The Relentless School Nurse: Iowa School Nurse of 2024, Wendy Donald, Has a Message of Belonging for All of Us!

Dr. Kate King, this blog post is dedicated to you! Wendy Donald, Iowa’s 2024 School Nurse of the Year credits you, Kate, for inspiring her leadership trajectory after reading the November 2023, NASN School Nurse President’s Letter; Inclusivity: Starting With Ourselves. Your words, inviting us to frame inclusivity by including ourselves, propelled Wendy to meaningful action that she shares in today’s guest blog post.

Lessons abound in Wendy’s powerful message as she reflects on 25 years of school nursing practice in her hometown school community. She takes us on her journey from being viewed as an administrative afterthought to a significant contributor to the school leadership team. Wendy, thank you for sharing your story, and hearty congratulations on your well-deserved recognition! 

Belonging: A Human Need is Fueled by *Connection, *Meaning, *Purpose. 

Inclusify: To live and lead in a way that recognizes and celebrates unique and dissenting perspectives while creating a collaborative and open-minded environment where everyone feels they truly belong. 

My name is Wendy Donald. My nursing career began in 1990 as a BSN RN staff nurse at my local hospital. Nine years later, I had the opportunity to work as a school nurse and I went for it! Twenty-five years later, I am still a school nurse in my hometown school district. Twenty-five years….doesn’t seem possible! In 25 years, I have worked under four superintendents, multiple principals, and with all grade levels. My current student population consists of parents who were also my students and their grandparents were my classmates! I was born and raised in the community I work in and have built strong relationships that have been maintained throughout the years. I have witnessed first-hand the shift in student health concerns; more mental health needs, more technology in the schools (pros and cons), the addition of student social-emotional education, school-based clinics/therapy services, chronic absentee issues, COVID and post-COVID health concerns. I am here! I am present! I am invested!! I have been involved in the school teams to help address these issues and am prepared to continue doing so! 

“Fighting for a place at the table” 

Wait…what?! What’s going on? When my building’s Student Success Team (SST) was formed, I wasn’t included. Surely an oversight, right? When the Building Leadership Team (BLT) was created, the school nurse’s voice for the team wasn’t even a consideration. Surely an oversight, right? When the administration team meets with the counseling and safety teams for input, feedback, and situation debriefing on a regular basis, they will want to meet with the school nurse as well, correct? Wait…am I not considered part of the school team? Do I not belong? 

I’m not going to lie. The 2023-2024 school year started rough for me. I was working under a new administrator and the role of the school nurse and my expectations of the role as the school nurse were not in alignment. Twenty-five years in this job, you can do the math to know that I am past 50 years of age. Have I been sidelined? Am I considered “old”, “irrelevant” or “close to retirement”? During COVID, I was instrumental in my building, or I thought I was. I felt good about my contribution to the daily operations of my building, my school district, and our local public health team. When did the shift from HERO to ZERO occur?

As a school nurse, you are usually a team of one. I get that. The job itself poses unique challenges in a nontraditional healthcare setting. A school nurse needs to have strength and independent thought. They need to have strong health assessment skills and autonomy. In the event of a crisis, they must be able to remain calm and direct lay people on what actions need to be taken. Not just anyone can do this job, let’s face it! School nurses have vulnerable conversations with students, families, and other school staff when working with student health and follow-up care needs. Yet, when it comes to building a school team composed of counselors, the social-emotional lead, security, and administrators, the health office (nurse) input is not considered part of the team. In addition, to help students, isn’t a diverse team with different strengths and points of view optimal? 

I can’t begin to describe the emotions that flooded into my brain and heart as the first semester began. No one wants to feel irrelevant and isolated in their role; no matter where you work or what you do, and I was miserable. My thoughts of resigning and moving on to something new were shadowed by fear and not wanting to give up a career due to “hurt feelings”. I enjoy my job and have a 25-year work history that speaks for that. I have worked under many administrators and every new school year has produced an “ebb and flow” of my role within the building. However, this year was different, firm lines had been drawn and I wasn’t part of it. After several discussions, this was a clear message. Door closed. I inquired about reassignment for the next school year and was met with “What, you’re not happy in your current building assignment”? Truthfully, I’m tired of having to prove relevancy. 

“The path to belonging” 

In November 2023, I received the NASN School Nurse Journal (Vol. 39; Number 6) and happened to read the President’s Letter “Inclusivity; Starting with Ourselves”. It felt like Kate King DNP, MS, RN, LSN was speaking directly to me! We could have been sitting together at a nice coffee bar discussing my situation! Her message couldn’t have come at a better time. More interesting, however, is that this was the second time I had heard her reference the book Inclusify: The Power of Uniqueness and Belonging to Build Innovative Teams by Stefanie Johnson Ph.D.

I heard Kate mention Inclusify in her opening statement for the 2023 NASN summer virtual conference. For those of you who didn’t get a chance to read her message in the November periodical, I urge you to do so. She addresses 4 things you can do to move forward on the topic of belonging, which are: Belonging to yourself; Belonging to your profession; Belonging to your patients, and Belonging to your nurse role. This is not an article that paves the way for a victim mentality (or to resign due to “hurt feelings). I shared the article with my nurse colleagues and some of the administrative team. Would this allow for an opportunity to meet regarding my concerns? 

I purchased the book and read it. Inclusify addresses different management styles and how creating team diversity fits within that management style (or challenges it). Based on the management style of an administrator, team diversity may be easier or harder to create due to bias. This bias may be unconscious and when it becomes conscious, then the opportunity for change is more prevalent. The book talks about three foundational points that need to be considered before embarking on the journey of “Inclusifying”: The playing field is not level; Systems can create inequality; and We live in a post #MeToo World.

In my case, I was feeling the pinch of working within a narrow-sighted system. I purchased another copy and arranged a meeting to discuss it with the Executive Director of Teaching and Learning in my district. Armed with a “gift” copy of Inclusify and a school nurse colleague (who is very level-headed, well respected, and speaking on behalf of her building challenges for inclusion as well) a discussion on building diverse building teams, school nurse inclusion and opportunities in which the school nurse role would benefit (even thrive) ensued.

A discussion on how a recognized unconscious bias can turn into “conscious inclusivity” and serve as a “new norm” once created. Nurse inclusion in school teams, health-specific professional development opportunities that allow for evidenced-based health practices to be implemented, staff assistance when needed in the buildings, common language and educational opportunities between the school counselor, school nurse, and social-emotional lead were all discussed and like the human brain, new pathways were identified and turned on during the meeting. Perhaps there is an opportunity for new growth here! 

“Starting slow to go fast” 

I would love to say that after the meeting with the Executive Director, my situation quickly improved but that would not be factual. However, a few key things that were a tremendous help in my situation occurred. First, my district sent out a survey to all staff, students, and parents regarding their “Daily Desired Experience” with the school district. The survey focused on the areas of feeling valued, respected, and accepted as well as how our work and development are real, relevant, supported, and recognized. The survey fits in very nicely with what I was trying to communicate. The results of this survey led to the creation of the district-wide “District Environment Committee” (DEC) in which all employee domains were to be represented.

I now serve on this committee as a voice for the school nurses in my district. Since I am on the DEC committee, that opened the door for being placed on my building leadership team (BLT). Finally, and this is huge….I was nominated for the Iowa School Nurse of the Year and was chosen. Part of the reason I received this award was based on my current work with school nurse inclusion. I received some press coverage and spoke about working with my school administration on inclusion. I am happy to report that I am currently associated with the school teams that I desired to be a part of and wasn’t at the start of the school year. Let’s see what next year brings as the “ebb and flow” will surely continue. 

In summary, if you find yourself in a situation of isolation, not being seen or heard, lack of professional resources, etc., you can do something about it. Start with yourself; know who you are and what you can do. Be a continual learner; keep data on the number of students you see daily, referrals you make, parent communication, etc. It’s important to keep data on what you do. Belong to your professional nurse organization (state and national) and determine what resources you need to provide optimal student care. Learn (or review) the school nurse’s scope and standards of practice. Before you can become a “disruptor”, you need to be armed with knowledge as emotions will get you sidelined. Finally, embrace what is out of your control, and that can be hard. I know. I’ve been there. We all have been there. 

Through this process, I developed a new mantra. Please feel free to use it if it resonates with you. You know when you travel by air, part of the instructions include what could happen with extreme turbulence. If turbulence occurs, oxygen masks may drop from the compartment above you. Put your oxygen mask on first, before helping others. 

Mantra: Today, I am putting my oxygen mask on first.

We can’t help our students fully and hope for optimal results without belonging and inclusion within the school teams. Best of luck to you if you choose to embark on this journey! Remember…You got this!! 

Warm Regards,  Wendy

Wendy Donald BSN RN NCSN

2024 Iowa School Nurse of the Year

You can reach out to Wendy via email: wendy.donald@mcsdonline.org

References:

Johnson, S. (2020). Inclusify: The Power of Uniqueness and Belonging to Build Innovative Teams. New York, NY: Harper Business.

King K. Inclusivity: Starting With Ourselves. NASN School Nurse. 2023;38(6):280-281. doi:10.1177/1942602X231202730

National Association of School Nurses (2022). School nursing: Scope and standards of practice (4th ed.). NASN.