Hawaii Keiki’s Valuable Role During the COVID-19 Pandemic

Even before the COVID-19 pandemic, being a school nurse was a challenging role with too few nurses and thousands of students to serve. When the pandemic hit, Hawaii Department of Education (HIDOE) schools were forced to close and provide virtual education for most of its students. The Hawaii Keiki (HK) school-based clinics that once provided students with care for acute and chronic illnesses, health education and health screening, and served as a safe place to speak to a trusted nurse – seemed to be gone forever.

Hawaii keiki nurses at vaccination site

The unforeseen pandemic forced the HK team to think creatively on how best to continue providing students with physical, mental and social-emotional support and services, resulted in the creation and launch of the HK Health Hotline. HIDOE students and families were able to call and speak to a nurse about health concerns, as well as to receive answers to questions about DOE resources, health guidance, where meals sites were located, and to get accurate information about the COVID-19 virus.

Acknowledging the importance and impact of health on student learning and success, the HIDOE provided CARES funding to support 15 new COVID Support RN positions – one for each of the complex areas across the state. The first cohort of COVID Support RNs started in September 2020. Their main role is to support the HK efforts to keep students, teachers, staff and communities educated about COVID-19 and to assist HIDOE in the safe reopening of schools.

In addition to the entire HK clinical staff, the COVID Support RNs are actively involved in the COVID response activities in their schools, complex areas, and communities. From July to December 2020, HK nurses provided 329 school readiness site visits. The school readiness site visits were available to all schools in an effort to help support the school administration for reopening the schools safely which included providing health education and resources based on HIDOE health and safety handbook, Hawaii Department of Health and Centers for Disease Control and Prevention (CDC) guidance.

HK nurses also serve on the HIDOE COVID Response Team which communicates with close contacts, assesses the need for students to receive health services based on their symptoms, and assures that families understand and are following the return to school guidance to ensure a safe school environment for students and staff. The nurses also assist with updating health policies related to personal protective equipment (PPE), isolation, and assisting with HIDOE wellness checks and return to school guidance to assure that students and staff that are noted to be ill at school are cared for in a compassionate manner while maintaining a safe school environment to prevent the spread of the virus.

While many schools are still not fully open to all students, the HK team continues to be busy supporting positive student health outcomes with face to face visits with students in the clinic or virtual visits through the Health Hotline.  The HK team continues to be ready to care for student health needs and to support families and schools by providing healthcare advice, assessments and education.

For more information about the Hawaii Keiki program, contact Deborah Mattheus, Hawaii Keiki senior practice director at

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