School Nursing

The Relentless School Nurse: Calm in the Chaos

Screen Shot 2018-12-23 at 9.22.32 AMCalm in the chaos has been my mantra for the last 18 years as life in the School Health Office has become more and more challenging. The mantra reminds me to breathe through the unpredictable moments that can wreak havoc on my sense of inner peace.  All school nurses know that jolt of adrenaline mixed with rising cortisol levels that washes over us when the office door flies open and emergencies pile in seemingly on top of each other.

The scenario is still seared into my mind because it was one of those, “you can’t make this up” moments that generally happen at the end of any given day.  I was relishing the quiet moments, getting ready to shut it down for the day when the office door flew open and in piled two injured students.  They were escorted by a security officer, who quickly disappeared.  The students had significant injuries, one had a large laceration across his knuckles and the other had an eye injury.

The story I quickly unraveled was as troubling as the injuries. The student with the hand laceration was locked in the bathroom by unsupervised classmates.  There was a sub that day, who abandoned her duties after being assigned to a self-contained behavioral class with no assistant. Once the student who had been locked in the bathroom was freed, his anger intensified when he attempted to enter his classroom which was also locked. He was so furious, he punched out the glass insert in the door frame, shards of glass entered the eye of a student who was standing on the other side of the locked door.

Calm in the chaos, stay calm in the chaos, I kept on reminding myself as I simultaneously assessed the injuries, separated the students to avoid further confrontation and called 911.  My Health Office was in the worst part of the school, in the back of the building away from the Main Office and far from being able to easily get help.  Calm in the chaos, stay calm in the chaos, I repeated as I took mindful breaths, waiting for EMS to arrive.

I distracted the student with the hand laceration giving him instructions on helping to stop the bleeding while quickly inspecting the student with the possible foreign body (glass) in his eye and praying that 911 would hurry.  I never felt so alone or isolated in my time as a School Nurse and I knew that I was going to take a stand for safety after this incident was over.  My mind was reeling with “root cause” analysis and the “cause behind the cause” of this very preventable scenario. Calm in the chaos helped me maintain my outward composure, even though I was trembling inside.

Soon after this incident, NASN had a call for school nurses to share their experiences with eye injuries on NASN Radio.  I answered the call and was chosen to share my story.  Here is a link to the NASN Radio interview from May 8, 2009:

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