SHIELD Celebrates 10 Years of Supporting School Nurses.
SHIELD Celebrates 10 Years of Supporting School Nurses
School health professionals Karen Robitaille and Mary Jane O’Brien share insight into the pivotal role Boston University’s School Health Institute for Education and Leadership Development has played in making state-mandated trainings and other resources accessible to Massachusetts school nurses.
In 2026, the School of Public Health marks its 50th anniversary—and, through the work of the School Health Institute for Education and Leadership Development (SHIELD) in the Department of Community Health Sciences (CHS), a decade of putting SPH leadership into practice to promote safe, healthy schools.
Funded by the Massachusetts Department of Public Health (Mass DPH) and operated with BU Chobanian & Avedisian School of Medicine’s Barry M. Manuel Center for Continuing Education (BU CCE) and Wheelock College of Education & Human Development, SHIELD has supported the continuing education of school nurses and school-health professionals across the Commonwealth since 2016.
Over the past ten years, the SHIELD team has delivered hundreds of state-mandated and elective trainings and built an extensive online resource library to meet the evolving needs of this complex profession.
“School nurses are engaged every day in important public health work. They are an essential connection between children, their families, and the school environment,” says Trish Elliott, a clinical associate professor in CHS and a SHIELD principal investigator since 2021. “[School nurses] play a role in supporting the integration of new children and families into the community, actively advocate for the health of all children—especially those with special health care needs—and serve as leaders within schools.”
Two longtime SHIELD collaborators, Karen Robitaille and Mary Jane O’Brien (Nursing‘75,‘77), have drawn on decades of school-nursing experience to help tailor SHIELD programs to the workforce’s current needs.
When O’Brien transitioned from hospital to school nursing in the 1990s, her supervisor joked she was “too young to retire.” “They thought it was putting band-aids on boo-boos,” she says. During 30 years working in Boston Public Schools—as a school nurse, lead nurse, and later senior director of health services—she learned the realities of practicing alone in a school setting. “It was just me and my stethoscope—not like the emergency room, when I would say, ‘I don’t like the look of this kid,’ and 15 residents and interns would run over.”
At the end of the day, a school nurse has three choices concerning an acutely injured or ill student: send them home, send them to the hospital, or send them back to class. The nurse must assess both how sick a child is and what support the family can provide—a sensitive decision when a parent might lose a day’s pay to pick up a child. They often work alone and must rely on their own judgment, which is where SHIELD’s support becomes critical.
“I’m very proud of the work that BU SHIELD does. They’re really cutting edge,” O’Brien says. “We need that because things are always changing in school nursing, and we need [a] resource we can go to that’s guaranteed to be up to date.”
Moved by a memory decades later, she recalls one of her first patients as a school nurse: a 12-year-old who was often exhausted from nights scouring Logan Airport parking lots for carts to return for 50 cents. Awareness of income disparities and other social determinants of health has only grown since, she says.
Robitaille agrees. “The job has changed from immediate, discrete tasks to systems thinking—considering the student’s environment, family, social situation, and community,” she says.
Meanwhile, the acuity of chronic illness among children is rising, Robitaille adds. “We have many students with complex healthcare needs, and because the healthcare system is fractured, the school nurse often becomes the de facto case manager for a family—the constant in that family’s life,” says Robitaille. “Nurses see children for many years across elementary, middle, and high school and can be life changers.”
Both O’Brien and Robitaille point to SHIELD’s Special Health Care Needs (SHCN) courses and learning library as one of its greatest assets—a “one-stop shop” for caring for students with conditions such as diabetes and epilepsy and those who use specialized medical equipment.
Schools nurses often first encounter SHIELD through their Foundations of School Nursing Practice and Introduction to Medication Administration and Delegation in MA Schools, courses required for initial school-nurse licensure. From there, they can consult SHIELD’s resource wheel to access additional trainings on topics such as school health screenings, mental health, and leadership. Since COVID-19, SHIELD has shifted from offering primarily in-person programming to delivering most courses online.
“BU SHIELD has done an extraordinary job […] to provide high-quality programming virtually,” says Robitaille. “We’re fortunate in Massachusetts to have the structure we do around school health. We can create and deliver professional development specific to school nurses’ needs, and that’s a huge gift. I enjoy working with BU SHIELD—it’s wonderful and we have a good time.”
O’Brien, who recently retired as a nurse consultant for the Boston region, is proud that the regional-consultant model used in school nursing has recently been adapted for public health nursing. “People are starting to understand that [school nursing] is also a huge part of population health and child health.”
While O’Brien and SHIELD’s longtime director Beverly Heinze-Lacey have stepped back, they say SHIELD’s foundation is strong, adaptable, and ready to transform to meet the needs of the workforce and the communities they serve. Now under the direction of Amy Dark, who was previously with the National Association of School Nurses, SHIELD is well-positioned for the future, says Elliott.
“This year alone we’re talking about doing a community needs assessment […] so we’re getting a playbook. We’re getting professors from BU who are teaching school nurses in these seminars,” says O’Brien. “BU SHIELD recognizes the value of school nursing […] there’s never been a need for me to say what the cost-benefit is.”
