went to Campbell University. Initially, she wanted to study pharmacy. However, her interests changed and she decided to transfer to East Carolina University to pursue nursing, where she graduated in 1992 with a Bachelor of Science in Nursing.

Becoming a nurse is no small feat, in and of itself, but school nurses have some extra steps to take. First, they must be licensed to practice as a Registered Nurse (RN). Additionally, within three years of hire as a school nurse, they must have, or obtain, a bachelor’s degree or higher in nursing, and earn the National Certification for School Nurses (NCSN). “It’s a complex specialized area of nursing,” said Marshall. 

Another aspect of school nursing that most people aren’t aware of is its autonomy. Being the only medical professional in the building requires decisions to be made on the fly. “You’ve got to know your stuff,” Marshall said.

Basically, since graduation, Marshall has been a nurse in some capacity, although there was a span of about six years when she stepped away from hands-on nursing. Her son was about to graduate high school, and Marshall just needed to earn more money. She returned to her job as a senior nurse consultant at a law firm. 

That position involved massive amounts of medical records that had to be dissected. Then, the lawyers were given the information, and Marshall would help them fully understand the material before going to trial. She said she still enjoys the law experience from that job, but being a school nurse ranks first for Marshall. “This is what I love,” she said.

When she came to JCPS in January 2021, the COVID pandemic was at its height, so Marshall had to hit the ground running. During that time, school nurses were the frontline workers to ensure the health and safety of students and staff. In addition to their normal practices, these nurses were in charge of COVID testing and tracing.  

A lot of children only have school nurses as a resource for medical needs and assessments. Marshall and her team are positioned to support student’s success by digging deeper into the students' needs, and how to meet those needs. 

School nurses train staff within the schools to be first responders, diabetic care managers, how to give medication, and how to perform CPR  and first aid, in case the school nurse is off campus. They also go into classrooms to teach students lessons such as proper hand washing and teeth brushing techniques.

“We want to keep children healthy and in the classroom.”

Marshall said she and her team communicate with and refer to other medical professionals in different fields to help families find the resources that are available to them. They even assist with obtaining funds for such services. “We want to keep children healthy and in the classroom,” she said.

Out of all grade levels, Marshall enjoys interacting with high school students the most. “It’s a different vibe,” she remarked. She loves seeing the students in ninth grade, grow up, blossom into adulthood, and head into the next chapters of their lives. 

In addition to tending to students' health and well-being, Marshall’s role allows her to use her organizational skills. “I like working as the coordinator, because I get to make the program the best it can be,” she said. Now that life has returned to normal post-pandemic, Marshall plans to continue moving JCPS forward into the future of school nursing.

One aspect she is impressed with is the JCPS community as a whole. Another attribute that stands out to Marshall is the cohesiveness and coordination between JCPS and the local health department. “I’ve never seen it quite like this,” Marshall commented.

During the height of COVID, the district’s school nurses administered over 2,000 COVID tests, provided 178 health education presentations to students, staff, and parents, had 277 home visits, and nearly 30,000 health room visits.

They also assisted the Johnston County Public Health Department with immunization clinics, provided annual training for Diabetic Care Managers and First Responders (CPR/First Aid/AED), as well as ensured that all JCPS students were current with the required vaccinations for school. “It’s been a whirlwind for everyone,” Marshall reflected.

When asked to describe a day in the life of a school nurse, Marshall responded, “Be prepared for anything. No two days are the same, and your world is ever changing.” 

Her fondest memory of making a difference in the lives of students was during COVID, when she was a school nurse at a Title 1 high school in Forsyth County. As a lot of school districts did, she and the staff hand delivered yard signs for all of the seniors as a way to give them the spotlight they deserved. 

For Marshall, that day would be the last time she would see a lot of these students. When they walked out of their homes and their faces lit up, she saw first hand the impact it had on them. “We were all overwhelmed with a vast array of emotions,” she recalled. That moment reinforced to Marshall that she was fulfilling her life’s purpose.