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Elementary nurses - mask question

Specializes in School Nurse, past Med Surge.

So in our state we have been told that when the kids are in their classroom, sitting down, socially distanced, facing the same direction like when the teacher is doing instruction the kids can take off their masks. Also the kids can take off their masks when they’re out at recess - but they need to wear their mask until they get to the point on the playground where they can be distanced enough from each other for that to be safe. What are you guys doing with masks when they do have the chance to take them off? The idea in my district is to get breakaway lanyards that the kids can clip to the ear loop of the mask that I assume they will wear all the time. I’m not in love with the idea but I haven’t thought of anything else especially for recess. Any ideas?

JenTheSchoolRN, BSN, RN

Specializes in School nursing.

Guidance in my state is face-up on paper towel.

Remember, not touching the inside of the mask if one intends to put back on is important, especially if hand washing/sanitizing is not happening before and after putting a mask on/off. Those landyards, the inside of the mask can touch everything as the kid runs/etc. (Still, they are better than nothing!)

Personally, I'm teaching folks how to touch the loops only when taking off, folding it to protect the inside and having either small paper bag or plastic baggies to put the mask in to protect it. Then wash/sanitizer before taking mask out and putting it on while best trying to not touch the inside of the mask.

Yes, folks will say ideally one shouldn't touch the outside of the mask either (or your face all day). But I'm a realist and we are human, both kids and the adults.

SaltineQueen

Specializes in School Nurse, past Med Surge.

We keep asking for guidance on best practice but haven’t seen anything yet. That was my concern with the lanyards - they’re going to be flopping around & touching everything. Maybe I’ll teach them to clip both loops on so that the inside is folded together???

These kind of look interesting.

mask keeper.jpg

JenTheSchoolRN, BSN, RN

Specializes in School nursing.

16 hours ago, SaltineQueen said:

We keep asking for guidance on best practice but haven’t seen anything yet. That was my concern with the lanyards - they’re going to be flopping around & touching everything. Maybe I’ll teach them to clip both loops on so that the inside is folded together???

What about attaching a thicker baggie of some sort, so mask can be taken off, put in there, but still not lost? But the double clip to fold the mask will offer more protection to the inside certainly.

Masks are more for protection for others or course, but I'm also trying to not have kids inhale other germs out there to a degree and overall hope this will help the importance of good hand hygiene sink in ;).

ruby_jane, BSN, RN

Specializes in ICU/community health/school nursing.

19 hours ago, SaltineQueen said:

We keep asking for guidance on best practice but haven’t seen anything yet. That was my concern with the lanyards - they’re going to be flopping around & touching everything. Maybe I’ll teach them to clip both loops on so that the inside is folded together???

There isn't good guidance. Because....this is the first time that I'm reusing a surgical or N95 mask!! Inside folded together sounds good to me. Also we'll need to instruct on proper mask removal. People dragging their masks down on their necks...eeesh.

JenTheSchoolRN, BSN, RN

Specializes in School nursing.

45 minutes ago, ruby_jane said:

There isn't good guidance. Because....this is the first time that I'm reusing a surgical or N95 mask!! Inside folded together sounds good to me. Also we'll need to instruct on proper mask removal. People dragging their masks down on their necks...eeesh.

YES. I hate seeing it so much. All those germs. Nope, nope, nope.

I've already send out one video to staff re: COVID scenarios with a clear mask demo (we are purchasing this for any staff that requests it, reusable and 2/per staff) that talks about prior mask usage (like wash it every day, please!). One video of a long line of videos I'll be making.

Not sure if this is a great idea, but our district is providing neck gaiters to every staff and student. This was their idea for this topic. That way, they just have to pull it down when not using it and pull it back up when they need it. I don't love the idea of it during the Summer months because it gets HOT HOT HOT here and the gaiters essentially become a scarf. But alas, that is what we're doing.

JenTheSchoolRN, BSN, RN

Specializes in School nursing.

36 minutes ago, KeeperOfTheIceRN said:

Not sure if this is a great idea, but our district is providing neck gaiters to every staff and student. This was their idea for this topic. That way, they just have to pull it down when not using it and pull it back up when they need it. I don't love the idea of it during the Summer months because it gets HOT HOT HOT here and the gaiters essentially become a scarf. But alas, that is what we're doing.

They are also one layer, which worries me. I vetoed them for my school. Also, covering the neck just adds to the hot factor. I have a large supply of lightweight disposables for kids/staff to use.

Assuming recess comes approximately mid-day, what about requesting all students come to school with at least one extra mask per day? Kids take off their morning mask before they go out to recess, and put on their clean afternoon mask when they're done.

During instruction time, they could put their masks on a designated clean part of their desks, like on a paper towel, and reuse. But it's hard for a kid to keep a mask clean at recess, and I think a lot of them will end up dragging on the ground or catching on play equipment (breakaway clasps keep the kid from getting strangled, but the mask is still contaminated).

k1p1ssk, BSN, RN

Specializes in pediatrics.

We are getting ziplock containers that will be used during lunch/recess/mask breaks and will be student specific. There are concerns for lanyards, where the outside and inside of the mask may become soiled/contaminated if it is hanging off a kid's neck during recess. The kids will be taught/supervised performing hand hygiene before and after removing their masks and placing them in the container. I think it would be some thing like: Hand Hygiene, open container, take mask off, hand hygiene, close container. I'm basically taking the CDC recommendations for mask re-use and adapting it for school use. Families will be encouraged to have children use a clean/new mask daily. Our district has purchased surgical masks for use in situations where a mask becomes unusable during the day (it becomes soiled or breaks, etc).

21 hours ago, k1p1ssk said:

Families will be encouraged to have children use a clean/new mask daily. Our district has purchased surgical masks for use in situations where a mask becomes unusable during the day (it becomes soiled or breaks, etc).

Not a school nurse, but my kids' supply lists ask for 5 reusable masks. As they don't go back until next week, it's unclear if I'm supposed to send all 5 masks to school for extras (like the extra outfit I need to send for my kindergartener in case of an accident) of if those are merely meant to be a week of clean masks, one per day. My middle school kids have lanyards on their lists for mask breaks, but no lanyard on the elementary list.

15 hours ago, turtlesRcool said:

Not a school nurse, but my kids' supply lists ask for 5 reusable masks. As they don't go back until next week, it's unclear if I'm supposed to send all 5 masks to school for extras (like the extra outfit I need to send for my kindergartener in case of an accident) of if those are merely meant to be a week of clean masks, one per day. My middle school kids have lanyards on their lists for mask breaks, but no lanyard on the elementary list.

I'd send at least one extra mask if I were you--just in case they get the mask wet, get a nose bleed, sneeze in it.

k1p1ssk, BSN, RN

Specializes in pediatrics.

20 hours ago, turtlesRcool said:

Not a school nurse, but my kids' supply lists ask for 5 reusable masks. As they don't go back until next week, it's unclear if I'm supposed to send all 5 masks to school for extras (like the extra outfit I need to send for my kindergartener in case of an accident) of if those are merely meant to be a week of clean masks, one per day. My middle school kids have lanyards on their lists for mask breaks, but no lanyard on the elementary list.

There are some concerns for using lanyards, which may be why they aren't being used in the elementary schools in your district/asked for. May also be that the school is providing them? Who knows!

We are using lanyards- but they have the breakaway clasp. 

SaltineQueen

Specializes in School Nurse, past Med Surge.

58 minutes ago, nursetlm said:

We are using lanyards- but they have the breakaway clasp. 

We had a student at one of our elementaries get “lanyard burns” (for lack of a better word I guess) on his neck when his breakaway lanyard didn’t breakaway.  I was worried something like that would happen.  I would seriously rethink lanyards if I were you.  

First, my admission that I am not a nurse or healthcare professional. I am merely a school bus driver and adjunct to an educator (my wife runs a Head Start). I'm also an avid learner and fancy myself to be a halfway decent researcher. (Aren't we just the worst!? 😁 I'm still chuckling about the parent from the "my first c'mon of the day" thread who'd researched and found that "female head lice fly.") I found allnurses while looking for answers on a different subject.

But I signed up because on this thread I may actually have 2¢ I can offer, for whatever that's worth. I recently read, from a credible but forgotten source, that just over six minutes of Summer sun exposure (more like 10 or 15 if it's less direct) renders >90% of sars-cov2 inert on hard surfaces. So at least for recess on a sunny day, it might be that a well managed clothesline, as far as it would be from a perfect solution, could have some merits.

There would be problems of maintaing physical distance during hanging, distance and hygeine while donning, keeping masks paired with the correct students, placement of lines, and the time it would all take. On top of that, masks are not hard surfaces, and both inner and outer faces couldn't get maximum UV exposure. (At least not without some really cool mirror setup to concentrate the rays! I'll leave your imaginations to run with that.) Maybe recesses would have to be extended a bit to ensure adequate UV exposure and time for mask retrieval and donning. But the fresh air's good for 'em anyway, right? And it's a foregone conclusion that some instructional time will be sacrificed to pandemic procedures. Anyway, I know my bit is not an whole "actionable plan" or adoptable policy. But ideally it would allow those mask-free minutes to serve to lessen mask contamination rather than spread it to more surfaces. Anyone who wants to educate me on why it's a totally stupid, implausible idea, feel free. I'm not saying mine is the way of the future. But it seems we're dealing with an extraordinarily unique an cumbersome situation with a lot of challenges working at odds with each other, and no great solutions so far. I often find that's a great time to look outside the box.

Anyway, thank you for having this forum. (I actually found allnurses while looking for guidance regarding a child who's showed up today with a live flea and some bite marks. If I'm really lucky your forum might also help steer me regarding a child with "chronic ringworm." All I know is what a semi-educated lay person knows, which is bound to include some myth and bias, and searches of our state dph have not yielded much as yet. Best advice I've found so far is "contact local public health nurse." I found that recommendation here, and it is probably good advice and probably what I'll do.) Thanks again.

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