The Relentless School Nurse: Unsustainable Workloads are Crushing School Nurses Across the Country

When I spoke at my school board meeting last month asking for additional supports, one of the board members publically commented “When health professionals ask for help, we need to listen.” I will be speaking at this month’s meeting as a follow up to the requests that so far have gone unanswered.

I encourage all of our colleagues to read the letter featured in this post. It was presented by 115 Columbus City school nurses to their Superintendent and Board of Education. The letter details the intolerable workload, unsafe working conditions and lack of consistency in implementing public health mitigation strategies. The school nurses lay out a compelling argument to support additional staff and clerical assistance because of the added responsibilities related to contact tracing. They calculate 2,410 collective years of nursing experience in their group, what a brilliant data point!

Kudos to this group of highly seasoned school nurses. I wish them well in their pursuit of tolerable and safe working conditions, which no one should ever have to fight for, yet here we are.

The following letter was retrieved from Columbus City Schools nurses plead for help, saying they’re overworked, overwhelmed Megan Henry The Columbus Dispatch

Dear CEA Family:

Please see the letter below, signed by 115 of our 119 School Nurses that was sent to Dr. Dixon and the members of the Columbus Board of Education earlier this morning.

Dr. Dixon, Columbus City School Board, and CCS Administration,

We, the 115 undersigned Columbus City Schools School Nurses and proud Columbus Education Association members with a total of 2,410 collective years of nursing experience write to you with an urgent message regarding the status of our Department and the health and safety of our school community. School Nurses are overwhelmed with implementing COVID-19 protocols and are asking for help.

Firstly, School Nurses are overwhelmed by the scope of our contact tracing responsibilities. The sheer volume of exposures and positive COVID-19 cases has left nurses exhausted and burnt out in the first weeks of school. There are no clear directives from the district concerning which school staff are responsible for helping to carry out the multiple steps it takes to contact trace, resulting in the School Nurse doing it all. One positive case can generate hours of work. Add a few more positive cases to the day, and the nurse is working late into the evening to ensure that everyone’s health and safety is protected.

The beginning of even a normal school year is an especially busy time for School Nurses who are tasked with protecting the health and safety of students and ensuring their readiness to learn. This is especially crucial for our most vulnerable learners, who need medical orders, medication and treatments at school and staff trained to respond to their particular medical needs in an emergency. Additionally, state mandated immunization exclusions and screenings are required to be done quickly. The State of Ohio is not deferring the requirements this school year.

In addition to the overwhelming scope of contract tracing work, we are witnessing the effects of unclear directives from the district and alarming misinterpretation and misunderstanding of protocols, which is causing confusion and frustration among staff and families.  Last week, one school principal even sent an email to all staff stating that if they tested positive for COVID-19 they could continue reporting to work as long as they wear a mask and social-distanced. It took two days to get a correction notice to staff.

Our nurses are bearing the brunt of this confusion and despite working as hard as we can, we are working in hostile environments; being yelled at, disrespected, and in one case even being reported to ODH. Nurses have thick skin, and we are used to being on the receiving end of people’s frustration, but what we can’t reconcile is fighting to keep people safe from COVID-19 and knowing that we can, and need to, do better. Nurses who have worked for the district for over 20 years are reporting that they cannot keep up this pace and have serious health and safety concerns for their students. We are hearing comments like, “nurses are absolutely drowning and I feel like there is no lifeline”, “I feel as though I am on the Titanic” and “this is year 22 for me and I cannot keep up with it all. I am feeling stressed and overwhelmed all the time”.

This situation is so unsustainable that seasoned and new nurses have expressed that they are considering quitting their jobs. We have worked hard to hire 23 qualified new school nurses this school year, which is not an easy task during a national nursing shortage. Losing nursing staff during a global pandemic would be disastrous and would further destabilize our efforts to keep schools open.

Finally, the District recently sent out a notice to principals that homecoming dances could be held outdoors and that “High School administration will work with Safety and Security as well as your school nurses to design a plan for outdoor Homecoming Dance”. For nurses, this was like adding salt to the wound. Let’s be clear, there is no safe way to hold a school dance during this time and your School Nurses do not have the time to plan it.  School Nurses are asking the District to fully recognize and understand the work involved with what they are being asked to do.

There are three things that Administration can do right now to assist overwhelmed School Nurses:

1) The Administration needs to immediately designate additional staff to help with the clerical work associated with contact tracing.  Our current MOU states that non-Nurse Certificated staff can work extended hours to help with after hour contact tracing, helping alleviate the after-hours burden from school nurses, yet to date this has not been done.

2) The Administration needs to immediately ensure that everyone is on the same page regarding existing protocols.  This means Administrators, School Nurses, and all other CCS staff need to hear the same message regarding our health and safety protocols at the same time from the same leadership team.

3) The Administration needs to immediately revise health and safety protocols to reflect our current reality.  Protocols that made sense last year, when distant(remote/hybrid) learning and cohorts were in place, need to be revised to account for everyone being back in schools. The District has assured the public that mitigation strategies are in place in order to keep their children safe.

If School Nurses do not receive immediate assistance with clerical contact tracing work, if health and safety protocols are not being implemented with fidelity, and if protocols are not revised to reflect an “all-in” model,  School Nurses face a moral and professional dilemma.

Our licensure requires us first and foremost to protect our patients. We cannot passively stand by and witness COVID-19 run rampant in our buildings while protocols are unclear or ignored, and staffing is not adequate to keep up with the work. Our Department of Health, Family and Community Services has been operating without a Director of Nursing and only one of the three Supervisor positions is currently filled. Our brand-new Supervisor, despite doing her best, reports to individuals with ZERO medical or public health knowledge. Consequently, our School Nurses feel like they are shouting their concerns into a void.

We are formally asking the district to take action and respond to our requests immediately. The present situation is unsustainable and a clear health and safety danger for our entire school community.

Thank you for your prompt attention to these critical matters,

Alexandra K. Peabody, RN, BEATTY PARK SN, TREVITT ES
Allison A Grywalski, BSN, RN, LSN, CASSADY ES
Amy Thompson, BSN, RN, WEST BROAD ES
Andrea E Ross, RN, BSN, LSN, EAKIN ES
Andrea M. Spaulding, BSN, RN, LSN, CHAMPION MS
Angela E. Patterson, RN, BS, BSN, LSN, COLS CITY PREP BOYS, DUXBERRY PARK ES
Angela Spangler RN, BSN, LSN, BISHOP WATTERSON
Barbara J Buckley, WESTMOOR MS
Barbara Lafferty RN, BUCKEYE MS
Brandi Jennings, RN, LSN, GEORGIAN HEIGHTS ES
Brandi L. Zeiter, RN, NORTHTOWNE ES
Carolyn Bernard, BSN, RN, CENTRAL ENROLLMENT
Carrie E. Andrick, RN, COLUMBUS SPANISH IMMERSION ES
Cassi L. Harr, RN, BSN, CSN, MOLER ES,
Catherine M Donohoe, INDIANOLA INFORMAL K-8
Cheryl Cuckler, RN, BSN, LSN, BINNS ES
Chris Morford, RN, NON PUBLIC SCHOOL,
Christina M Crist MSN RN LSN, CENTRAL ENROLLMENT
Christy West, RN, WHETSTONE HS
Ciera Weisbeck, BSN, RN, NON PUBLIC SCHOOL, INDEPENDENCE HS
Corey R Ganoom RN, FAIRMOOR ES
Cori D. Heflin MA, BSN, RN, LSN, CENTRAL ENROLLMENT
Dana M Godfrey RN, BSN, WALNUT RIDGE HS,
Debbie Seastone MSN, BSN, RN, LSN, WEST MOUND ES
Deborah L. Strouse, WOODCREST ES
Debra Judy RN, BSN, LSN, JOHNSON PARK MS
Deidre L. Opoku MSN, RN, LSN, EAST HS
Donica D. Key, RN, BSN, MEd., PARKMOOR ES,17TH AVE SERVICE CTR
Elizabeth M Sauer, COMO ES, OAKLAND PARK ES
Ellyn Wirth, BSN, RN, LSN, FOREST PARK ES
Erin L Tatum RN, BSN, LSN, SHADY LANE ES
Gretchen Bodnar RN, COLERAIN ES
Gretchen Fabian, MSN, RN, LSN, COLUMBUS ALTERNATIVE HS
Heather E. Bell Budai, MSN, BSN, RN, C-EFM, LINCOLN PARK ES, STEWART ES
Heather E. Blevins, RN, HILLTONIA MS
Heidi L. Dooley, RN, MIFFLIN ALTERNATIVE MS
Holly A Lonczak, MSN, RN, INDEPENDENCE HS
Iman Elhaj Omar BSN, RN, MIFFLIN HS
Jacqueline Broderick Patton, CENTRAL ENROLLMENT
Jeannie Bakker RN, CENTRAL ENROLLMENT
Jenna M. Scheidegger, RN, SOUTH MIFFLIN ES
Jennifer Blair MEd, BSN, RN, LSN, CENTENNIAL HS
Jennifer J. Moir, BSN, RN, WEDGEWOOD MS
Jennifer L Mosic RN, EASTMOOR ACADEMY HS,
Jennifer R. Young, MSN, RN, LSN, LIVINGSTON ES
Jenny Burley RN, BSN, LSN, PARSONS ES
Jodi Van Zile, BSN, RN, LSN, ECOLE KENWOOD
Judy Harmon,6TH STREET ANNEX,
Kate King DNP, MS, RN, LSN, WORLD LANGUAGE MS
Katherine A. McKeel RN, BSN, MA, LSN, NORTH LINDEN ES
Katherine Fetter RN, SALEM ES
Kathleen M. Budd, MEd, BSN, RN, LSN, CENTRAL ENROLLMENT
Kathryn A. Gordon RN, CENTRAL ENROLLMENT
Katie Skinner RN, COLS CITY PREP GIRLS, CRANBROOK ES
Kelly D Hoyer RN, BERWICK ALTERNATIVE ES
Kelly Koesters RN, BSN, Licensed School Nurse, WATKINS ES
Keri E Wilson RN, AVONDALE ES, HIGHLAND ES
Kimberly Carpenter, RN, GABLES ES
Kimberly L Fackler, MEd, BSN, RN, COLERAIN ES
Kristi Thomas, RN, WEINLAND PARK ES, BROADLEIGH ES
Lacey L. Leath, RN, BSN, BURROUGHS ES
Laura K Savage RN BSN LSN, INNIS ES
Laurie A Tufts, MSN, RN, COLUMBUS AFRICENTRIC EC
Linda Davis, RN, MSN, LSN, SOUTHWOOD ES
Lindsey C. Welch RN, INDEPENDENCE HS
Lindsey Cook RN, NORTHGATE INTERMEDIATE
Lisa M Mason, BSN, RN, LSN, HUY ES
Lisa M. Rossy RN, FAIRWOOD ES, EASTGATE ES
Margot WALLACE RN, OAKMONT ES, LEAWOOD ES
Marsha S Colahan RN, CEDARWOOD ES, CEDARWOOD ES
Mary N. Ramming, BSN, RN, LSN, COLERAIN ES,
Megan L Colombo, SHERWOOD MS,
Megan R Farwick, BSN, RN, CPN, NON PUBLIC SCHOOL
Melanie Young, BSN, RN, LSN, LIBERTY ES – COLUMBUS
Melissa Smetiouk, BSN, RN, HAMILTON PK-6
Melissa Willis, RN, EAST COLUMBUS ES,
Michelle A. Thomas, RN, BSN, VALLEYVIEW ES
Michelle K. Treaster, RN, MPH, LSN, DOMINION MS
Molly R. Spangler RN, CENTRAL ENROLLMENT
Nancy B Lynskey RN, BSN, LSN, NORTHLAND HS
Nancy J. Click, RN, MA LSN, RIDGEVIEW MS
Natalie Swartz, NON PUBLIC SCHOOL
Neva O. Ryan, BSN, RN, EAST LINDEN ES, HUBBARD MASTERY
Parris M Bragg MSN, RN, BRIGGS HS
Rachel L. Patrick RN, WINDSOR ES
Ragen Liddell, BSN, RN, LSN, ARTS IMPACT MS
Randi Carnahan, RN., BSN., MSEd, CENTRAL ENROLLMENT
Rebecca M Kauffeld R.N., COLUMBUS DOWNTOWN HS
Renata Weaver, BSN, RN, LSN, WEST HS
Rosemary A Plapp, MSN, RN, MEDINA MS
Ruth Ann Farthing RN, NON PUBLIC SCHOOL
Samantha E. Dorsey, MSN, RN, GIFTED ACADEMY
Sara D. Klose, BA, BSN, RN, YORKTOWN MS
Sarah B. Bartczak BSN, RN, SIEBERT ES
Sarah E. Boiarski BSN RN LSN, INDIAN SPRINGS ES, LINDEN PARK EARLY CHILD
Sarah Emery, RN, WINTERSET ES, ALPINE ES
Sarah J. Aurant BSN, RN, LSN, CLC, MARION-FRANKLIN HS
Sarah J. Moore RN, LINDEN-MCKINLEY STEM
Sarah Wentworth, RN, NON PUBLIC SCHOOL
Saundra A Deighton RN BSN LSN MA, MAIZE ROAD ES
Shannon M Armpriester RN, CLINTON ES
Sharon I Gombas, BSN, RN, LSN, ARTS IMPACT MS
Stephanie A. Dillon RN, BSN LSN, AVALON ES
Susan E. Casto, MEd.,BSN, RN,LSN,SCOTTWOOD ES
Tamara E Harris, M.Ed, BSN, BS, RN,OHIO AVENUE ES
Tammy K Krug MSN, RN, LSN, LINDEN PARK PREK-6
Tammy L. Starr RN, OLDE ORCHARD ES
Taya Griffith BSN, RN, LSN, LINDBERGH ES, SULLIVANT ES
Tiffany B. Coles-Thrweatt, MSN, RN, LSN, WESTGATE ES, BEECHCROFT HS
Tina L. Peterson RN, SOUTH HS
Tina Logan, RN, COLUMBUS SCIOTO 6-12
Tonya D Schuetz, RN, COLS NORTH INTERNATIONAL HS, COLUMBUS GLOBAL ACADEMY
Troy Woodtke, RN, BSN, WOODWARD PARK MS, WOODWARD PARK @ WALD
Virginia I. Shaffer MS, BSN, RN, LSN, CENTRAL ENROLLMENT