I’ve been a PICU nurse for just over 11 years and I became a mom three years into my nursing career. Now a mom of two elementary-aged girls, I went part-time as a nurse after my first child was born and have been fortunate enough to maintain a fixed work schedule since then, thanks to an incredibly supportive unit manager. I work my 12-hour shifts every Monday and Saturday on Day Shift, while my husband works in his office from Tuesday through Friday. Because of our work schedules, we have been fortunate enough to always have a parent at home to take care of our kids, which has proven to be invaluable throughout the pandemic with Distance Learning for 1.5 years and now the ever-looming threat of needing to quarantine our kids at home at the drop of a dime.
This family schedule also means that I haven’t been able to pick up extra shifts in our PICU as nursing staff shortages have hit critically low levels everywhere. Never in my life have I felt the pull between needs in nursing and needs in motherhood more than now. The potential for personal burnout with the combination of the nurse and mother roles in a pandemic has loomed over me, and I have felt protective of myself while still trying to stay sensitive to the endless needs that exist around me.
With my vaccinated kids back in-person for school even as this Omicron variant has swept over the world in waves, I’ve paid close attention to the alerts and emails coming through my phone about the next new school protocol, the next new positive case identified on their school campus. In efforts to stay as informed as possible about what was happening in our School District, I logged onto the bimonthly School District Board meeting one night to hear what the Board and other community members were thinking about this current surge.
I stopped in my tracks as I listened to one of our District’s school nurses plead for more support and relief from the District. She described how completely overworked and overwhelmed the school nurses were, between their normal school nurse responsibilities, complicated contact tracing, paperwork to verify permission to return to school, COVID testing, vaccine administration, and endless phone calls. I listened to other school staff members vouch for the distress they’ve witnessed in the school nurses as they work 12-14 hour days, weekends included.
The District responded to these pleas by stating they had no objections to trying to hire more nurses, but the problem was there were no nurses in the community to be found. Everyone everywhere was competing heavily for the very scarce resource of available nurses.
I thought about how I had 5-6 hours at home on my off days while my kids were in school, time typically given to housework, meal preparation and other personal obligations. I listened to the school nurses plead for help, listened to the District say “There are no nurses to be found,” and I thought, I’m a nurse, I’m here. I was humbled as I acknowledged to myself that I knew little about school nursing, but still, I’m here. I can administer COVID tests, I can give vaccines, I can do contact tracing and paperwork. I tossed and turned all that night with the thought, “I have to help. I can’t not help.”
The next morning, I emailed the School District Board introducing myself and offering to help in any way I could. The Superintendent called me directly the following afternoon, looking to expedite the volunteer clearance process so that I could get started as soon as possible. I told him I’d just finished my fingerprinting and TB test clearance to volunteer at the school a few weeks ago, so we were already steps ahead. I was eager and nervous and grateful at the thought of providing any relief I could to these school nurses whom I considered to be my colleagues.
As it turned out, there were too many uncertainties around what was legally appropriate even under a valid nursing license for a volunteer RN to step into a public school setting and perform nurse duties. For this reason, the District and school nurses agreed to pause on exploring this idea of bringing on a volunteer nurse for the time being, but they thanked me for my willingness to help.
Through this process, I came to some significant realizations that have changed the way I think about nursing in general, and school nursing in particular.
- I realized how intimately connected the work of school nursing and ICU nursing really are at the end of the day. As I thought about our school nurses being on the edge of their breaking point, I started to consider what would happen to the community if the school nurses quit due to burnout. So much of their distress is knowing that even with their impossibly long hours, they can’t meet all the overwhelming needs of the community in this pandemic with their current low staffing. Yet I see how they are doing phenomenal work trying to keep as many kids as healthy as possible. The result of not having enough school nurses is more kids potentially falling through the cracks and ending up in our hospital. Any help given to school nurses benefits not only the community directly, but also benefits the local hospitals by keeping them from becoming even more inundated with patients.
- I realized anew just how much the nursing profession is in jeopardy. These school nurses are near – or perhaps at – their breaking point. Even in my desire to help them, I was also acutely aware of how I too have been walking the tentative line of potential burnout as a PICU nurse. I felt so protective of my own well-being as I considered how much of myself I could offer. I understood why they declined my offer at the end of the day, yet the helplessness continues to plague me. These are my colleagues. This is my community. These are my children. This staffing crisis is hurting all of us.
- Robin Cogan, MEd, RN, NCSN, FAAN has been an incredible voice and advocate for school nurses throughout the country. This experience, along with her work, has shown me that school nurses have not received the kind of recognition, support and appreciation they have long deserved and needed. It’s true that nursing as a whole is incredibly broad; no nurse can be expected to understand every other nursing specialty that exists outside of his/her own experiences. That said, I was humbled to realize that as a nurse and a mother whose children fall under the care of these school nurses, I really was not aware of the scope of their practice even pre-pandemic, and certainly did not realize how tremendous their burdens were under pandemic conditions until I logged onto that District Board meeting. So much attention in this pandemic has been given to hospital and ICU nurses dealing with COVID patients and staffing issues, but so little has been given to school nurses responsible for caring for entire communities on both the prevention and treatment fronts.
One of the silver linings I found through this experience was the response I received from friends and family as I shared about this on social media. So many people thanked me for making them more aware of the tremendous work and needs amongst school nurses. Many friends told me they immediately went to their computers and sent gift cards to their school nurses in support and appreciation. Others indicated they wanted to be more informed about what was happening in their District and be more active in advocating for their own local school nurses.
I still wish for a better ending to this story. I wish I had been able to help. I wasn’t looking to be a hero or a martyr, but I did hope to help our school nurses at least catch their breath for a moment before diving underwater again. I am grateful for them in new ways, and after what I have experienced here, I still hope one day to have a chance to work alongside these invaluable colleagues also very much on the frontline of this pandemic. In the meantime, we as the community they serve need to shine a light, raise our voice, and advocate for these nurses who advocate for our children, our future generation.