The spread of the H1N1 virus has Wake County teachers taking on more responsibilities.

In the past, a sick student would be sent to the nurse's office. But in Wake County, 65 nurses cover 153 schools. Most schools in Wake County have a nurse on staff only once a week.

"You juggle to make it all work," nurse Gina Cornick said. She divides her time between three schools.

When a nurse is not available, North Carolina law allows trained lay people to take care of the sick. That leaves teachers to determine if students are sick enough to be sent home.

"The staff is very well trained," Cornick said.

"We spend a great deal of our time doing staff training at the beginning of the year and throughout the year. They know to call us with questions."

Dillard Drive Elementary School teacher Heather Smith says she must sometimes stop teaching to care for her students.

"At times, I have to stop my instruction in order to take their temperature or ask, 'Have you used the rest room?' ... It's a balancing act," she said.

Dillard Drive Elementary saw 161 absences last week. There have been days when up to 10 percent of the student body was out sick.

For teachers, flu season adds up to a heavier workload -- taking care of sick students while still trying to teach the healthy ones.