How Can Admin Help to Retain School Nurses?

Why would anyone leave a cushy school nurse job? The same unruly parents that are chasing teachers away are also impacting the staffing of nurses in the school setting. How can administration help?

Updated: May 10, 2023

How Can Admin Help to Retain School Nurses?

Experienced school nurses, we've all had that frightening moment. You have vomiting Vanessa in your office and you need to call THAT parent to pick her up. Her mother had used profanity when you called to ask for the student's required Kindergarten physical and then posted all over social media how poorly she was treated. You take a deep cleansing breath and dial. Maybe today she might be in a better mood.

School nursing is yet another venue losing staff in droves. It's not because of poor pay or long hours, because both are really not bad (with the exception of contact tracing when Covid was at its peak). It's absolutely not the kids, although there are days when they can be mischievous. It's not the heartbreak of being the witness to neglect or abuse and having to work with authorities. As a certified school nurse, IEP and 504 caseloads can be high in the economically challenged communities where up to 25% of the students may need special education services or accommodations, but this is not the reason. So what is the problem?

FACT: Parents who cannot respect reasonable boundaries are the problem.

I am a parent of three children and have worked as a school nurse since 2013 in seven elementary schools and one high school. I have been the camp nurse for many summers while my children attended. I have been both the girl scout and boy scout leader and worked vacation bible school for several summers; so it is a fair statement that I have spent a fair amount of time working with children. The idea sounds light and fun, and for the most part, it can be. But if there are children to be supervised, there are parents to be managed and this can drastically alter the experience.

All school nurses face being sworn at, being argued with about policies and student pickup, and admittedly, most of my school nurse stories are not as serious as the situation I will now describe. The one that finally broke me in the high school setting occurred during the 20-21 school year when guidance surrounding Covid had its greatest impact on student attendance. I had contacted a father to pick up his son because he was identified as a "close contact" to a positive case. He was unvaccinated and was going to have to be quarantined, as was health department protocol at the time. His father was angry because the student was going to miss a highly anticipated football game. This physically intimidating former military veteran stood in the lobby making physical motions like he was going to hit me because he deemed this my fault. Security was watching and called the principal and the two went into a conference room so that the father could vent and I went back to waiting students. Later that afternoon the father returned and angrily told the security guard, "Tell that nurse to get out here!". The security guard came to tell me about the father's reappearance at the door and his demands and stated that he had shared this with the principal and then offered to escort me to my car at the end of the school day. The principal never spoke to me about it, even after I requested a meeting to discuss it. There was no administrative follow-up with that parent, nor were any assurances made to me that I would remain safe in the building. Several weeks later, the principal had come to discuss a parent complaint about one of my nurses with me as her supervisor and I brought up the incident that had been occupying my thoughts daily. He shrugged his shoulders and said that was not what he recalled. He did not ask any questions and expressed no interest in addressing the matter. He sat across from me with a flat expression and remained stoic and silent. It was astonishing to me, given the continuous stress from that year including a fire to fights and the nursing team's level of dedication to providing our best care to the 4000 students in that building, that there was no disputing how little I was valued.

So what was I hoping for and what is the answer? The first and most obvious solution is supportive administration. Most school nurses are supervised by non-medical personnel who do not truly understand the role or know what it takes to manage a busy health office. Regular communication between the administrator and the nurse is paramount to growing the relationship and establishing trust. The principal/vice principal/dean should feel confident in standing up and supporting the nurse's decisions. They can have faith that evidence is weighed carefully and protocol followed as dictated in the district. When an angry parent calls or a teacher complains, the administration should not automatically apologize for nursing staff behavior, but should investigate complaints and respond accordingly. I am not saying that nurses never make errors because we are human and certainly do. I am simply asking for fair treatment and a reasonable level of support. We should not have to stand alone against unnecessary abuse.

Many youth sports programs require the parents to sign a code of conduct that prohibits swearing, yelling at players, and aggressively confronting the referees. The parent handbook and online registration systems have a student code of conduct that must be signed that addresses plagiarism, appropriate use of the school computers, and the dress code. If either the parent handbook or the online registration included a section that also addressed parent conduct we might feel that the school board supported the respectful treatment of all school staff. That is what we seek, after all.

FACT: We want to be treated with common courtesy and moderate respect.