The Relentless School Nurse: Let’s Talk

We all know the focus of school nursing is centered on the health and well-being of our students. That is a fact, a given, our purpose. Let’s set that aside for a moment and talk about us, the school nursing workforce. We are or maybe even beyond our tipping point. The exhaustion from pandemic school nursing has taken a dramatic toll on our well-being. One tell-tail red flag is how many of our most seasoned school nurses are retiring or not renewing their contracts for the upcoming school year. Newer school nurses are questioning their choice to join this specialty practice. While my observations are anecdotal, these stories reveal a trend that cannot be discounted or ignored. 

I am the clinical coordinator for the Rutgers-Camden School Nurse Certification program. In preparation for summer practicum, I am running into difficulty placing students as many of my preceptors are taking a much-needed summer off or have decided to retire. The loss of institutional knowledge that will retire with these school nurses will take years to recover. 

The big question remains, what do we want school nursing to look like in a post (if we ever get there) pandemic world? How do we repair and rebuild relationships that have been ruptured during the last few years? How do we find our footing again? Perhaps the first step is acknowledging the pain, the hurt, the disappointment, the lack of support, the trauma we have lived through, including deep grief for what has been lost. We cannot repair what we don’t recognize. 

And so, while it is always about the children/youth/teens, it is also about us, the school nurses. It is time to talk about how we are doing and what we need. It is not selfish, it is not self-centered or unprofessional. If we do not repair our hurts, recognize our needs and take action to garner support for our workforce, more of us will leave and that will most certainly impact the students. The well-being of school nurses is the upstream focus that will directly impact school communities if we fail to care for ourselves. I am not talking about resilience training, meditation, yoga, or chair massage. While they may be helpful tools, they do not solve the systemic problems that have always plagued our nursing specialty.

School nurses need to be supervised by school nurses. We need an infrastructure that is built on interprofessional collaboration. We need a health services team that meets the needs of our students and staff. Current staffing ratios are untenable and create unsafe and impossible work conditions. Certainly, that has become glaringly evident through the pandemic. Our charge, caring for other people’s children, demands much more than we have been given. We cannot tolerate intolerable working conditions that are unsafe and do not allow us to provide the most comprehensive care possible. 

The leadership skills honed through school nursing practice should be embraced by school administrators and leveraged to create healthy school environments. We have had enough of being the hidden healthcare system that is only sporadically recognized or worse, hardly acknowledged. I hope this blog post begins and/or continues much-needed conversations among us. If you care to share, please feel free to reach out to me via email: relentlessschoolnurse@gmail.com with your reflections.