This week, I had a deeply resonant conversation with Donna Gaffney, a psychotherapist, nurse, and author of Courageous Well Being for Nurses. She asked me two simple yet powerful questions that delve into the heart of every school nurse’s experience, especially now: “What do you need to stay in your position?” and then, “When do you know it’s time to go?”
In her book and in her work, Donna speaks to the courage it takes for nurses to care for others while tending to their own well-being, acknowledging that sometimes, staying is a radical act—and sometimes knowing when to step away is the bravest choice. These questions carried particular weight as I read through countless online posts from school nurses across the country this year, which shared stories of exhaustion, frustration, heartbreak, and resilience. Many are asking the same questions I heard in Donna’s voice.
What I Need to Stay
For many of us, staying means more than just showing up—it means honoring why we became school nurses in the first place. Here’s what I hear from school nurses and what I know myself:
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Support that goes beyond lip service. Genuine respect and understanding from administrators, colleagues, and policymakers are essential. We need clear communication, meaningful involvement in decision-making, and staffing that makes our workload manageable.
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Resources that match the reality. This includes everything, from being part of a health services team to access to necessary tools, supplies, resources, and mental health support, as well as continuing education that recognizes our unique challenges.
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Acknowledge the emotional toll. What often gets overlooked is the heavy emotional labor—holding space for trauma, chronic illness management, healthcare inequities, and now, the ongoing stresses of significant budget cuts. We need time and tools to take care of our mental and emotional health.
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Professional recognition and validation. School nursing is a specialty with its own complexities—when that expertise is acknowledged and championed, it fuels our commitment.
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A clear pathway to advocacy and change. We stay when we have a voice. Being able to advocate for ourselves, our students, families, and profession in meaningful ways isn’t just empowering—it’s necessary for sustainable practice.
When Do You Know It’s Time to Go?
The signs are often subtle at first—persistent fatigue, cynicism replacing passion, a growing sense of isolation. Sometimes it’s a single event, other times a slow-burning realization:
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When your physical or mental health is consistently compromised despite your best efforts to care for yourself.
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When systemic barriers and a lack of support make it impossible to deliver the care your students deserve.
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When your values and the realities of your work environment clash too sharply, you feel drained rather than fulfilled.
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When your role shifts so far from your professional scope that you lose your sense of purpose and identity as a nurse.
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When staying feels like survival rather than service, and the cost to your well-being feels too high.
Holding the Tension
There is no one right answer. These questions demand ongoing reflection. Some days, we find renewed strength and reasons to stay. Other days, stepping away might be the healthiest decision for ourselves and the profession.
Donna’s question is an invitation—not just to evaluate our environment but to name our needs boldly and honestly. And when we share these struggles openly, we break the isolation that can feel so suffocating.
To my fellow school nurses reading this: What do you need to stay? What signs tell you it’s time to go? Your voice matters. Your well-being matters. Your story matters.
Together, we can foster a profession where staying is supported and where leaving is not a failure but a step toward a new path of well-being and courage. Let’s continue to explore these questions and answers. Feel free to share your reflections by emailing me at: relentlessschoolnurse@gmail.com
