After more than four decades in nursing—and six years leading the Lexington Public Schools as Director of School Health—Karen Rufo will retire this June, leaving behind a career defined by compassion, mentorship, and trailblazing leadership.
“She’s an absolute trailblazer,” said school nurse Jacqui Falco, who worked with Karen for six years. “She empowered school nurses to have a seat at the table because of the work we do. Karen made sure that happened in Lexington and across the state.”
Rufo’s 43-year career has spanned clinical and school settings, with the last 25 years dedicated to school health. In Lexington, she became a trusted leader during some of the most challenging years in public health. When COVID-19 struck, Rufo led with clarity and calm, helping the district navigate the uncertainty with protocols that later served as a model for other schools across Massachusetts.
“She was a state-wide resource,” said school nurse Karlee Dana. “Other districts looked to Karen for guidance.”
Rufo was a key figure in the launching of Lexington’s “Test and Stay” program, which allowed exposed students to remain in school through daily testing—minimizing lost learning time while maintaining safety. She also worked with local pharmacies to organize nearly 100 vaccine clinics—not only for students and staff, but for the entire Lexington community.
Throughout the pandemic and beyond, Rufo helped bring school nurses together at a time when many felt isolated and overwhelmed.
“She really supported our team and made sure all the nurses came together and felt seen,” said Dana. “That’s what a leader truly is.”
Rufo’s commitment to equity showed up in both policy and practice. She championed marginalized students—including LGBTQIA+ youth and those with special health needs—and advocated for inclusion at every level. Under her leadership, the district adopted the SNAP Health Portal, a communication tool that allowed nurses and families to share health information in hundreds of languages. She even ordered bandages in a range of skin tones to ensure every student felt seen and welcome in the nurse’s office.
“She always wanted to make sure everyone felt represented when visiting the clinic,” Falco said.
A strong believer in professional growth, Rufo encouraged countless nurses to pursue advanced degrees and training. She regularly shared education opportunities and pushed her colleagues to take on leadership roles within the Massachusetts School Nurse Organization (MSNO), where she served as Vice President of Programs.
“I went on to get my bachelor’s and master’s through her encouragement,” said school nurse Sheila Slowe. “She was always someone who let you find the time and space to grow.”
For her work, Rufo was named Nurse Administrator of the Year—a recognition that reflects the deep respect she earned from peers across the state. But for the Lexington nurses she mentored and led, her most lasting legacy will be personal.
“Thank you for helping me be a better school nurse,” said Dana. “And for your positivity, and everything you’ve done for this field.”
As she prepares to step away from the role, her team is already thinking about how to carry forward her example.
“She gave me such confidence to grow as a school nurse,” Slowe said. “I hope that someday I can be a strong leader like she is and make an impact in school nursing.”