School Nursing

The Relentless School Nurse: Making the Hard, Right Choice


Nurses are not quitters. It is in our DNA to come back for more the next day, no matter how challenging our last shift was. But COVID has changed some nurses’ perspectives and they are not wrong. The chronic presence of persistent traumatic stress wears on our psyche. Couple that with episodes of abuse, disrespect and incivility, you can’t blame nurses for needing to step off the COVID hamster wheel.

School nurses are feeling the massive responsibility on our shoulders too. We are being put in impossible circumstances where the expectation is that we can be the de facto health department, full service school health center, full-time mental health practitioner, health educator, nurse navigator and much more. We are often alone in our health offices, or worse, alone in multiple health offices covering buildings that can be miles apart. 

It is way past time that every school has safe staffing of a team of school nurses, health office aides and supervision from nurses if we are to truly care for our nation’s children on any given year, but especially in the midst of a pandemic. School nurse : student ratios of 1:2000 or 1:3500 are not uncommon in school districts across the country. Even when you have the “gold standard” of a school nurse in every building, what if that building has hundreds and hundreds, if not thousands of students? 

School nurses are finding themselves working long past the last bell rings, bringing home hours of work every night just to keep up with what happens in terms of COVID and contact tracing requirements every single day. This unsustainable workload is crushing our workforce and our spirits. Compensation for these extraordinary efforts is mostly absent, but even when it is extended, it is typically a one time stipend that is more of a pat on the head than actual pay for services rendered. 

I value my colleagues dearly, but I especially value their mental health and well being. I respect our colleagues who have had to make the hard/right decision regarding these unsustainable workload expectations. Deciding to resign/retire early is a personal one that I know is made after doing everything possible to get support. No judgement here, only wishes that you find peace and relief.

1 thought on “The Relentless School Nurse: Making the Hard, Right Choice”

  1. We lost the BEST sub RN last week for these reasons……I respect and encouraged her decision. The health office is no longer the place she loved, cherished, found joy in and managed beautifully. In addition to the usual (enormous) school health office responsibilities, we are now a covid clinic, a swab and send site (pooled testing underway), a local Public Health/Contact Tracing office, a vaccination registry and occasionally a vaccine provider. We are increasingly eyed with suspicion and sometimes contempt by families and occasionally staff. This week 5 out of 5 RNs reported tough/abusive phone calls from parents. Families’ confusion is understandable, shooting the messenger is unacceptable. And what do the nurses do? Get up and do the whole thing again the next day, hoping unrealistically that they’ll be able to get to their “usual” school RN responsibilities. They are reporting feeling like they’re incompetent, inefficient, that they can’t get it done, they should be able to do more. The reality is that they are silently with very little support doing more than any person should have to do alone. I find myself using the word heart breaking more than I ever have but that’s what it is.

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