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The Relentless School Nurse: Reaching a tipping point

By: By Robin Cogan

I am honored by the number of school nurses from across the country who reach out to me to share their COVID challenges. It is important that we all have safe spaces to share our truths. In nursing, we are conditioned to soldier on, to carry the load, no matter how intolerable. School nurses work in an educational system that oftentimes does not understand the scope of our role or the intricacies of our practice.

COVID has brought the need and importance of school nursing front and center, but still, we are often not in positions of decision making when it comes to implementing known mitigation strategies. This wears away our sense of agency and disempowers even the most seasoned school nurse. Many are or have already left, retiring early or choosing to resign for self-preservation. These decisions are not made lightly or on the fly, they come after being worn down from more than eighteen months of pandemic school nursing with no reprieve and little support.

I am sharing thoughts from a seasoned school nurse who is grappling with this decision. She wanted to remain anonymous for now but agreed to have her message reprinted. Read her words carefully, they reveal the struggle so many of us are confronting:

I was going to respond to your post that it was heartbreaking. Then I started writing more. And then I started to reveal thoughts that I wasn’t sure I was ready for my colleagues in this district to hear yet.  

The overarching message I’m beginning to believe is that when I say “I can’t take another minute of this”, it is no longer a figure of speech. I’m very close if not there, I guess in the spirit of not really knowing exactly where your bottom line is until you breach it.  And this is in a district where they have done just about everything right. Ventilation went great from the get go. Social distancing and masking were in great shape last year. We had a couple of vaccine clinics. People were on board.  

Masks were basically ditched in May/June, summer was ON and the pandemic was in the rear view mirror although we all knew that was not the case. We had a couple of weeks to breathe and try to regroup after a HELLACIOUS year, then came July with creeping increases of Delta. Alarms were going off by the end of July.  

Then came some guidance by the state with a fairly confusing constellation of “how to avoid quarantine”. Our state leadership took some time on Aug 12 to read us the confusing document and remind us how special we all are. That’s the last time we’ve heard from them. They have created regional teams/liaisons who were rolled out last week which will help, but they’re all new to this game and solid answers are hard to come by. 

Admin is working as hard as possible to please everybody, which has zero chance of becoming a reality. Cannot happen in this situation. Families are largely supportive. In some who are not, civility is reaching a low. In the admin’s attempt to balance the total, nursing is put in the position of having to repeat what needs to happen to keep people as safe as possible. And repeat and repeat. Time is lost. The testing program could be underway by now. More communication from us would be happening but I can’t tell you for sure what I’d say. Is your child safe? Maybe?. Are we doing everything possible to keep them safe? Nope, not yet. Here’s your consent for the pooled testing, oh wait, we need to talk about staff anxiety first before we can do it. (poll revealed overwhelming support by staff of pooled testing). I can’t plan for it if I don’t know how many people are going to participate. Is your school nurse OK? No. 

This year is a hundred times worse than last year when we were simply terrified. We know so much more now and we are OVERWHELMED. Across the board, rural, urban, supportive admin, non supportive. All scenarios have their peculiarities, but the main feature is that things are not going well in school nursing. I’ve got to believe that the shortage we are seeing now is well on its way of becoming more acute. 

It’s heartbreaking and a tough piece to write this morning but we are not OK. I was just about to apologize for this shaky, not optimistic email but you are a safe place to vent and you can feel free to copy any of this you want.   

I have been writing about the impact COVID-19 has taken on school nursing since the beginning of the pandemic. What I have found most helpful in recent months is to share the words of my colleagues, many of whom I have never met in person. School nurses are not OK, in fact, we may have reached our tipping point.

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.

2 Comments. Leave new

  • Tiffany Gaylord
    October 1, 2021 6:27 pm

    The month of September felt like we have been in school for 6 months. First day of October I got cursed out by a parent inside the school and in front of children.

    This school nurse is tired

  • I an glad to know I am not alone. That is all I have the strength to say.


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