The Relentless School Nurse: The Uphill Battle – Reflections and Realities as Another School Year Closes

Closing a Difficult Year

As another school year comes to a close, I find myself reflecting on everything we carried personally and collectively. The weight, the worry, the moments of heartbreak, but also the connection, the quiet victories, and the fierce determination to keep showing up for our students, no matter what.

Though I speak from my own experience, I know my story is far from unique. School nurses across the country have faced many of the same challenges, and we’ve leaned on each other in ways that have kept us going. This work is often invisible, but we see each other. And we know we are not alone.

The Weight We Carried

🧠 Mental Health Crises Are Part of My/Our Daily Routine

Each day brought students to my office with invisible wounds, panic attacks, sleeplessness, self-harm, and deep anxiety. They were overwhelmed, and many didn’t have anyone else to turn to. I sat with them. I listened. I reminded them they weren’t alone.

I wasn’t trained as a therapist, but I’ve become a bridge, connecting students with the limited mental health resources we have, coordinating with families, following up, checking in. I know so many school nurses are doing the same. We are filling a gap because someone has to.

🦠 Public Health Didn’t Go Away

COVID may no longer dominate the headlines, but the public health challenges haven’t stopped. From measles outbreaks to flu surges, and low vaccine compliance to ongoing misinformation, I’ve been on the frontlines trying to keep my school community informed, calm, and safe.

I spent hours tracking immunizations, educating families, managing illness protocols, and sometimes being the only source of healthcare a student had access to. And I know that in rural, suburban, and urban schools across the country, thousands of my fellow nurses were doing the same.

🔐 The Fear of Violence Is Always With Us

We practiced lockdown drills again this year. I watched preschoolers hide under desks. I stood in my office thinking about what I would do, who I could help, if something unthinkable happened. 

Gun violence is a public health crisis. As school nurses, we see its ripple effects every day: the anxiety, the hypervigilance, the trauma that doesn’t always have visible symptoms. We are asked to be caregivers, first responders, and protectors, and we do it, even when we’re afraid, too.

Focus on Advocacy

⚖️ Fighting for Health Equity—One Student at a Time

This year, I advocated for students who didn’t have insurance, who were navigating homelessness, or whose parents worked three jobs and still couldn’t afford medications. I pushed for access to care, connected families to community resources, and called every clinic in town until I found someone who would help.

Health equity isn’t theoretical when you’re the one making those calls. It’s the lived reality of school nursing—and it’s one of the hardest, most important parts of what we do.

📋 Managing Chronic Conditions in Broken Systems

Asthma, diabetes, epilepsy, and life-threatening allergies don’t pause when budgets are tight or staff are short. I created care plans, trained teachers, managed emergencies, and made sure students could safely participate in school life. Sometimes, I did it without backup, without subs.

I know I’m not alone. Every school nurse I talk to is juggling complex medical care with minimal support. We do it because we care deeply, but we’re also sounding the alarm that it shouldn’t be this way.

What This Year Taught Me

• Listening Matters More Than Ever. Sometimes, the most healing thing I offered was presence—a quiet, steady place where a student could exhale and feel seen.

• We Are Stronger Together. I leaned on my fellow school nurses. We vented, shared strategies, and reminded each other to keep going. That solidarity kept me afloat.

• I Have to Take Care of Myself, Too. This year taught me to rest without guilt. To say no. To take walks. To ask for help. We can’t care for others if we’re running on empty.

The Policy Threat We Can’t Ignore: Undermining Children’s Health

What keeps me up at night isn’t just what happens in my school building; it’s what’s happening at the federal level.

We are witnessing deep rollbacks in protections that impact the health and safety of children. From undermining environmental safeguards that affect air quality and asthma rates, to efforts to eliminate school meal nutrition standards, to ongoing attacks on Medicaid CHIP funding and vaccinations, children’s health and well-being are under assault. 

As school nurses, we see the impact of policy decisions play out on children’s faces every day. We are witnesses to what happens when access to healthcare is stripped away, when food insecurity rises, when children breathe polluted air or go without mental health support, and to the resurgence of childhood illnesses. These aren’t abstractions. They are our students who fill our health offices, trying to learn while hungry, anxious, or ill. Parents are under extreme stress too, and let’s talk about the school staff also deeply impacted. 

We must speak up. We must push back. Our silence would be complicity. Our advocacy is our responsibility.

Looking Ahead: Doing More With Less

As we look to next year, I’m deeply concerned. Budgets are being slashed. Positions are being eliminated. The needs are growing, and the resources are shrinking.

💸 The Cuts Are Real—and Harmful

I’ve seen nurse positions cut. Counselors reassigned. Health aides were let go. In some districts, entire health teams are disappearing. The justification is “tight budgets.” The result is children going without basic care.

📉 The Ratio Is Unsustainable

Some of us are covering two, three, even four schools. Many have over 1,500 students and more. With rising rates of diabetes, asthma, anxiety, and other conditions, this isn’t safe for students or nurses.

🧩 We’re Expected to Do It All

We are Chief Wellness Officers, health educators, care coordinators, emergency responders, mental health first aiders, and advocates. But we’re not superhuman. We need support. We need policies that prioritize student health. We need to be heard.

The Emotional Toll Is Real

📣 We’re Advocating Harder Than Ever

I’ve written letters to school boards, spoken at public meetings, and joined coalitions fighting for better ratios and stronger school health infrastructure. So have hundreds of other school nurses. We’re raising our voices because our students need us to.

💔 But It Still Hurts

It hurts to send a student back to class knowing they need therapy. It hurts to explain to a parent that we can’t offer something their child desperately needs. It hurts to feel invisible in a system that leans on us without investing in us.

🌱 And Yet, We’re Still Here

Because there’s joy, too, there’s healing. There’s the student who finally got their inhaler. The child who said thank you after we helped them feel safe. The parent who expressed deep relief when someone finally listened. That’s what keeps me going.

Moving Forward—Together

Next year won’t be easier. But I won’t face it alone. I’m part of a powerful community of school nurses who are showing up, speaking out, and supporting one another.

We are relentless. We are resourceful. And we are not going anywhere.

Let’s keep pushing forward—together. Our students are counting on us, and we will not let them down.

Summer is a few days away, no wonder we are ALL Tired! Rest up, friends, the 2025-2026 is around the corner.