The Relentless School Nurse: When Policy Harms Children – A School Nurse’s Call to Action

Recently, I had the opportunity to participate in a powerful panel discussion hosted by Nurses for America, titled Trusted Voices, Clear Warnings. I joined this conversation in my role as The Relentless School Nurse, bringing with me over 40 years of nursing experience, including 24 years as a school nurse in an under-resourced urban district in New Jersey.

Since 2017, I’ve used this blog to shine a light on the intersection of school nursing, policy, and public health—from the fight against gun violence to the erosion of systems meant to protect our children. Now more than ever, we are bearing witness to a dangerous unraveling of public health and education infrastructure, driven by policy decisions at the highest levels of government.

This isn’t theoretical. It’s happening now. It’s real. And it’s harming children. I shared the following message:

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A Broken System—By Design

Let’s begin with the big picture. Since Secretary Robert F. Kennedy Jr. assumed leadership at the Department of Health and Human Services (HHS), we have seen a catastrophic series of actions:

• Mass layoffs across federal agencies like the CDC, NIH, NINR, and CMS

• Critical divisions dismantled, including those focused on chronic disease, reproductive health, and vaccines

• The elimination of public comment on sweeping federal health policy changes

These changes aren’t just bureaucratic. They are silencing frontline providers like nurses, erasing community voices, and undermining the transparency and accountability that have long been safeguards of public health.

At the CDC, entire teams have vanished. Policy changes now roll out with no warning, stripping nurses, patients, and advocates of the ability to respond. At CMS, alterations to Medicaid are being implemented behind closed doors. The result is devastating: millions of children and families are being pushed further into crisis, with less access to care and fewer safety nets to catch them when they fall.

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A Dismantled Department of Education = A Dismantled Future

The situation is compounded by the active dismantling of the U.S. Department of Education. The DOE is essential to enforcing civil rights, funding low-income schools through Title I, and supporting students with disabilities through IDEA. Its elimination is not just an administrative reshuffle—it’s a direct attack on educational equity and school-based health services.

In my district in New Jersey, we are already seeing the consequences:

• Health services are being slashed by 27% for the 2025–2026 school year

• Over 300 staff positions—including school health staff, one school nurse, 5 crisis counselors, and 4 behavioral support staff—are being eliminated. 

This means fewer screenings, more untreated chronic conditions, and more students falling through the cracks. For many children,  the school nurse is the only health provider they see. When school health is cut, children’s lives are put at risk.

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Immunization at Risk

Vaccines are one of the greatest public health achievements of our time. But today, those protections are rapidly eroding.

Since Secretary Kennedy took office, $2 billion has been cut from vaccine programs serving low-income children. The ripple effects are chilling:

• In Dallas County, Texas, 50 school-based vaccination events were canceled

• In Minnesota, the loss of $220 million led to 170 layoffs and a less reliable immunization registry

• In California, public health officials warn they may no longer be able to provide vaccines for nearly half of the state’s children

• In Washington State, mobile vaccine clinics for rural and homeless children were suspended, with more than 100 events canceled

These cuts reflect deliberate disinvestment in public health infrastructure—decisions that disproportionately harm families already struggling with access to care.

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Medicaid: A Lifeline Under Siege

The attacks continue with Medicaid, the primary source of healthcare for millions of children, people with disabilities, and low-income families. Congress is currently considering more than $700 billion in cuts to this vital program. Combined with work requirements and the loss of public input at CMS, these changes threaten to dismantle Medicaid as we know it.

Medicaid is not just a budget item—it’s a lifeline. It pays for therapies, mental health care, medications, and yes, school nursing services. Cutting Medicaid is not about saving money; it’s about abandoning the most vulnerable members of our society.

Hospitals warn they’ll be forced to absorb more uncompensated care. For schools, it means fewer resources to meet growing health and behavioral needs. For families, it means the difference between access and crisis.

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Hunger in the Land of Plenty

Meanwhile, changes to the Supplemental Nutrition Assistance Program (SNAP) threaten to leave millions of children without consistent access to food. Forcing states to contribute more funding may sound like fiscal responsibility, but in reality, it means families may have to go without.

No child should go hungry in one of the wealthiest nations on Earth. And yet, because of these policy choices, they are.

Hunger is not just a food issue—it affects attention, learning, emotional regulation, and physical health. Schools can’t teach hungry children, and nurses can’t treat them effectively without addressing the root causes of their health challenges.

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What This Looks Like in My District

Let me bring this home.

In my district, 1 in 4 children live in poverty, and 1 in 4 has asthma. We support students with disabilities, manage chronic illnesses, and address trauma that has only deepened since the pandemic.

Now, as health services are gutted and nurses are laid off, we are left with a dangerous gap. Students come to school with undiagnosed diabetes, unmanaged asthma, untreated anxiety, and fewer professionals to help.

School nurses are care coordinators, safety nets, and first responders. I have seen the relief in a parent’s eyes when they know their child can access an inhaler, a meal, or simply a caring adult who will listen.

When we lose school health services, we don’t just lose a nurse. We lose the foundation of a safe and supportive learning environment.

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What Can We Do?

We are not powerless. In fact, we are powerful.

Here’s how we fight back:

• Demand full funding for HHS and the Department of Education.

• Reject cuts to Medicaid, SNAP, and school health programs.

• Support legislation like the NURSE Act and the Protect Our Schools Act.

• Show up. Attend school board meetings. Ask questions. Push for transparency.

• Tell your stories. Let lawmakers know how policy affects real children, real families, and real communities.

• Build coalitions. Partner with unions, advocacy groups, disability rights organizations, and fellow public health professionals.

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This Legacy of Harm Is Not Inevitable

The harm we’re witnessing is the result of choices, and that means we can choose differently. We can choose investment over austerity, care over cuts, and equity over indifference.

Nurses are trusted voices. We are relentless. And we are powerful advocates for our communities.

Let’s be clear in our commitment, united in our vision, and relentless in our advocacy for a healthier, more just future for every child.

Let’s keep moving forward—together.