Our district was “hybrid” for three quarters of that school year with all students returning to in-person learning in March of 2021. Students who chose to attend in-person that year were divided such that half of the students were in the buildings on Monday/Tuesday and the other half were in the building on Thursday/Friday. The buildings were closed on Wednesdays for “deep cleanings”. Class sizes were small with the hybrid schedule so we had maybe ten (or fewer) students in the classroom and we were able to keep the students at least six feet apart to accommodate social distancing. Athletics continued and as cases in the classrooms increased, so went athletic teams. We learned, on the fly, about contact tracing and how the state wanted positive cases reported. We were, unofficially, a branch of the health department. We were told to tell parents that the health department would follow up with them after we gave them return to school dates and gathered the requisite information. If the department of health contacted the families, they gave the same information we did. Families frequently reported that they never heard from the health department.

The amount of time spent on state reporting, and in particular with contact tracing, caused the greatest disruptions to school nursing. Students had to be quarantined for vague symptoms and had to be isolated in the school setting which was very challenging. One positive student could cause an athletic team to be quarantined as well as multiple students in their classroom and on the bus. The cafeteria was another area we had to consider when quarantining. Students who had been in close contact with the positive case had to be pulled from the classroom for immediate dismissal in the hopes that the parents would come quickly to free up a space in a holding area for another student. Teachers had to stop what they were doing to recall what happened in their classroom 3-5 days prior and consider who was where and for how long. Parents who were gracious when they were called to collect their student for the first quarantine were not so much with subsequent calls.

Parents were frustrated that their student was being quarantined for the second (or more) time, perhaps, when s/he was not even having symptoms. I understood their frustration. My son was quarantined four times that school year (ten days at a time) and his building was closed twice due to excessive positive cases. It was the new normal and we were on a ride that we all wanted to get off. Parents vented their frustration to the school nurses because we were contact tracing and the point of contact. Some recognized that we were just the messenger and we were trying to keep all students as safe as possible.

Parents notified us of positive cases at all times of the day, so we were on call at home as well. There were no boundaries. If we didn’t call the parent back from home, they would send the student to school further exposing more students. Parents called for advice. Faculty and staff texted for advice or to report their own positive cases. Again, there were no boundaries – calls, texts, and emails were received without regard for my personal time. There was no down-time.

Dealing with Covid quickly overwhelmed the school nurse’s office leaving little time for routine sick/injury visits and daily meds. It was difficult to maintain confidentiality while calling parents to quarantine their student if ill students were in the health room. Students were sent home for just about any ailment, per health department guidelines, so it truly became all Covid, all day. It was impossible for the school nurse to make 20-50 calls a day to parents (just for pick-ups), so the main office needed to help. It was not sustainable. Somehow, we school nurses prevailed, because that’s what we do.

The availability of testing and vaccines changed the course of Covid-19 in the school setting. School districts re-opened for the 2021-2022 with a mask mandate in PA and a variety of district-specific protocols. Covid this school year is very different from last year. Masks are not required in my district, but there are students who choose to wear a mask. We are not contact tracing. We are not sending students home for vague symptoms. Cases decreased. As was reported in South Africa, positive cases in my building decreased precipitously in mid-February and I’ve had 3 reported cases since then.

My school nursing practice today resembles what it was prior to the pandemic. My folder of Covid papers/procedures is still on my desk, on stand-by. I hope I won’t need to use it in the next 20 days. I do feel as though Covid is still standing behind me, skulking. I don’t know what Covid will look like in the school setting in the future, but I am still standing. School nurses are resilient – it’s what we do.

This is the time of year when I enjoy getting out into my garden and getting my hands a bit dirty.  Soon it will become too hot and humid for it to be enjoyable, but I will always be amazed by the miracle that occurs when I put a dry, dead-appearing seed into the ground.  I wait eagerly, checking daily for that first little peek of green.  Even when I know it will be days and days before it happens – I can’t help myself.  Out to my tiny garden I go to look for the little sprouts.  Then it happens! Lo and behold, a brand new plant life.  When I look upon this burgeoning garden, all I see are tiny two-leafed green threads.  There is very little that would promise the hearty meals to come.  If I did not label my rows, I often would not even be able to discern what kind of plant is growing, but in a few weeks time, each plant’s nature begins to emerge.  In these early days I watch carefully, water frequently and cover these little baby plants when the air threatens to freeze in the night.  It is a labor of hope and love.  

In my life as a nurse I have had a number of roles and responsibilities.  I have nursed tiny premature babies from incubator to car seat.  I have walked with families through a devastating diagnosis and shared the life their child cut short by genetics out of anyone’s control.  Now, I find myself growing new nurses.  It is a role that I relish and cherish.  No longer do I experience the rush of adrenaline in an urgent life and death sort of way.  Instead, it is more like my time in the garden.  But instead of the gardener, I am the dirt.  It is only when I remember my role as dirt that I can truly successfully help in the effort to raise nurses.  

We are all gardeners of our own lives and careers.  When students come to us, they have realized that they carry a seed, a desire to do something beyond themselves.  With recognition of this seed comes the need to find the right medium to move from thread-like sprout to productive plant.  

EMU is a lovely garden.  It is well cared for, lovingly tended, and thoughtfully fertilized.  We know that the dirt is important in our gardens, but we often don’t consider the whole of what it provides.  Each season, dirt receives seeds.  Seeds are sometimes carefully covered and tended, sometimes land accidentally in the dirt, and sometimes fall into insufficient dirt.  For a seed to germinate and grow, the dirt must have nutrients available.  It must be able to hold water around the new seed in a way that causes that seed to burst open and push for the light.  The dirt must allow itself to be moved by the new roots and shoots that spring from the seed.  

As I reflect on what that means for me, a teacher, I realize it is a very humble job.  I do not get to choose my students.  They decide whether or not to be planted in the garden I occupy.  It does not matter how much I know or how fancy my pedagogy, the real work belongs to the students.  If I lack the proper tools, encouragement, and knowledge, my students certainly will not grow.  I cannot force those tools and knowledge on to the students, but my ability to hold space, lead gently, allow warmth to penetrate, and create room for growth is essential.  It is a privilege and a joy to watch students sprout.  Like dirt with seeds, I have an up close view of the beauty and struggle of growth.    

I am dirt.  My work is to be good dirt.  

In what ways can we all be good dirt?  As nurses, we watch our patients emerge and grow into health.  We equip ourselves with critical thinking and compassion. We nourish, hold water to quench thirsts, assess for safety, and give space for good growth. We promote and allow healing.  As nurses who are teachers, we follow a similar path with our students.  

Growth cannot happen without good dirt, and I like to think that here in the EMU Nursing department, there is a lot of good dirt.  

-Dr. Audrey Myers, Assistant Professor EMU Nursing

We nurses learn about professional boundaries during nursing school and in practice.  refers to the ways in which we are to therapeutically relate to our patients and our colleagues while separating personal from professional life.  The boundaries delineate what personal information is appropriate to share and what should be kept private.  They also define what types of relationships are appropriate between nurse and patient and nurse and colleague — for example, expressing romantic affection is off-limits.  Unspoken boundary rules promote the idea that nurses (and doctors) are stoic, steady, and emotionally “strong.”  They are expected to be calm in the face of crisis, and the expression of negative emotion (e.g. anger, sadness, fear, grief) in professional settings is often frowned upon.

Clear professional boundaries do serve us well — most of the time.  But what happens when maintaining boundaries inadvertently leads to feelings of shame or unworthiness, or when they prevent us from authentically sharing our stories and who we are with each other?  What happens when boundaries cut off our avenues to connectedness, deep caring, and collegiality?  What results occur when there is no forum for emotional expression, naming of our grief, distress, and sadness?  We can begin to feel demoralized and emotionally exhausted.

Boundaries need to be healthy ones that have some permeability and that still allow to occur.  Bonding occurs when we experience a place of safety and support.  Bonding is what happens when we listen well and make space for each other to be heard.  The bond between a nurse and patient (and between nurses and their colleagues!) can form well when there is attunement to the patient’s needs on the part of the nurse, as well as an ability of the nurse to differentiate self from the patient’s self, not personally taking on the needs of the patient, but creating a space for them to be held and handled with care by the nurse.

is a psychological concept that may at first glance seem paradoxical to forming safe bonds with others, but it provides another framework for defining healthy boundaries.  Self-differentiation means being able to clearly name and own your personal thoughts and feelings and to distinguish them from others’ thoughts and feelings.  We can also think of self-differentiation as a process of not losing connection to self while still being able to stay deeply connected to others, including people whose views may differ from our own.  Self-differentiation enables the nurse to deeply care for self at the same time as caring for people who have so many needs that it would be impossible for the nurse to meet them all.  It enables the nurse to maintain a permeable boundary that is open to deep caring and bonding.

Nurses and healthcare professionals need to take the time to attend to permeable boundaries, healthy bonds, and self-differentiation.  Attention to these concepts provides the space for healing and wholeness to occur, for the nurse and the patient.  I’m grateful to be able to say that at EMU, I experience permeable boundaries, healthy bonds, and self-differentiation in my interactions with colleagues and nursing students on a daily basis.  May each of you continue to find your way toward such beautiful boundaries and bonds, too.

Dr. Laura Yoder, Program Director and Associate Professor

On the day before Valentine’s Day 2021, I look out my window at the beautiful snow on the ground while falling snow and ice create a scenic view of the woods and farmland around my house. As I ponder the experiences of nurses and other healthcare providers since our last Valentine’s Day – I am struck by the beautiful stories – even more beautiful than the snowy landscape – of these people comforting those in need around the world and how those stories reflect a love much greater than the popular intent of Valentine’s Day. This also reminds me of James Kouzes’ and Barry Posner’s bold thesis in a Journal of Business Ethics article from 1992 that “Love is the magnetic north on the leader’s ethical compass […] comprises transformational leadership, […] and constitutes the soul of ethical leadership.” (p. 480).

Kouzes and Posner continue by demonstrating how such leadership generates staff confidence, creates a desire to grow, transforms followers into leaders, and fosters people’s sense of purpose, fulfillment, and fun in their life. So who would have considered that as leaders, we are actually loving those we work with, care for, and report to?

In the EMU nursing department – at all levels of education – we emphasize that nurses are leaders in all they do, if they choose to accept the challenge. One’s role – whether one is a staff nurse or a nurse executive, or one’s practice setting – whether working in the geographic outreaches somewhere or in an urban tertiary care setting – all provide for nurses to demonstrate love. Leadership has more to do with making a difference in someone’s life rather than being a parade leader.

The EMU nursing philosophy describes that nurses demonstrate this leadership through the practice of agape love. Such love affirms the characteristics of leaders as described by Kouzes & Posner – listening deeply and empathetically to another, providing compassion through bearing other’s pain, emphasizing service first, advocating to right injustice, demonstrating the value of all, and communicating with honesty. Further, they cite Ferris who indicated “[…] there is a connection between love, trust, and energy. Felt love inspires trust, trust fosters a commitment to something other than the self, and these then foster creativity, commitment, and energy” (p.483).

Jesus role models this love as he comforts, heals, and serves. Most dramatically, he engages the outcast, dines with tax collectors, heals the leper on the Sabbath, and washes the feet of his disciples. How can we also demonstrate our love to those we report to, work with, or provide direction to through figuratively washing their feet? Washing the feet of students, colleagues, and patients daily through all I do continues to challenge me.

Over the years as well as most recently, I have also been challenged that love as a nurse and human being also includes loving those whose life stories, responses to life events, and worldviews contrast with mine. This could be patients, students, colleagues, employees, supervisors, spiritual leaders, or even neighbors. Jesus serves as the role model here as well when he said, “Love your enemies and pray for those who persecute you” (Matthew 5:44 NIV). I would hope to believe these are not enemies. Almost 20 years ago, Chip Anderson – professor at Fresno Pacific University at that time – called us as faculty to see persons through lens as God sees them. While I have not been consistent with this invitation, I am continually called and strive to see others through God’s eyes. Thus, loving them as God loves them. Are you also willing to so love others?

Such leadership love can emerge in any setting –

• comforting a new parent;
• consoling someone in isolation;
• grieving with a fellow worker who lost a family member;
• encouraging staff about a new procedure;
• walking with a student as they choose a different profession or through a challenging time;
• sheltering someone struggling with depression or abuse; or
• inspiring someone to create a new nursing model.

The greatest payment for serving as a nursing faculty is hearing how our graduates and current students offer this love around the world in all kinds of settings and circumstances. Then I hear how those nurses inspire others to love – and the idea of leadership love then literally spreads around the world similar to throwing pebbles into a pond. Multiple ripples intersect and spread over a wide reach of the water. Love can spread to the far reaches of the world from one toss.

I am old enough to remember with fondness Dionne Warwick singing the Burt Bacharach song “What the world needs now, is love sweet love…” That song might sound shallow or sentimental – but really – that is exactly what everyone all over the world needs in this year of illness, violence, racism, isolation, and loss. In addition, so many people have worked tirelessly in health care, education, service industry, and factory settings – who all need a strong gift of love from their leaders. May we all as leaders be challenged this Valentine’s season to give love to those around us.

With love….from EMU nursing. Happy Valentine’s Day to all.

Here at EMU, we have, along with many other nursing programs around the country, worked constantly to readjust, reschedule and rethink how we can best provide nursing education to our students while living through a global pandemic. One of the many benefits of being a small, close knit program, is that we can change our plans and try new things more quickly and easily.  We have added additional virtual and in-person simulation experiences for students. We have learned to have class online and in-person while remaining distanced and masked.  We have leaned heavily on our strong partnerships with local clinical agencies to provide our students with as many hands-on, in-person clinical hours as possible.  

We have recognized the incredibly historic moment that we are all living through and provided opportunities for our students to safely be a part of the Covid response.  Students have cared for patients in acute care settings, as they always do, but we have also had students administering Covid-19 tests, helping answer calls through the local health department’s Covid-19 hotline, and this Spring semester, we will be on the front lines of the massive Covid-19 vaccination rollout by giving vaccinations to our community with the local health department.

EMU teaches students to care for patients’ whole selves.  This past year, we worked to apply that approach to our interactions with each other; to care for each others’ whole selves.  Many of our faculty and students have taught and learned while also caring for children or loved ones at home.  We have found new and creative ways to connect with our students through zoom “coffee chats” or outside visits.  Faculty have actively sought out input from students as we make schedule changes that impact them.  We have practiced stress reduction strategies and have taken lots of deep breaths, together.  Grace has been extended in all directions and we have given and received words of encouragement, affirmation and support.  

As I look ahead to this Spring with hope, I am grateful for the work we have done together.  I am proud of the nurses EMU is sending out into the world.  Nurses who believe in science and whose practice is rooted in evidence.  Nurses who recognize the interconnectedness of individual choices, family dynamics and community/public health.  Nurses who understand that we must first care for ourselves if we hope to care for others.

This past year has been hard, but together, nurses can do hard things.

A. Kate Clark DNP RN PHNA-BC

Assistant Professor of Nursing

EMU

According to NASA “Watch the Skies”, the Geminds are the most widely recognized meteor shower. Each year in December, the Earth passes through the trails of dust left by 3200 Phaethon, and we have the opportunity to view this spectacular astronomical display of light. This year, I eagerly awaited December 13^th, the first day of the peak display. As darkness approached, I ventured outside and was immediately rewarded with my first sighting. “Come outside!”

Twinkling Christmas lights, streets lights and the ever-present lights from cars driving down my street surround me. The Geminids are best viewed without surrounding light. This year, I was weary. The strain and busyness of the past semester and the past nine months, settled over me and kept me rooted in my backyard as opposed to venturing to the top of a hillside or mountain, far from the light pollution of the city. Yet, there they were. Those streaks of light across the sky were no less brilliant and fascinating than if had I viewed them from the top of Reddish Knob.

As I reflect on this past year, this theme of light resonates with me. From raging wildfires to a global pandemic, it would be easy to focus on the darkness. Yet, we have a choice. Focus on the darkness or watch for that streak of light that pierces the darkness and brings excitement and joy. I choose light and as I look back, I can see those instances of light.

In March, EMU made a quick shift to online learning. At the undergraduate level, faculty were faced with creating simulated clinical learning experiences, and figuring out how to finish out the semester in order to gradate our seniors. Faculty and staff problem-solved, students adapted, and we did it. It wasn’t easy and it wasn’t perfect, but we did it together. And at the end of the semester, we were able to celebrate and send another graduating class of EMU nurses into the workforce. In the fall, creative scheduling, virtual simulations, use of a new pediatric high-fidelity simulator (courtesy of a generous donor) and a high-flex learning environment allowed our nursing students to complete their clinical hours for the semester and make up missed hours from the spring. What an extraordinary accomplishment!

The RN-BSN, MSN and DNP programs, being online, did not require rapid shifts in curriculum. Yet the students in those programs, who are practicing nurses, were immediately thrust into the unknown. Extra shifts, furloughs, illness, new and ever-changing demands in the workplace, and barriers to projects quickly became obstacles for students to overcome. Faculty and students worked together and were able to successfully navigate the various circumstances that arose. And they didn’t just survive, they thrived!

The EMU nursing faculty, staff, and students rose to the challenge of 2020. I am continually amazed at the creativity and perseverance of my colleagues, and the adaptably and grace of our students. I am grateful every day to be a part of this community!

There is no question that this year has been challenging. To say that there were no moments of darkness would be unrealistic. Looking back, those streaks of light blaze true and clear.

“Look at this! Come outside!” I wonder if the words I uttered as I gazed on the brilliance of a meteor shower were similar to the words uttered by the wise men 2000 years ago as they gazed upon the Star of Bethlehem.  I wonder what the shepherds proclaimed when the sky filled with the glory of the Lord, and the angel proclaimed the birth of Jesus Christ, the long-awaited Messiah. In John 8:12 (NRSV), Jesus tells us, “I am the light of the world…” As we bring this year to a close, let us remember Christ, the Light of the World, who truly pierces the darkness.

Dr. Melody Cash, Professor and Department Chair