The Relentless School Nurse: A Teachable Moment



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Teachable moments are those seconds of clarity when someone experiences an absolute understanding that previously eluded him or her. In my work as a School Nurse, I was accustomed to creating the “teachable moments” for my students. On this particular late afternoon, it was my turn to experience a “teachable moment” from a student.

Who recognizes this scenario? It was another endless day of problem-solving, crisis management, sewing ripped pants, helping a staff member deal with a personal issue, chasing down paperwork and try to screen at least one class. This describes almost every day, and that’s only the morning. Let’s not talk about the endless nightmare that recess can bring to the Nurse’s office.

It was my usual, chaotic ballet, as I lovingly referred to the never-ending dance of students that came to see me. Most days, my door does not close for my lunchtime because inevitably, disaster strikes for someone right at 1:00 pm. Interesting to note what we as school nurses define as an emergency is not the same definition as anyone else in the school. Are we speaking a language that no one around us understands? It certainly feels that way at times.

I have learned over my many years of school nursing that children often have unstable living arrangements. I quickly stopped asking, “Do you live with your mom or dad?” I ask, “Who lives in your house?” That has helped me not make assumptions and has given me more information about the child’s home life than a simple yes or no question. So, I learned a new lesson this particular afternoon.

It was the very end of this busy, frenetic, mind-numbing day and in walks my little guy that I had seen earlier for a vague complaint of “heart pain”. He could not pinpoint a history of onset. The pain was not connected to any event, accident or game. Sometimes I use ice for comfort measures, this is one trick in my school nurse magic arsenal. I have learned if you do nothing and send the student away they feel unheard and uncared for and then often boom=a-rang back. I value my motto that I strive to treat every child the way I would want my children to be treated.

My encounter with my semi-frequent flyer went in a totally different direction during his next visit. I said, “Oh, I think you must love visiting the nurse, I have seen you a bunch of times today.” “What’s happening, did the ice help you?” The student had a half smile and said, “the ice did help, and I came to get some more.” This is where the learning opportunity for me popped up like a huge neon sign, flashing “listen, listen, listen”. I said, “Honey, school is already dismissed, why don’t you wait until you get home and put some ice on it.” He responded, with a look of sadness and he was no longer making eye contact with me, “We don’t have ice at home.” I thought for a minute, and asked, “Is your refrigerator broken? Do you have electricity?” He looked me straight in the eyes, a bit teary and said, “we don’t have a refrigerator anymore. We had to move out of our house really fast, I don’t know why, but live in a motel now.”

My heart sank, my eyes welled up as well and I reached over to touch my student’s arm. Time stood still for both of us, I no longer cared that it was the end of the day, I no longer felt a bit annoyed that another person was asking me to do yet another thing. His teachable moment was hitting me hard, in my heart, exactly where his nondescript pain had been. My little student was homeless, something traumatic had happened to the family and mom and the siblings were living in a motel. We talked, he cried, I felt tears well up, but he felt heard and I felt a renewed sense of why I was a School Nurse. You see, see our true work comes in our interruptions.


Robin Cogan MEd, RN, NCSN is a Nationally Certified School Nurse, currently completing her 17th year in the Camden City School District. Robin holds leadership positions on the New Jersey State School Nurses Association Executive Board as well as with the NJ Department of Education Preschool Nurse Advisory Board. She has been recognized locally and nationally for her community-based work, including the 2017 Johnson & Johnson School Nurse of the Year and the NJ Department of Health 2017 Population Health Hero Award. Robin serves as Faculty in the School Nurse Certificate Program at Rutgers-Camden School of Nursing where she teaches the next generation of school nurses. View all posts by Robin Cogan, MEd, RN, NCSN

Originally published at on June 21, 2018.


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