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The Relentless School Nurse: Coming to terms with the era of COVID

By: By Robin Cogan

It’s been a rough school year and it’s only November. I am not sure where to turn to feel a sense of balance or equilibrium. Everything feels off-kilter. The energy in school is charged with stress and anxiety. This game of hide and seek with a deadly airborne virus that has invaded our third school year, has left all of us depleted. This level of exhaustion creates a heightened sense of tension between school nurses and anyone we need to give guidance regarding their own health and safety. For example, teachers believe we are not doing enough to protect them and often parents think we are doing too much by sending their children home with COVID compatible symptoms. The result is the school nurse in the middle as the unwelcome public health messenger.

“This is not what I signed up for” is a popular refrain that I hear over and over again from colleagues across the country. We continue to press on, tolerating intolerable conditions, hoping that things will improve, but they don’t. School nurses have written letters of resignation, some have submitted them, some still holding onto them, waiting for the next hostile conversation as the final straw. Our children are the canaries in the coal mines, emotionally fragile, and seeking safety nets in schools that are stretched far beyond their capacity. School violence in on the rise across the country, including school shootings.

In the midst of this pandemic storm, school nurses need to be the solid object in the room.  It is a heavy lift, one I relieve every single day through my health office and those of my colleagues. Being the solid object in the room is maintaining our calm, even while those around us are swirling with concern, anger, frustration, or sheer exhaustion. It is not easy and that is why, more than ever, we need to ask for what we need. Finding the words, knowing what to ask is a journey towards finding our voices. If nothing else, this pandemic has shown the importance of our presence, our contributions to school health and safety of school communities, and the value of our expertise in public health. But, we are tired, under-resourced, under-represented, and feeling abused.

The collective trauma of living through the pandemic and working in extremely challenging environments has added the stress of an already beleaguered school nursing workforce. How do we find our footing? Can we hang in there until COVID is in our rear-view mirror? But is there really going to be a delineated end? Not according to this sobering  New York Times article, Past Pandemics Remind Us Covid Will Be an Era, Not a Crisis That Fades. It articulates the “collective dismay” we are all feeling:

“What we are living through now is a new cycle of collective dismay,” Dr. Greene said — a dismay that has grown out of frustration with the inability to control the virus, fury of the vaccinated at those who refuse to get the shots, and a disillusionment that astoundingly effective vaccines haven’t yet returned life to normal.”

“We tend to think of pandemics and epidemics as episodic,” said Allan Brandt, a historian of science and medicine at Harvard University. “But we are living in the Covid-19 era, not the Covid-19 crisis. There will be a lot of changes that are substantial and persistent. We won’t look back and say, ‘That was a terrible time, but it’s over.’ We will be dealing with many of the ramifications of Covid-19 for decades, for decades.”

At the very beginning of the pandemic, I turned to Lillian Wald for inspiration and guidance. I posted a blog on May 5 2020, way back in the early days of COVID:

The Relentless School Nurse: Remembering Lillian Wald & Her Response to the 1918 Flu

“A Stern Task For Stern Women.” This handbill was created to garner support for a community response to the influenza epidemic. It was signed by Lillian D. Wald, Chairman of the Nurses’ Emergency Council.

The text of the handbill reads as follows:

A Stern Task for Stern Women

There is nothing in the epidemic of SPANISH INFLUENZA to inspire panic.

There is everything to inspire coolness and courage and sacrifice on the part of American women.

A stern task confronts our women–not only trained women but untrained women.

The housewife, the dietitian, the nurses’ aide, the practical nurse, the undergraduate nurse, and the trained nurse herself–all of these are needed.

Humanity calls them

Lives depend upon their answer

Capable, though untrained hands, can lighten the burden of the trained ones. There are many things intelligent women can do to relieve the situation, working under the direction of competent nurses.

Will you help do some of them?

Will you enroll for service Now?

If possible, apply personally at the New York Country Chapter of the American Red Cross, 389 Fifth Avenue. Come prepared to fill out an enrollment blank like that printed below. To physicians and to the nurse-employing public this appeal is made:

Unless it means life or death, please release for service all nurses attending chronic cases. Physicians should not employ nurses as office or laboratory assistants during this emergency.

Nurses’ Emergency Council,

Lillian D. Wald, Chairman

Courtesy of the New York Public Library Manuscripts and Archives Division.

Robin Cogan, MEd, RN, NCSN is a Nationally Certified School Nurse (NCSN), currently in her 20th year as a New Jersey school nurse in the Camden City School District. She serves on several national boards including The American Foundation for Firearm Injury Reduction in Medicine (AFFIRM), a gun violence prevention research non-profit organization and the National Board of Certification for School Nurses (NBCSN). Robin is the Legislative Chair for the New Jersey State School Nurses Association (NJSSNA). She is proud to be a Johnson & Johnson School Health Leadership Fellow and past Program Mentor. She has been recognized in her home state of New Jersey and nationally for her community-based initiative called “The Community Café: A Conversation That Matters.” Robin is the honored recipient of multiple awards for her work in school nursing and population health. These awards include 2019 National Association of School Nurses (NASN) President’s Award; 2018 NCSN School Nurse of the Year; 2017 Johnson & Johnson School Nurse of the Year; and the New Jersey Department of Health 2017 Population Health Hero Award. Robin serves as faculty in the School Nurse Certificate Program at Rutgers University-Camden School of Nursing, where she teaches the next generation of school nurses. She was presented the 2018 Rutgers University – Camden Chancellor’s Teaching Excellence Award for Part-time Faculty.


Robin writes a weekly blog called The Relentless School Nurse. You can also follow her on Twitter at @RobinCogan.

The views and opinions expressed by My Nurse Influencer contributors are those of the author and do not necessarily reflect the opinions or recommendations of the American Nurses Association, the Editorial Advisory Board members, or the Publisher, Editors and staff of American Nurse Journal. These are opinion pieces and are not peer reviewed.

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