School Nursing

The Relentless School Nurse: This Moral Injury is Real – What Would You Do?

In the context of school nursing, moral injury occurs when nurses are confronted with situations or decisions that challenge their deeply held moral or ethical beliefs. This is the story of a dedicated group of school nurses in Texas who took a public stance against a woefully misguided school administration that chose dollars over public health. How many school nurses have found themselves in similar circumstances when vaccination compliance is ignored for the sake of the budget? 

In Grand Prairie, Texas, a troubling situation unfolded when four nurses from the Grand Prairie Independent School District (ISD) stepped forward, claiming that they were pressured by administrators to overlook state laws during the beginning of the current school year. The nurses, fearful of potential repercussions, chose to remain anonymous while expressing their concerns to CBS News Texas.

The nurses disclosed that they received emails from Executive Director of Information Services Bill Young and Associate Superintendent Traci Davis, urging them not to enforce state laws related to student vaccinations. According to the nurses, this directive was seen as an attempt to boost the district’s budget.

Expressing their shock and discontent, one nurse remarked, “Unbelievable. It was a big slap in our face. It’s unethical. It’s immoral. We felt like we were being attacked.”

CBS News Texas verified the authenticity of the emails, and the nurses insisted on anonymity to shield themselves from possible backlash.

The nurses revealed that the district was allowing unvaccinated students into classrooms, potentially violating state laws, all while still receiving funding for non-compliance. Data provided by the nurses indicated that, by the second week of school, almost 2,000 unvaccinated students, comprising 7.5% of the student body, were attending classes.

The nurses, concerned not only about the health risks for unvaccinated students but also for immunocompromised ones, decided to take action. They sought written confirmation from the district acknowledging that students were “out of compliance.”

“We want something in writing that says, ‘You’ve been notified,'” one nurse emphasized.

A letter outlining state law and recommending the exclusion of unvaccinated children was drafted by their director and sent to principals. However, administrators instructed principals not to sign it. Faced with this resistance, the nurses signed the letter themselves and filed a Safe Harbor, a protective document for nurses in potential violation of the State Nurse Practice Act.

Despite the district’s claim that the Safe Harbor didn’t legally apply to them, the nurses contended that it did according to the Texas Board of Nursing. They asserted that almost every nurse in the district signed the Safe Harbor.

As a consequence, the nurses felt they were being punished with increased workload and insufficient time for their essential tasks. They detailed a routine of checking in with unvaccinated students every Friday, updating numbers, and reporting to higher-ups. Though the immunization numbers eventually increased, it took months.

In response to CBS News Texas inquiries, the district declined an interview but provided statements emphasizing herd immunity. However, CBS News Texas couldn’t find legal backing for the concept of herd immunity in this context. Despite the conflicting information, the district eventually stated that they had started excluding unvaccinated children, asking them to stay home until they received immunizations. According to the nurses, this exclusion began in mid-October.

Facing a challenging work environment, the nurses admitted to considering leaving their jobs on a day-by-day basis. They emphasized that their situation was not unique and that numerous nurses might not return the following year.

In the aftermath of the interview in mid-October, one nurse had already left, and the remaining nurses expressed reluctance to return next year. The nurses plan to file formal complaints with both the Texas Department of State Health Services and the Texas Education Agency, expressing their concerns about the violation of state laws in the district.

You can read the full article and watch the CBSNews interview here: Grand Prairie ISD nurses say the district is asking them to go against the state



8 thoughts on “The Relentless School Nurse: This Moral Injury is Real – What Would You Do?”

  1. Enormously proud of this group of RELENTLESS SCHOOL NURSES IN TEXAS! Imagine waking up every day facing going into that environment? They are doing the equivalent of standing on their desks with a super hero cape on saying NOPE. Also wonder if there are consequences for this kind of callous, disgraceful, misbehavior for places that receive federal funding, like schools???

    1. Thank you for this important comment Judy! Sending them our greatest support for taking a stance!

  2. Thanks Robin,
    This is distressing news.
    I feel that nurses can no longer remain silent as the antivax movement does all the talking with results like this .
    To that end I wrote this letter to the editor of the Washington Post published last Sunday . See link below.
    Thanks for all you do speaking out against gun violence and the increasing loud noise from the antivax/ anti science movement.
    Adriana van Breda

    1. Adriana, this is excellent! Thank you for sharing, would you like to write a guest blog about your experience? School nurses could learn so much from your example!

      1. Yes, but since I have never written a blog before could you give me some advise?

      2. Certainly, it is super easy. Most blog posts are less than 500 words. It would be great to have a pic of you and a brief bio.

    2. Hi Adriana,
      I hope you might consider writing a guest blog sharing your experience publishing an OpEd in the Washington Post! Congratulations, I would love to feature your message!

    3. Great job advocating and I haven’t even read it yet…..paywall. Looking forward to reading it when you share on a blog post. Thanks!!

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