December 9, 2021
I was listening to a podcast today and the host said, “we are beginning to think about what it [life] is going to look like after COVID”. I wondered, “Have school nurses begun to think about what school nursing will look like after COVID?”
This question it is so important and needs to be given some thought. This is a historical time in school nursing. School nursing will and should look different after the pandemic. School nurses have navigated tremendous shifts in practice, time commitments, and have acquired significant new knowledge and skills. I hope and believe that school nurses have garnered new respect from their school communities. School nurses have stepped into the spotlight and taken the lead. Many school nurses have also expressed being at their breaking point and a need to create a more manageable workload. A question we need to ask ourselves, is “how do we downshift and create a manageable school nurse practice while maintaining the visibility that the pandemic has garnered for school nursing?”
I encourage school nurses to take some time to reflect and plan for their future practice, consider it an act of self-care. Find a quiet place and ask yourself, “What did my nursing practice look like pre-COVID, what does it currently looks like, and what do I desire for my future school nursing practice?”
An activity to consider would be to document a “typical” pre-COVID and a current day, review the days on the two lists. Some questions you may consider asking yourself are:
- What activities did you do pre-COVID that you no longer do?
- What activities do you do now that you did not do before COVID?
- What new activities were you required to do during the pandemic that you plan on continuing?
- Are there areas of your school nurse practice that you miss?
- What are you excited to stop doing?
- What are you excited to be able to do in the future that you are not able to do right now?
- During the pandemic, what activities were you forced to delegate to others that you have now realized do not need to be done by you and you can continue to delegate?
- What new relationships have you developed?
- What new relationships will you prioritize and nurture?
- What relationships have been beneficial to your nursing practice?
- Which activities cause you the most stress?
- Which activities bring you the most joy?
After you have spent time reflecting on your practice, I have one final question for you to consider, “How can you share what you have learned during the pandemic with other school nurses?” COVID-19 has transformed school nursing and many school nurses have developed innovative ways to address the pandemic. It is vital that this information be shared with colleagues and peers. Consider authoring an article for your state association newsletter or a National Association School Nurse (NASN) publication. Present at your state conference or submit an abstract for a poster or breakout session at a national conference. Although this has been a trying and exhausting time for many, identifying and highlighting the transformative changes that has occurred in your practice could be a way for you to refresh and recharge.
Remain Focused on Reality
October 12, 2021
I recently went to my healthcare provider for an appointment and noticed a sign near the entrance that informed visitors that violent behavior would not be tolerated, and that action would be taken if someone was verbally or physically abusive to the healthcare staff. Sadly, I wasn’t surprised that this type of sign had to be displayed. There have been numerous stories of healthcare providers, including school nurses, being verbally abused, and threatened as a response to anger and frustration over the Covid 19 pandemic.
These threats of violence have also been directed at school personnel and school board members. In response to this increasing concern, the National School Board Association wrote a letter to President Biden in September 2021 asking “federal law enforcement and other assistance to deal with the growing number of threats of violence and acts of intimidation occurring across the nation”.
Ask any school nurse and they will tell you that they have, in the past, had to navigate a difficult conversation with an angry parent but it seems the intensity and frequency of this anger has increased. Not only are school nurses subjected to the anger of parents over the implementation of Covid 19 mitigation methods, such as mask wearing and quarantining, but school nurses must also navigate, the sometimes, harsh backlash from school personnel and school leadership when school nurses advocate for evidence-based strategies that people are tired of having to implement.
As I think about these challenging times that we are all facing, I often find myself searching for the “easy button”, the one or two actions that we can take to make our current situation, in this case, communicating with angry individuals, easy or at least less complicated. Unfortunately, these complex relationships are not easy. These challenging situations require us to be thoughtful and intentional. Below are some suggested strategies to implement when communicating with others who are expressing anger.
School Nurses: Invisible Shields
December 17, 2020
Last week I had the privilege of moderating a panel discussion with four Wisconsin School Nurses (SN). The SNs discussed how their roles have changed since the onset of the pandemic. They shared stories of longer hours, increased responsibilities, and new expectations, such as contact tracing. SNs are undoubtedly experiencing greater amounts of stress this school year but surprisingly they did not talk much about stress. The SNs spoke of concern regarding the health of staff and students, satisfaction in supporting student learning and gratitude for the increased recognition of the role of the SN.
SNs have been silently promoting the health of the youth of our country since 1902 when Lina Rogers was hired to provide care to students who had high rates of absenteeism due to communicable disease. Fast forward to 2020 and SNs are still implementing strategies, including contact tracing, case management, and disease prevention interventions. This year, SNs have been working tirelessly to support student learning. Some SNs are working to keep kids present for in-person instruction, others are creating innovative ways to engage with students who are learning virtually, but all SNs are working to keep kids safe and decrease the spread of COVID-19 to minimize the stress on our healthcare systems.
During last week’s panel discussion, one of the SNs described the SN as “a shield working hard to decrease disease spread and try to lessen their [hospitals’] numbers [of patients sick with COVID-19] from the outside.” I was moved by this description of a shield; it offers such as terrific visual representation on what SNs are doing during the COVID-19 pandemic. But SNs have always been a shield, but most of the time the shield is invisible.
Eosinophilic Esophagitis (EoE) and Considerations for the School Nurse
January 23, 2020
Eosinophilic esophagitis (EoE) is an allergic condition that is becoming increasingly more common in children and adults. EoE has only been recognized as a specific clinical condition since the early 1990s. Over the past two decades there have been great strides in the understanding and treatment of the disorder. There is still much to be learned and changes to the management of the condition continue to occur. Given the child’s complex relationship with food, school nurses need to be aware of this condition and understand what steps should be taken to help manage this condition and keep the student safe.
What is EoE?
EoE has been defined by a panel of experts as “a chronic, immune/antigen-mediated, esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation” with other causes excluded. EoE occurs when eosinophils (a type of white blood cell), accumulates in the esophagus. The elevated number of eosinophils cause injury and inflammation to the esophagus and this damage may make eating difficult or uncomfortable, potentially resulting in poor growth, chronic pain, and/or difficulty swallowing.
Symptoms of EoE:
Symptoms of EoE may vary from one individual to the next and may differ depending on age.
- Infants and Toddlers:
- Food refusal
- Failure to Thrive
- School-Age Children:
- Recurring abdominal pain
- Trouble swallowing
- Adolescents and Adults:
- Difficult or painful swallowing
- Food impaction2
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