School Nursing

The Relentless School Nurse: Do You Feel Like You are Swimming Against The Tide?


The first few months of school have been a whirlwind of confusion, missteps, and a complete lack of clarity. All of this adds up to often making me feel like a salmon, swimming fiercely upstream, against the tide. The tide, in this case, is the complacency in protection that has grown out of the misunderstanding that COVID is behind us. Meanwhile, ask most school nurses, and you will hear about cases growing, but they may not be counted because home tests are not being accurately reported.

Outbreaks are happening in schools, but who is capturing the data? The five days of home quarantine while symptomatic, hardly seem adequate only to return to school with masking that is not being monitored. So, what are we really doing? School nurses are not the “mask police” or the health department. We are trying to explain confusing masking policies to parents who have grown intolerant to put it mildly.

Swimming against the tide is utterly exhausting and it is taking a toll on our school nurse workforce. I do worry about the future of school nursing. It’s sadly ironic, because just a few short, well actually very long, years ago, I was eager to talk about school nursing for the Future of Nursing 2030 consensus report. That feels like a lifetime ago though and I am sitting here on a quiet Sunday morning, wondering how we can repair the many ruptured relationships that COVID has created. The first ruptured relationship we need to repair is our own. Who are we as school nurses through the trauma of pandemic school nursing?

I ask these questions from a deep concern for our own well-being, which directly impacts our ability to care for our students. We don’t want to go through the motions of school nursing, that is not who we are. We want to be fully invested in our practice. But coming through the pandemic, I know that it does not take much for me to feel off-kilter. Being on high alert has taken on a new meaning since COVID. Once again, the underlying sense of safety hangs in the balance. 

NASN’s recent release of the survey highlighting the mental health of school nurses during the pandemic also included solutions!

Improving school nurse mental health is essential to creating safe environments for young people in our nation’s schools.

These survey findings highlight opportunities to improve supportive policies and practices to reduce workplace stressors and increase workplace supports for school nurses.

Supportive policies and practices could include providing adequate staffing, training, and support, particularly as they relate to COVID-19 or future public health emergencies. – retrieved from Mental Health of School Nurses in the United States during the COVID-19 Pandemic Highlights from a national survey | March 7-30, 2022

Had COVID never happened, the solutions suggested as a result of the survey would have been a welcome relief from our current workload expectations. We would all benefit from reducing workplace stressors and increasing workplace support. School nurses have held the health and well-being of our nation’s students and staff on our shoulders for far too long without relief or much-needed proper staffing. It is no wonder that when the pandemic crash landed, so did we. 

What we do know is that we cannot go back to pre-pandemic circumstances. We must demand proper staffing, administrative support, and clear boundaries when it comes to our work day. We must work in interprofessional teams to manage the impending mental health crises that we are seeing every day at school, and in younger and younger grades. 

These are the brave conversations we need to have both privately and publicly. We can say what we need out loud, which means speaking to our school boards, our state legislators, and our national organizations. But first, we need clarity on what we need. Let’s spend some time and discussion determining what we need. For example, let’s look at the suggestions that came out of the NASN survey and define the following:

  1. What supportive policies and practices do we need?
  2. What is adequate staffing in the school health office?
  3. What training and support do we need to be prepared for the next national emergency?
  4. What workplace supports will decrease workplace stressors?
  5. What do school nurses need to safely care for students and staff?
  6. How can financing the needs of highly effective school health services become sustainable and not a brief reprieve because of the pandemic?

So much to consider and I offer these questions to open dialogue with the readers of this blog. Please consider responding, I would love to post your responses in follow-up guest blogs. 








2 thoughts on “The Relentless School Nurse: Do You Feel Like You are Swimming Against The Tide?”

  1. Spot on again!! I’m beginning to wonder about our message re mental health, ruptured relationships, stress and damage done. How do we get it heard loud and clear? It is uniquely ours. We are not trying to say it’s a worse experience than others but I sometimes get the feeling that it’s being interpreted that way. I don’t know what the answer is right now but it is a thought. Here’s another thought and I do not know if it is in place/practice anywhere but I would like to have the conversation, “what if school nursing were shifted from the umbrella/authority of Departments of Education to Departments of Public Health? The current is not working well.

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