I had to read the title and content of the email several times before the request sank in. It said, “White House: Invite New Jersey Clinician Leaders Listening Session.”
The White House Office of Public Engagement creates opportunities for practicing clinicians to engage with the White House and have a role in influencing the policy process by sharing their experiences as clinicians and advocates. Each of you was recommended by a colleague because of the work you have done for your communities as clinicians, as well as the work you put in to advocate for policies that promote health equity and access.
My response to the email swung wildly between “this must be a mistake” to “wow, what an opportunity.” Of course, I enthusiastically agreed to participate. It was a Zoom, so that made the logistics really easy. The agenda was very tight, 1 minute to introduce yourself, your affiliations, and advocacy work, and each participant was given 2-3 min to share their remarks based on the following prompt:
Based on your experiences caring for patients and/or your work in the area of health equity, what is the most important message you would convey to the White House on equity-related issues impacting patients?
Here is how I introduced myself:
My name is Robin Cogan, I am a practicing school nurse in Camden, New Jersey where I have spent the past 21 years of my 37 career as a nurse. I represent the NJ State School Nurses Association as Director to the National Association of School Nurses. For the past decade, I have also been on faculty at Rutgers-University Camden Nursing in the school nurse specialty program that leads to an MSN in school nursing. My advocacy is school safety in all forms including preventing exposure to gun violence, teaching about Adverse Childhood Experiences, and supporting systems of care that are healing centered. I write a weekly blog called The Relentless School Nurse in an effort to amplify the voice of school nurses so that the community understands the scope of our role in efforts to advocate for safe staffing in schools to meet the increasingly complex needs of our students.
Here are my remarks to the prompt:
The presence of a school nurse in every building, every day democratizes healthcare for our most vulnerable and underserved students. Equity is dependent on eliminating barriers to care because health happens in the community. If a community is rooted in systems that create adverse community environments like exposure to violence, housing insecurities, food insecurities, and poverty, the ability of a child to learn and even to connect to a trusted individual is deeply impacted.
Maslow before you Bloom is an educational tenent. Meaning unless we address basic health and safety needs, learning will be thwarted. Health and learning are inextricably linked and one does not happen without the other.
We want our children to flourish. And yes, children are resilient, but they need to be in caring environments where connections are nurtured and built over time. The presence of a school nurse is a protective factor. School nurses stand at the intersection of health and learning, home and school.
But what happens to our 56 million students across the country when 25% of schools have no school nurse or 35% only have a part-time nurse. The 40% where there is a full-time school nurse, like my state of NJ, may have very high ratios, with one school nurse to hundreds and hundreds if not thousands of students. Remember we also care for staff and as an extension, family members and the community.
For far too long school nurses have been a hidden healthcare system. COVID made it clear that school nurses are frontline healthcare workers tasked with keeping students and staff safe in school.
Let me finish by telling the story of one little girl, who left her home country of Guatemala, trekked miles and miles for more than a year with her mother, and siblings through treacherous terrain, and ended their journey in Camden, NJ. She entered preschool at 4 years old, having never been in school. She spoke an ancient Mayan dialect from her country of origin and was learning Spanish as a second language.
This little girl, at age 4, came to preschool every day, but she refused to eat both breakfast and lunch which were available to her. Instead, we found out that she was putting the food directly into her little pants pockets, filling her pockets with food to bring home to her mother and siblings. She felt so responsible for the health and well-being of her family at the tender age of 4. This is school nursing in the year 2022. This story repeats itself in health offices across the country.
The good news is that we were able to identify the issue, support the family by creating a food pantry that was delivered to their house, and link them to community services immediately. Care Coordination is one of the pillars of school nursing practice. School nurses are well positioned to work with students and families in their neighborhoods and homes because health happens in the community and school is at the heart of the community, but we have to be present to make a difference.
The response to my remarks by the moderator of the panel was “Wow, you really gave us something to think about in terms of the need for school nurses in every building.” I think the story that I shared about the little girl who stuffed her school breakfast and lunch in her pockets to bring home to her family was an important reminder of the work we do. We should take the opportunity at any chance to give “one-the-ground” examples of school nursing practice to those who function at 20,000 feet above ground level. It was a memorable experience and I hope that there will be more and that my contribution to the discussion opens eyes and minds about the urgency for school nurses in every school.
10 thoughts on “The Relentless School Nurse: In Conversation with The White House”
Bravo!!! Once again Robin, you have hit the proverbial nail on the head. You are a remarkable school nurse, writer and advocate! I truly feel, that our role as a care coordinator, is really the central place that we work from. I often feel the font of information in my head that I share with families, does more good than the typical Band-Aids and ice packs that many think are the central focus of our practice.
Thank you for once again shining the light on the very difficult challenging and gratifying job we do for our kids!
Please tell the president that a school nurse is a must in every school due to the gun violence.
Thanks for doing such an amazing job representing school nursing. Sharing the riveting story of your student was brilliant. The image of a 4 year old child denying her own basic needs to help her family is profound, indelible and unforgettable. 👏
Yes Robin ! thanks for representing. I often find and insert myself in absolutely every opportunity imaginable in my little corner of the world to introduce school nursing, what we do and how it affects children and adults alike. Often I hear that exact same thing. Wow ! we had no idea. !
Thank you Robin. You did a great job representing school nurses and speaking out on behalf of our students. The story about your four year-old student was a wonderful example to share about our undocumented students and their serious needs.
Thank you for the good work you do and sharing so much of yourself, your wisdom, and your guidance. You are a hero to me (an RN to BSN student here and hopeful NASN applicant). We must continue on this path of advocacy to staff more schools with full-time nurses. Can we involve the Healthy People 2030 AH-R08 objective of increasing the proportion of secondary schools with a full-time nurse and bring this objective out of research phase and into concrete funding at the federal level?
Thank you for your comment and important point about Healthy People 2030. I am working on a response to the White House Office of Public Engagement and will include this information
Wow, so powerful!!! Your story gave me goosebumps and the will to keep advocating in the face of naysayers! Thanks for all you do!!!
This story provides a perfect illustration. Great Job!!!
Wow you are amazing !! Thank you for always having our back! I am a CSN grades 6-12 1,350 students- I desperately need another full time nurse to be able to care for my students thoroughly and safely-I cannot do everything alone anymore. I dread goi g back!.