The Relentless School Nurse: Sustaining the Profession We Inherited

 

 

We inherited a profession that other school nurses built.
Now we are responsible for sustaining it.

But that is not something most of us understand when we first become school nurses.

Most of us enter school nursing focused on learning the job. We learn how to manage medications, respond to emergencies, write care plans, navigate special education law, manage communicable diseases, document everything, and somehow keep the health office running every single day. For many years, the work feels very local. It is about our school, our students, our families, our staff, and our community. The job itself is so complex that just learning how to do it well can take years.

Over time, something begins to shift. We start to see patterns across schools and districts. We start to understand how laws, regulations, and policy decisions affect our daily work. We begin to recognize the names of people who are writing practice standards, advocating for legislation, conducting research, and leading professional organizations. We begin to realize that the work of school nursing is not only happening inside our health offices. It is also happening in conference rooms, committee meetings, research projects, legislative offices, and professional organizations.

At some point in our careers, we move from learning the profession to practicing the profession, to slowly realizing that we are also part of sustaining the profession.

For me, that realization did not happen at the beginning of my career. It probably happened about a decade into my practice. Early in my career, there simply was no space for me to expand my commitments beyond my school. I was learning the job, building my practice, and raising twin daughters. Like many school nurses, my world was already very full, and my focus needed to be where I was most needed at that time.

But as the years passed and I became more confident in my practice, I began to understand that the profession I was practicing in did not appear on its own. Someone wrote the standards. Someone created the certification. Someone organized the conferences. Someone advocated for the laws that define our practice. Someone built the professional organizations that represent school nurses at the state and national levels.

Most of those people were school nurses working full-time in schools while also doing that work.

We are practicing inside a structure that we did not have to build from scratch, and that is both a gift and a responsibility.

I have been thinking about this a lot lately because I have learned that in several states across the country, school nurse organizations have had to cancel their annual conferences because there were not enough registrations to hold them. Many school nursing conferences happen on weekends because coverage is so hard to find. Even our professional learning often has to happen on our own time because there is no one to cover our offices while we are away.

When I first learned that conferences were being canceled, I felt more concerned than surprised. Not because school nurses do not care about the profession, but because I know how tired school nurses are. It is difficult to leave a building for a day or two, or give up a much-needed weekend. Many districts no longer pay for conferences, and as a result, school nurses end up paying out of pocket or using personal days to attend professional events. When conferences are held on weekends, it often means giving up time with family, time to rest, or time to recover from a week that was already full.

So this is not a criticism. It is an observation about the reality of our work and the structure we work within.

But it is also something that made me think about the profession more broadly.

Because this is not really about conferences.
This is about how professions sustain themselves over time.

We are very good at showing up for everyone else. We show up for students who are sick, anxious, injured, overwhelmed, hungry, tired, or just need a safe place to sit for a few minutes. We show up for families who are trying to navigate a complicated healthcare system. We show up for teachers who are worried about a student. We show up for administrators when there is a crisis. We show up for public health when there is an outbreak. We show up for communities when there is an emergency.

Showing up is what school nurses do.

But professions also survive because people show up for the profession itself. Not all at once, and not all in the same way. Some people mentor new nurses. Some are present at conferences. Some serve on committees. Some write articles. Some participate in research. Some advocate for legislation. Some step into leadership roles. No one person does all of those things, but collectively, that is how a profession sustains itself across generations.

We inherited a profession that other school nurses built, protected, expanded, and strengthened over decades. They did that work while they were also working full-time in schools, raising families, and managing all the same challenges we face now. We are now practicing inside the structure they built, which means we are also part of what school nursing will become for the next generation. Whether we realize it or not, we are not just practicing school nursing. Over the course of our careers, in small ways and large ways, we are also shaping what school nursing will look like after we are gone.

None of us is responsible for sustaining a profession alone, but over the course of a career, we can play an important part in making sure the profession remains strong for the nurses who come after us.

Professions are not sustained by job descriptions.
They are sustained by people who show up over time, in different ways, at different stages of their careers.

School nurses have always been very good at showing up — for students, for families, for schools, and for communities.

Part of the long arc of a professional life is that eventually, some of that showing up is for the profession itself.