School Nursing

The Relentless School Nurse: Why We Leave

Why school nurses leave their positions has been on my mind a lot lately. I noticed a significant uptick of conversations on Facebook about nurses who were resigning. Some negotiated an earlier “release” date to preserve their own mental health. The support for these school nurses who are leaving our ranks is plentiful and filled with sentiments like, “I might coming right behind you.”  One school nurse I contacted explained her difficult decision to leave her school district, for another opportunity shared;  “I was not given the tools needed to succeed, support or professional respect.”

The school nurse perfectly summed up the crux of our crisis, lack of tools needed to succeed, support to tackle our responsibilities that grow more complicated by the day, and the professional respect we should be, but are not often afforded. In many hours of private conversations with school nurses across the country, the discussions often turn to concern about our workforce. Many school nurses “hung in” through COVID, only hoping that this school year had to be better than the last three. Unfortunately, that does not seem to be the case.

My wise friend, Judy Doran and writer of “Maine Points” shared her perspective on why we leave:

I’m thinking about what we touched on last night and I think that you are on to something…..that last years’ resignations could be topped this year. It could be that so many of us were too damned numb to make a decision. Maybe thinking that it’ll get better. Maybe hanging in for one more year to see if it still fits. Maybe coming to the realization that it can now officially be called untenable. Intolerable. 
While I’m semi on a rant we need to STOP saying what they won’t give and TAKE what is ours. If the first month of “uninterrupted break” is standing at the door turning people around so be it. If you have a leader use them. If you don’t, maybe make one. If that doesn’t work, collaborate to broadcast what is actually going on in your offices.
Make gatherings. Call them meetings if you want or not. Consider doing them off hours because scheduling is nearly impossible. Make them off site. Make them remote. Involve food, gathering. They get to be fun.  I’m from a tiny district so this is easy and don’t even know what I don’t know about large ones but there’s got to be a few kindred spirits scattered throughout.
Want to know how we got the leader position here? I was one year in, H1N1 happened and I asked who in the HELL is in charge around here? I sold it to the supt, the senior RN took on the responsibility and a role was born. We were/are lucky. Do not accept support role status. If you don’t know what Superintendent looks like, invite them to a meeting. Send them a monthly nursing update. Do not wait for them to ask; they may never. Do not wait for some sweeping systemic change to illustrate/recognize your expertise. Make it. Protect your time. This is kind of like in public health if you do everything right, nothing happens. That’s fine, not looking for limelight but demanding respect while doing everything right. 
The message here is the status quo is not serving us individually or collectively and can be challenged one small step at a time.
– Judy Doran
I have shared this suggested school health office schedule that one of my colleagues uses with great success. It has taken time for the staff to comply, but the school nurse starts each school year off by setting boundaries to protect her time. Being on the teacher’s union contract has benefits, but only if we follow the language of the contract. Remember, we teach people how to treat us.

Daily Schedule Health Office Schedule for the School Nurse

This is our time to take a stand for ourselves, friends. Here are some suggestions that might help us regroup and regain equilibrium; at least I hope so:
  • Be realistic about what you can achieve during the school day.

  • Look at what’s on your plate, set your priorities, and stick to them. Focus on the urgent and important.

  • Don’t let other people’s lack of planning become your emergency.

  • I know it’s hard when demands surround us, setting true emergencies aside, try as hard as you can to stick to boundaries. 

  • Speaking of boundaries, set them and stick to them. It might feel hard to say no, but it’s essential to guard and manage your energy

  • Focus on what’s in front of you and try to concentrate on what’s in the moment. Equally, try to have something to look forward to, no matter how small. We are not machines!

  • Talk to people you trust about how you’re feeling – don’t judge yourself too harshly or compare yourself to what someone else thinks. Notice your self-talk, be gentle with yourself, we are all trying our best.

  • Take your lunch, I know there are lots of obstacles to doing so, but protect your breaks, it will help.



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