Sheila Freed
Clinical Operations Director of School Health and Senior Care
Jessica Gaikowski
Executive Director of Marketing and Sales Operations
Key Takeaways
- Avel eCare’s Virtual Health System gives school nurses real-time clinical backup, helping nurses who work alone or cover multiple buildings access experienced support when challenging student health situations arise.
- Avel eCare extends existing school health teams rather than replacing them, connecting nurses, paraprofessionals, and school staff with dedicated virtual nurses who can help assess students and determine appropriate next steps.
- Avel eCare assigns dedicated nurses to its school partners, creating long-term relationships with school staff, students, and families while providing consistent clinical support throughout the school year.
SIOUX FALLS, SD — When people picture a school without adequate health coverage, they often picture a school with no nurse at all. But for many districts, the bigger problem is a nurse stretched across multiple buildings — or a nurse who is the only medical professional in the building, with no one to turn to when a difficult case comes through the door.
Avel eCare, the Virtual Health System that has set the national standard for virtual care since 1993, is highlighting this often-overlooked gap: even schools with nursing staff frequently lack the backup and specialty support that clinicians in hospitals and clinics take for granted.
“When you become a school nurse, a lot of times you’re used to being in a very supported medical setting — a hospital, a clinic,” said Sheila Freed, BSN, RN, NCSN, Director of School Health at Avel eCare, a nationally certified school nurse and 2015 Johnson & Johnson School Health Leadership Fellow. “Then you come to the school, and you’re like a medical island in a school of educators. You’re the only person in your building who does health. So who supports you? Who comes alongside you to help when you have to make a decision and you’re not sure?”
A Nurse Stretched Across Buildings
Freed knows the coverage problem firsthand. Early in her career, she supervised three schools in Sioux Falls, South Dakota, and could never be in the right building at the right time. “I have a theory that the minute the school nurse steps out of the building, there’s a notification that goes to all the children that they need to go to the office,” Freed said. “We need that school nurse.”
That experience is common across the country, particularly in districts too small to justify a full-time nurse in every building but too large for a single nurse to physically cover. Avel eCare’s Virtual Health System partners with these on-site nurses directly — not to replace them, but to extend their reach into buildings they can’t always be in.
A Colleague, On Demand
For nurses who are the sole clinician in their building, Avel eCare functions as an on-demand second opinion. Through a HIPAA-compliant device that supports true clinical assessment — not just a video call — school nurses can bring in an Avel eCare nurse to look at a rash, review a set of insect bites, or talk through a case they’re uncertain about.
“I had a call one day where one of our nurses said, ‘Hey, do you want to look at these bites? I’m not sure what they are,'” Freed said. “So I joined the visit and looked at the bites too. We came up with a plan, called the parent, and took care of what was happening.”
That kind of peer support also extends to the paraprofessionals and secretaries who often serve as a nurse’s only help when a school does have coverage. At one small school on a reservation in South Dakota, a secretary in her seventies works alongside Avel eCare’s virtual nurses despite having limited comfort with technology.
“She said, ‘I’m willing to do it because I want to talk to Nurse Pat. Nurse Pat tells me what I need to do, and I know this community — I know these families. But Nurse Pat knows the medicine,'” Freed said. “That partnership is one of my favorite things we do.”
Building Long-Term Relationships, Not One-Off Visits
Avel eCare assigns each school a dedicated nurse rather than rotating clinicians through, so on-site staff always know exactly who they’re calling. Some of these relationships last years — Freed pointed to students Avel eCare has supported since they were three years old who are now entering the fourth grade, cared for by the same nurse the entire time.
“There’s been a partnership that’s developed with the school staff, with the kids, and with the parents,” Freed said. “Nurse Jennifer is their nurse.”
A Model Built to Extend Local Teams
For districts evaluating their school health staffing ahead of the new school year, Freed said the choice isn’t always between hiring a nurse or going without one. Often, the better question is how to give the nurses and staff already in the building the same kind of backup that clinicians in a hospital setting rely on every day.
Districts interested in learning more about how Avel eCare’s Virtual Health System supports existing school nursing staff can learn more here.
Continue the Conversation with Sheila Freed
This topic is explored further in an episode of Avel eCare’s Virtual Health Connections podcast featuring Sheila Freed, BSN, RN, NCSN, Director of School Health at Avel eCare. Drawing on her experience as both a school nurse and a leader in virtual school health, Freed discusses the challenges schools face in providing consistent health coverage, the impact on students and staff, and how virtual nursing can help districts build a more sustainable approach to school health. Listen to the full conversation to hear more about how schools are using Avel eCare’s Virtual Health System to support students, educators, and on-site staff here.