The Relentless School Nurse: When the Words Don’t Come

I didn’t post last week, and for those of you who have been reading this blog for a while, you know that is not like me. Over 1,400 posts across more than a decade of writing about school nursing, showing up on this page the same way I show up in my health office, consistently and purposefully, with something to say about this profession I love. Last week, I had nothing.

Not because nothing was happening in school nursing. There is always something happening in school nursing. But because I hit a wall that I think a lot of us hit, and that almost nobody talks about, honestly. It is hard to stay passionate about a profession that doesn’t always celebrate you. Some days, some whole seasons, it all feels like a slog. I am saying that out loud because I suspect I am not the only one who has felt it, and because after 1,400 posts, I am not about to start softening the truth now.

School nurses give everything. We show up for students, for families, for buildings full of people who often don’t fully understand what we do or what it costs us to do it well. We carry the complexity quietly, the emergencies, the care plans, the fights for resources, the documentation, the relentless advocacy, and then we go home and do it all again the next day. And sometimes the profession we love that much doesn’t love us back in ways we can feel. That is a hard thing to sit with, and last week I sat with it. I let the silence be what it was.

After a while, I asked myself the question that had been sitting quietly underneath all of it: why do you keep going? My answer surprised me with how simple it was. Habit. Showing up is in my DNA. And the students. No grand revelation, no renewed sense of purpose arriving in a blaze of clarity — just the bedrock truth of who I am and why I chose this work in the first place. Habit is not a glamorous answer, but after all these years, I have come to believe that habit is what commitment looks like after it has been tested a thousand times. It is love that has been stress-tested and held, the thing that carries you on the days when passion cannot find its footing.

And then there are the students, who are always the non-negotiable at the center of everything. They are real even when the recognition isn’t. On the days when the profession feels hollow, I think about the child who comes to the health office not because they are sick, but because I am there, because somewhere along the way I became the person in that building who slows down, asks the real question, and actually waits for the real answer. That child doesn’t know anything about my slog. They just need me to show up, and so I do.

So here is what I want to say to every school nurse who is reading this from inside their own slog. Tell the truth about how you are feeling, at least to yourself and ideally to someone who understands this work from the inside. The silence we keep about our own struggles is the same silence that allows the profession to keep undervaluing us, and it starts to cost us in ways we don’t always recognize until the cost is very high. Find another school nurse, a colleague, a mentor, someone in your state association, someone in your NASN network, and say the real thing out loud, not the polished version, the real one. Because the moment you do, you will likely discover that the person across from you has been carrying the same weight, and that shared truth has a way of making the load lighter than you expected.

And if you need a mental health day, take it. I mean that seriously and without qualification. We would say that to any student or family we serve without hesitation, and we have to be willing to apply the same standard to ourselves. One day will not fix everything, and we both know that. But it is a start, and starting matters. Taking time for yourself is not a failure of commitment. It is an act of professional responsibility, because the students who need you tomorrow deserve the version of you that has had a chance to breathe, and so do you.

The truth is that thriving in school nursing doesn’t always look like passion and energy and a deep sense of purpose. Sometimes it looks like a habit, like showing up because it is in your DNA, even when the fire is low. Sometimes the most honest version of thriving looks like taking a day, telling the truth, and reaching for the hand of someone who understands. That is not a diminished version of this work. That is the full, honest, human version of it, and it is more than enough.