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Joined Jul 11, '05. Posts: 3,344 (65% Liked) Likes: 9,021

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  • Aug 8

    I'm good with Mr. Last name or Nurse Last name but if they address me by "nurse" they immediately become "student."

  • Aug 3

    Quote from starrernurse
    Having files for each patient ready to go in emergency situations is honestly what I would do as a school nurse. You can keep it locked ina file cabinet with a key on your person at all time to maintain hips and then all you would have to do is grab it quickly. You could even do that while ems is loading him up.
    With all due respect (and I have an enormous amount of respect for ED nurses) Some times we are the ONLY medical person in a building or on a campus. There may be anywhere from 500 to 1500 kids (and staff) we are responsible for. Sometimes spread out over multiple buildings....Before you dispense any ideas on how you would do our job, do our job.

    30-40-50 kids per day (in a 7 hour period) where we assess and care for any number of medically complex kids with trachs, insulin adjustments, g tube feeding etc etc....not often, if ever, time to put together a little dossier that can be shared.

  • Jul 26

    I think there are some misconceptions here that need to be addressed before you can really consider school nursing for being an "easier" nursing SPECIALTY (because that's what it is, a specialty). I think reading through the school nurse thread on AN will be very helpful to you, but also highly recommend substituting before even considering to apply to a full time position. I think you will be surprised how different it is than what you imagine it to be.

    Let me break it down for you so you can see some real differences between school and hospital:

    1.) The ratio between you and your patients is most likely 1:500. YOU, JUST YOU, ARE RESPONSIBLE for all of those little lives.

    2.) We may not have a patient who has constant meds, Q2 turns, Q4 vitals, bladder scans, or I&Os to chart but we FREQUENTLY have 6-10 kids in our office at one time that all think they are the most important. And there are no call bells, just yells and crying, LOTS of crying. No other nurses to pop into room 32 for you. No aides to take those vitals.

    3.) All kids come to school. You may see kiddos with diabetes, seizures, allergies, anxiety, bleeding disorders, cancer, asthmatics, CP, CF, and muscular dystrophy ALL IN THE SAME DAY. And you care for them, and you check up on them, and you chart their visits, and you make their care plans, and you talk to parents, and you discuss with doctors. You change diapers, you do tube feeds, you suction. You are the medical professional that sees them most days of the week. They are relying on you to keep them safe.

    4.) When you step off the hospital floor, you know that patient you worked so hard with that day is being taken care of by a whole other TEAM of nurses, doctors, aides, and resource staff. When my kiddos leave me at 2:30, I worry. Weekends are the worst because I have a whole 48 hours to worry. Will they be fed? Do they really have an appointment at the urgent care for that cough? Are they going to come back to school with bruises?

    5.) Teachers. The good and the bad. The ones that send you 13, yes 13, of their class of 22 all in one day because one student is out with a fever. Those 13 students add about an hour of your day because of assessments and charting. You now have no lunch (but, then again, when do you ever have a lunch?) Teachers take A LOT of time. Training them, because yes that's part of your 7 hours a day too. Convincing them they don't NEED to know everything medically going on with a child in their class. Reminding them I can't tell them everything because of HIPPA and FERPA, not that those acronyms mean anything to them.

    6.) Parents. Also, the good and bad. The parents that want a call everytime their kiddo has a hangnail, or the parents that never pick up the phone, or never pack a lunch, or never show up at dismissal. Or there are also (and these are my favorite) the parents that ask you, "Are you even a real nurse, like how do I know you know what you are talking about?". Or the ones that question everything you say, and then sure enough an abx little Jimmy is taking for his strep comes to school (unlabeled) in a plastic bag that you knew he needed three days ago. You feel alone and unheard most of the time.

    7.) There problems become your problems. The stories these kids have told me break my heart. I drive home crying. There are the kids that lost their parents. The kids who don't know when their next meal will be, or if they'll have electricity and heat when they get home. The kids that don't go home, but go to a homeless shelter. The psych! If you are going to be a school nurse you must be comfortable with you psych nursing. The amount of kids with GAD, OCD, PTSD, bipolar, and schizophrenia would probably shock you.


    8.) Emergencies. It's on you. There are no doctors. No nurses. No code team. No meds at your disposal. It's you and your assessment skills. And PLEASE FOR THE LOVE OF ALL THAT IS HOLY do not think for one second that emergencies do not happen at school. Allergies happen. Asthma attacks happen, and can be deadly. Injuries, boy do they happen. Just sent a kid via ambulance this week for obvious deformity of RUE after a fall from the playscape. This child needed 2 surgeries and 4 days in the hospital. I got him there. I made the 911 call. I splinted it. I iced it. I coordinated his ambulance ride to the RIGHT hospital for him. I advocated for him, as this child is nonverbal. And this week I'm revising his care plan for accommodations. And this is summer school. There were 22 kids here the day that happened. But you just never know and you always have to be ready. Kids lose lives from accidents that happen at school and aren't handled properly.


    I'm sure I could think of 100 more things to say, but kiddos are showing up for summer school, so duty calls. About to go change a diaper, do a tube feed, take vitals, and assess a wound all in the same STUDENT I love my job!

  • Jul 26

    Some food for thought...we have "patients" who yell, hit, and bite too. We have students with anxiety, depression, PTSD, bi-polar, suicidal etc. etc. Psych is a major component of school nursing. You deal with these kids while you are handling everything else, by yourself. Additionally, we are responsible for every human on the premises not just the students. If anyone has an emergency it's on us to respond.
    The major difference is that on a unit you have help, supplies and when experienced, know what to anticipate. Everyone in a school looks to us when things go sideways. We school nurses can plan to a degree but rarely know what urgent issue is coming next.

  • Jul 26

    I have. 6 years. And currently still do PRN.

    The stress is less (for me at least) but it's there in a different type of way. Sue-happy-media happy parents have principals and teachers afraid of not sending every little thing to the nurse. Things that take up unnecessary time that is need for your more serious students.

    In most cases you are THE ONLY medical professional in charge of over 500 kids. Some nurses are lucky and er a health aide. Most don't. This means you need to know your **** because there isn't anyone to ask (except the fine co-workers of AN). No charge nurse, no doctor. Just you. I don't have to deal with patient satisfaction scores which is nice...but a mad Momma doesn't leave an anonymous complaint-just sayin'-much worse.

    Most people think all we do is stick on band-aids, hand out ice packs and Saltines and cal it a day. In my district thee are students that have diabetes, seizures, severe asthma and allergies, trachs, g-tubes, students with muscular dystrophy who have no movement below their waist so you have to use a hoyer to change them. Not to mention your daily med kids which means most ADHD problems get sent to you.

    I don't think you were trying to belittle us school nurses but your original post talks about how you wouldn't mind being "bored" which put a bad taste in our mouths to begin with. Our jobs aren't easy. Just like your job isn't easy. They are both hard in their own ways.

    *Forgive typos-on the iPhone.

  • Jul 26

    Quote from Kreed10
    Just wondering...have any of y'all worked in a hospital?
    ????????? Seriously???????

  • Jun 30

    Quote from OldDude
    Would this be considered a "wet" dream?
    Possibly...

    But this is THE Wet Dream:

    WET DREAM
    Kip Addotta


    It was April the 41st - it being a quadruple leap year - and I was driving in downtown Atlantis.
    My Barracuda was in the shop so I was driving a red Stingray, and it was overheating,
    so I pulled into a Shell station.
    They said I'd blown a seal.
    I said, "Fix the damn thing and leave my private life out of it, okay?"

    While they were doing that I went across the street to the Oyster Bar - real dive.
    But I knew the owner, Gill, 'cause he used to play ball the Dolphins.
    I said, "HI,GILL!" - you have to yell, he's hard of herring.

    So I bellied up the sand bar, ordered a Rusty Snail, hold the grunion,
    with a peanut butter and jelly fish sandwich on the side, heavy on the maco.
    I was feeling good.
    I even dropped a sand dollar in the box for Jerry's Squids, for the halibut.

    Well, the place was crowded.
    We were packed in like sardines.
    They were probably there to hear the Big Band sounds of Tommy Dorsil.
    He was rockin' the place with a very popular tuna: Salmon-chanted Evening
    and the stage was surrounded by screaming groupers - probably there to see the bass player.

    Well, one of them was this cute little yellow tail, and she's givin' me the eye.
    So I figured this was my chance for a little fun - you know, piece of Pisces...
    but she said things I just couldn't fathom, she was too deep - seemed to be under a lot of pressure.
    And boy could she drink.
    She drank like a... she drank a lot.

    And then she gives me that same old line, "Not tonight, I gotta haddock."
    And she wasn't kiddin' either, 'cause in walked the biggest, meanest lookin' haddock
    I'd ever seen come down the pike.
    He was covered with muscles.
    He said, "Hey, shrimp, don't you come trollin' around here."
    I said, "Abalone, you're just bein' shelfish."

    Well, I could tell there was gonna be trouble and so could Gill 'cause he was already
    on the phone to the cods.
    The haddock hit me with a sucker punch.
    I landed him with a left hook.
    He eeled over.
    It was a fluke, but there he was lying on the deck flat as a mackerel.

    I said, "Forget the cods, Gill, this guy's gonna need a sturgeon."
    Well, the yellow tail was pretty impressed with the way I landed her boyfriend.
    She said, "Hey, big buoy, you're really a game fish.
    What's your name?" I said..., "Marlin."

    After that we had a whale of a time.
    I took her to dinner.
    I took her to dance.
    I even bought her a bouquet of flounders, on porpoise.
    And what did I get for my troubles?
    A case of the clams.

  • Jun 30

    It's a humor type to deal with this type of difficult situation. It also, I think, reminds people that many opiate overdoses are actually from affluent people in affluent areas. We need to break down this NIMBY attitude towards overdoses so that we can actually get to the root of the cause to try and stop it.

  • Jun 28

    I call on on old asthma orders. I can't force a parent to bring in an inhaler, but I document I called and if the child has an issue I will demand the parent bring it or the child can't return to school without it. I have my principal's backing on this. We have had to send out too many student's in ambulances with asthma attacks due to no meds and couldn't reach a parent. I have now remedied that issue. I don't play around with breathing issues.

  • Jun 15

    Call the Ombudsman office and high tail it out of there!

  • Jun 13

    Hi,

    Just an FYI I found a squirrel who obviously had a broken back and was totally paralyzed dragging itself along the side of the road. I brought it to a local vet to be euthanized and they did it for free without question!

    Vets take an oath too and most of them are compassionate enough to provide euthanasia to even a wild animal that is suffering!

    Annie

  • Jun 12

    "These new compact cars are ridiculous!"

  • Jun 9

    Teachers take days off
    No cover ever for me
    A school nurses life

  • Jun 7

    In unrelated news, as some of you may know I am leaving my school at the end of this year. Mr Tomato and I are moving since he got a promotion and I will not be working in a school once we do. I do, however, have 3 job interviews lined up for the weeks after school ends!

  • Jun 7

    Quote from Flare
    So i'm going to zombify this thread - the district, through an initiative through the county just had a few employees (including myself) take a narcan administration class. The thing is here that this "county initiative" group does these trainings and hands out these narcan kits to "concerned citizens" and family members that want to be prepared to save their loved ones. I voiced my displeasure but was essentially told by my boss - just do it. But what i am trying to impress upon them is that i don't believe the rules for school have changed that much - especially my pk-8 school. (there MAY be something in the hopper for high school here in my state) i don't believe narcan is a drug that can be delegated. I don't think all the pharmacies are even considering it otc yet - i think only some have a special permission and you have to i believe do something special to get it.
    I googled and found these:

    NASN position statement:
    Naloxone Use in the School Setting: The Role of the School Nurse (Adopted June 215) - SchoolNurseNetMain

    This is the NJDoE implying Narcan can be delegated in certain circumstances. OH has similar rules but I didn't see a guidance document on the subject.
    http://www.state.nj.us/education/non...2416Opioid.pdf But not all districts or school physicians permit delegation to anyone other than a licensed medical professional.

    And this commentary: Commentary: Naloxone Use in Schools: School Nurses on the Front Lines - Partnership for Drug-Free Kids - Where Families Find Answers


    Not sure if any of this will help you.


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