School Nursing

The Relentless School Nurse: Coming to Terms With the Era of COVID

It’s been a rough school year and it’s only the November. I am not sure where to turn to feel a sense of balance or equilibrium. Everything feels off-kilter. The energy in school is charged with stress and anxiety. This game of hide and seek with a deadly airborne virus that has invaded our third school year, has left all of us depleted. This level of exhaustion creates a heightened sense of tension between school nurses and anyone we need to give guidance regarding their own health and safety. For example, teachers believe we are not doing enough to protect them and often parents think we are doing too much by sending their children home with COVID compatible symptoms. The result is the school nurse in the middle as the unwelcome public health messenger.

“This is not what I signed up for” is a popular refrain that I hear over and over again from colleagues across the country. We continue to press on, tolerating intolerable conditions, hoping that things will improve, but they don’t. School nurses have written letters of resignation, some have submitted them, some still holding onto them, waiting for the next hostile conversation as the final straw. Our children are the canaries in the coal mines, emotionally fragile, and seeking safety nets in schools that are stretched far beyond their capacity. School violence in on the rise across the country, including school shootings

In the midst of this pandemic storm, school nurses need to be the solid object in the room.  It is a heavy lift, one I relieve every single day through my health office and those of my colleagues. Being the solid object in the room is maintaining our calm, even while those around us are swirling with concern, anger, frustration, or sheer exhaustion. It is not easy and that is why, more than ever, we need to ask for what we need. Finding the words, knowing what to ask is a journey towards finding our voices. If nothing else, this pandemic has shown the importance of our presence, our contributions to school health and safety of school communities, and the value of our expertise in public health. But, we are tired, under-resourced, under-represented, and feeling abused. 

The collective trauma of living through the pandemic and working in extremely challenging environments has added the stress of an already beleaguered school nursing workforce. How do we find our footing? Can we hang in there until COVID is in our rear-view mirror? But is there really going to be a delineated end? Not according to this sobering  New York Times article, Past Pandemics Remind Us Covid Will Be an Era, Not a Crisis That Fades. It articulates the “collective dismay” we are all feeling:

What we are living through now is a new cycle of collective dismay,” Dr. Greene said — a dismay that has grown out of frustration with the inability to control the virus, fury of the vaccinated at those who refuse to get the shots, and a disillusionment that astoundingly effective vaccines haven’t yet returned life to normal.”

“We tend to think of pandemics and epidemics as episodic,” said Allan Brandt, a historian of science and medicine at Harvard University. “But we are living in the Covid-19 era, not the Covid-19 crisis. There will be a lot of changes that are substantial and persistent. We won’t look back and say, ‘That was a terrible time, but it’s over.’ We will be dealing with many of the ramifications of Covid-19 for decades, for decades.”

At the very beginning of the pandemic, I turned to Lillian Wald for inspiration and guidance. I posted this blog on May 5 2020, way back in the early days of COVID:

The Relentless School Nurse: Remembering Lillian Wald & Her Response to the 1918 Flu

It seems appropriate to revisit her prescient messaging more than one hundred years later to find solace in her guidance as we slog through another COVID impacted school year. Her message, “A Stern Task for Stern Women,” while written in another era rings true today:

A Stern Task for Stern Women

There is nothing in the epidemic of SPANISH INFLUENZA to inspire panic.

There is everything to inspire coolness and courage and sacrifice on the part of American women.

A stern task confronts our women–not only trained women but untrained women.

The housewife, the dietitian, the nurses’ aide, the practical nurse, the undergraduate nurse, and the trained nurse herself–all of these are needed.

Humanity calls them

Lives depend upon their answer

Capable, though untrained hands, can lighten the burden of the trained ones. There are many things intelligent women can do to relieve the situation, working under the direction of competent nurses.

Will you help do some of them?

Will you enroll for service Now?

If possible, apply personally at the New York Country Chapter of the American Red Cross, 389 Fifth Avenue. Come prepared to fill out an enrollment blank like that printed below. To physicians and to the nurse-employing public this appeal is made:

Unless it means life or death, please release for service all nurses attending chronic cases. Physicians should not employ nurses as office or laboratory assistants during this emergency.

Nurses’ Emergency Council, Lillian D. Wald, Chairman

Courtesy of the New York Public Library Manuscripts and Archives Division.

No one is more “stern” than my school nurse colleagues. Hopefully, this message from Lillian Wald will give us some needed inspiration to continue to be that “solid object” in the room. Stay grounded friends, and remember to bring awareness to your own well-being as we care for so many others.  It is much easier written than done, but still urgently needed for us to find some sense of balance in this upside down era of COVID. 


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