The Relentless School Nurse: Judy Doran Shares “Flipping the Script”

Judy Doran happens to be the 2023 Maine School Nurse of the Year and a valued contributor to The Relentless School Nurse blog. In this guest post, Judy poses a challenge to all of us; what if we flip the script and consider not fixing everything all of the time without needed resources? Enjoy Judy’s message! It resonated deeply with me and I am sure it will with you too. Will you flip the script? If so, why and how?

here goes……..

I always appreciate your enthusiasm and passion when advocating for school nurses. You also maintain a positive vibe and solutions-based approach which I try to model. Sometimes I’m hard-pressed to maintain the vibe. Last week I flipped the script. This is an approach that presented itself and I went with it. Not necessarily advocating that anybody try it; just know that it’s tucked into everybody’s pocket. 

Baseline back story. There was a small rural school district with 5 RNs, 5 schools. During the pandemic, a 6th RN was added. This of course helped tremendously with more hands and a person who could function as a nurse coordinator. The little group of nurses worked endlessly, banded together, and created a highly functioning unit. They were proud, productive, and felt professionally respected by the admin. They were visible, had a strong sense of purpose and their professional brilliance was obvious. They also became exhausted.   2022-2023 the 6th RN went to half time. The little group was struggling but still had some support as they unburied and emerged from a couple of years of hell.  2023-2024 The coordinator could work PT until December. You know, budget. (Full disclosure, a milestone birthday was reached by the coordinator with the potential to change employment parameters but PT would have worked).

The little group started to unravel a bit with one resignation in late August and a second in early September. The resignations laid bare what DIDN’T happen in those health offices before the start of school and the first frenzied weeks of any school year. There were questions about “what do they actually DO?”, and suspicions that “not enough” was the answer. Rumors that maybe they should have mandatory summer hours. So what did the little group do? They made the damned thing work with one sub on their sub list and the coordinator. Staffed offices, managed the mounds of paperwork, hired and oriented two new RNs and one sub. They FIXED it, they made it work. They did what nurses do and got it done. An outsider could barely tell the difference. This kind of fix it, nurses to the rescue behavior I think is sometimes (oftentimes)  to our detriment. 

In reporting off to admin in late November the coordinator was told there was nobody to report off to, and the money for the coordinator for the year was spent. The coordinator finished her last day on December 1. She told the new folks she would always be available for questions/support. They took her up on it. The lack of support for them made her feel sad professionally. The little group was struggling and working very hard to stabilize.

On the third COVID case in 7 weeks amongst the group, things started to come to a head. The one sub had left for a full-time job and the new one didn’t have any availability. The newly departed coordinator had finally settled in her gut her decision to NOT sub despite the extreme need. With no authority, she requested a meeting with the little group and informed them that she could not work as a RN for twenty dollars and 20 cents per hour. They got it. They cheered. They deployed their A Game contortionist skills trying to cover everything. She stuck to her gut. Not subbing.

The Superintendent was out of town. The business manager of all people was calling people from a two year old completely outdated sub list. The former coordinator said the quiet part out loud while declining another request to please sub…..PLEASE DO NOT MAKE THIS WORK. MAKE IT OBVIOUS THAT SOMETHING HAS GOT TO GIVE. And steadily guess what happened? They traded in their valiant (invisible to most) efforts at again making it work for words. Words to their principals, words to the business manager, words to the special ed director, and words to the superintendent when he returned. 

And then what happened? The Supt offered some solutions……more training for subs, and hiring for the coord position because evidently some management needs needed to be addressed. , maybe some help in cajoling other staff into taking the med administration training…….This was all positive, heading in the right direction. They felt heard. And then the job postings came out. $20.20/hr for a RN Sub. $22.00-$27.00 for a bus driver, no experience required. HELLO????!!!! What????? 

This story has everything to do with keeping your foot on the gas. When things seem to be going pretty well and you feel like you might be making gains, do not let up. Channel leaders of school nursing, the folks who advocate, legislate, educate, and communicate. Anybody who speaks to/inspires you professionally. The storytellers on the Relentless School Nurse blog, Robin, and her many guest bloggers. Holly’s FaceBook group. The folks who get it. Nicole said this job is not EASY. Sometimes it’s not just not easy, it’s impossible; school nurses are simply experts at translating impossible into maybe doable. When you’re doing that, make sure folks know it. I understand the singular determination of school nurses and I understand their incredible resourcefulness in making stuff work. With that in mind, sometimes it might make sense to NOT make it work. It can be a real attention grabber. 

While contemplating the send button, it occurred to me that this is VERY wordy and could be distilled into a few short sentences……

• When you find yourself thinking things are going pretty well, do not let up.
• When you find that your responsibilities and resources are at complete odds, consider putting your “fix everything all the time hat” aside and loudly telegraphing that things are not in working order.
• Try not to enable an unsustainable solution that nobody ever even knows is happening.
• You’re going to have to fight like hell internally to do that but it is very much worth considering.