Andrea Stevens
AFRO Staff Writer
astevens@afro.com
When students with sickle cell disease (SCD) walk through the doors of Baltimore City Public Schools, they are not just met with a classroom. They are met with a care team, led in part by dedicated school nurses who build individualized plans to support their health and education.
Mary Caudle, manager of nursing for Baltimore City Public Schools, has worked closely with students who live with chronic illnesses like SCD since 2018. Her work focuses on ensuring every child can access their education safely, without stigma or unnecessary barriers.
“Sickle cell disease presents differently for each student,” Caudle said. “We go through what it looks like for them, what their triggers are, how we prevent exposure, and what their treatment processes are.”
The process begins when a family notifies the school. Nurses then gather medical documentation, meet with families, and collaborate with health care providers to build a care plan tailored to each child’s needs. This plan becomes the foundation for managing the student’s health at school.
But Caudle’s work goes beyond logistics. It includes empowering students to understand and advocate for themselves.
“You’re building a team with your student,” she said. “You’re both there to make sure they can go to school and access their education. You’re also helping them learn to better navigate their disease process.”
A key component of that support is a Section 504 plan, a legal document that outlines accommodations for students with chronic conditions. For students with sickle cell, this may include access to the nurse at any time, the ability to carry water throughout the day, or extended time for assignments.
“This child needs a 504 plan,” Caudle said. “They’re going to go through periods where they can’t leave their house, and they need to be held harmless for those things.”
Stigma can be another significant barrier. Classmates may not understand why a student misses school, leaves class often or skips recess during cold weather. Caudle believes open communication can help.
“Anything that sets a child apart from their peers and their peers don’t understand why… it can cause separation,” she said. “Talking to the class lowers the stigma and makes the child feel more a part of their classroom community.”
While resources for diseases like diabetes are widely available, Caudle notes that similar materials for sickle cell are lacking.
“The American Diabetes Association has put out an entire curriculum for schools. It’s remarkable,” she said. “I haven’t seen anything like that for sickle cell — but something like that would be wonderful and very helpful.”
Finally, Caudle emphasizes that care plans should never be static.
“These plans are all fluid,” she said. “They can be changed at any point based on student needs, parent reports, medical needs or even what we’re seeing in school.”
For students with SCD, support from school nurses and staff is more than a health plan, it’s a pathway to inclusion, understanding and academic success.
