School Nursing

The Relentless School Nurse: Believe in the Difference You Make & Set Boundaries!


Did I ever tell you that I LOVE snail mail, especially handwritten notes sent through the mail? The other day I sorted through the mail and found three cards! One was from Mom’s Demand Action thanking me for speaking at a recent rally. One was from Jeanne Kiefner, a school nursing treasure who will be our forever “Head Nurse,” thanking me for spending time together during our recent NASN conference. The third card, pictured above, was from Christa Varga, a school nurse who is one of the most generous and thoughtful colleagues I have ever had the pleasure of knowing.  

“Hold onto the realness of your voice. Believe in the difference you make.” I will hold onto this message as a catalyst to keep moving forward. There have been many times in recent months that I doubted my ability and questioned whether my blog was making a difference. I want to publically thank the lovely writers of these snail mail messages and the many school nurses who write me private messages. Your words lift my spirits and give me the fuel to keep plowing forward, even if I do not know where the road will lead. 

We are moving into another challenging year friends, the fourth one impacted by COVID. The message of believing in the difference we make is urgently needed if we are to face what is coming in 2022-2023.  Summer is for reviving our spirits, recharging our depleted reserve, and reimagining school nursing. We are the Chief Wellbeing Officers in our own school health offices. But that wellbeing must also include ourselves. It is not selfish to prioritize our own well-being, in fact, it is the only way we will be able to manage the next school year. 

Claiming to be self-less does not move our profession forward. Maybe, just maybe, we as school nurses have an unhealthy relationship with setting boundaries. We often share that we don’t take time for lunch or barely have a chance to take a breath in between the endless needs in our schools. We know that COVID needs have added exponentially to our workload. But maybe it’s because our bigger issue is not setting boundaries about needing more help or asking for compensation for the work we do outside of the school day. 

Knowing how to set boundaries is one of the most essential yet overlooked social skills. Boundaries are rooted in clear communication. As Brene Brown says: “Clear is kind, unclear is unkind.” The more precise you can express your boundaries, the more likely your boundaries will be respected. While you may need to repeat yourself a few times, don’t feel the need to apologize or explain your boundaries. – –Read more at:

I will be thinking deeply about setting boundaries as we move into the middle of summer. Transforming school nursing needs to include setting healthy boundaries within our own health offices. Our well-being is not negotiable, it must be the highest priority! Come August, I will share the boundaries I will be setting this coming school year. I invite the readers of this blog to think about setting clear boundaries with me.  Please share them by commenting on this blog post. We need a group effort to transform school nursing…remember transformation is possible!

6 thoughts on “The Relentless School Nurse: Believe in the Difference You Make & Set Boundaries!”

  1. Robin, as always, you nailed it! I need to reflect on what my boundaries shall be!

    1. I appreciate your message Meg. Please share your boundaries, and if you agree, I will post them in an upcoming blog!

  2. Boundaries

    Things I already do……
    NO work emails on personal phone.
    Literally shut off computer at home so that you can’t just walk by and jiggle a mouse or trackpad to check in on things. You need to make a deliberate effort.
    My friends know that I may let a text or phone message sit. If it’s urgent they will call back.
    In the health office……I let frequent fliers know that they don’t have to be unwell to visit but also know that if it’s busy in there or they are overstaying their welcome/visiting too often, they will need to return to class. It establishes a good, safe space/respite with boundaries.
    In the health office with staff……NO OTC meds. It’s a slippery slope and unless you have orders for them it is a very bad idea. Also broadly speaking it is not to be used as an emotional dumping ground (of course there are exceptions…..). It is also not a place to air perceived or real medical concerns ad nauseam.
    Try to establish some flexibility in your schedule with admin. For instance if the after hours staff meeting is dedicated to all things non nursing maybe you could a) skip it (because you have never had a duty free lunch and don’t even know what a prep period is), or b) stay in your office and work. I had a previous superintendent literally gasp when I suggested that, asking me if a nurse would unilaterally make that decision. My answer was, “yup”.
    NO DUTIES…….anything that you would need to be replaced for if you had to attend to a student is off limits. (Bus, lunch, recess, whatever…..)

    Make a plan now about potential (likely) extra hours next year. How have you handled them? How do you want to handle them? Figure out how to document them and what your pay rate should be. It should be at least your per diem rate. Or you can just say NO, cannot do it.

    I just read an interview with Dr Peter Hotez. He said he’d been working “really hard” but that he didn’t mind it because he found it meaningful. This is the part that started to get particularly sticky for me………..I couldn’t not do it, it was meaningful and interesting and the right thing to do. Then the edges started to fray, disinformation, pushback and incivility came. It was still the right thing to do but the cost was increasing. What few boundaries I had were wobbling. I became exhausted, felt burnt out, unheard, under appreciated, doubtful and pissed honestly. I get a lousy physical sensation when I think of next year. I unexpectedly resigned during an unrelated conversation with my superintendent who I will say has been enormously supportive of the nursing team. I’d been thinking of it but it was not on the agenda for this meeting. Anyhow, we compromised and I now have a part time position and I’m 100% confident that I made the best decision. (I should note that the resignation declaration came at a point when he was being particularly thoughtful and supportive of our efforts and I just blurted out I CANNOT EVER DO THIS AGAIN. NEVER.

    Can we do this again? My answer is no, not like we have done it. I can’t anyhow (even part time), so I’m really looking forward to filling in some pointers under the heading of Things I Will Do.

    1. Hmmm… interesting comments …. for me to have adult visits is actually a treat and I like to help staff with OTC Tylenol or Motrin if they have for example headaches/muscle spasms. I figure they are adults so they are responsible. I also love to be an emotional dumping ground … again I don’t have a. lot of grown people visiting me and get burnt out with adolescent kids all day long in and out…. you must obviously have too many staff coming in (curious – how they find the time for this? ours are overwhelmed constantly having to use their prep periods to cover for absent staff)

      1. Hi Maria,
        I sometimes like adult visits/conversations too but with boundaries. Sometimes you are too busy to visit. Sometimes it looks like you’re not busy and you’re trying to catch up during a lull in activity. Sometimes it’s great to visit with them. We used to give OTC meds to staff until one day…..there was an anaphylactic reaction, a trip to the ER, lost work time, an angry teacher and narrowly avoided litigation. Bottom line, unless you have a med hx and orders……we do not have a therapeutic relationship with these folks and dispensing meds to them is outside our scope of practice. There may be a strategically place stash of ibuprofen and Tylenol outside of the health office but we do not have anything to do with them.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.