I haven't worked acute care pedi (one day during maternal/child health rotation didn't offer too much), but I did complete my community health clinical at a K-5 elementary school, and I found it to be extremely
valuable for showing me the baseline... and how varied it really is. Most of the kids who came in to the elementary school nurse had been injured or had an acute illness, so their baseline was "normal" (or at least their underlying issue had nothing to do with why they came in). That is extremely useful just to start with: what is expected at what age, and how do we know when someone deviates from it?
The kids with chronic medical issues like those mentioned in the above posts are also great to learn from because you see them over time and get familiar with the ebb and flow of their condition and how it affects their everyday lives. You'll also see children with special needs, and you'll learn to ferret out the problem they are having while addressing their communication, behavioral, and developmental issues.
We had one little guy with special needs who just loved the nurse and came to see us a lot. He was congested much of the time, but one day he was just in worse shape than usual: very cranky (not normal for him), and much less communicative and cooperative. Based on the deviation from his
normal, we really checked him out; sure enough, both of his ears were very stopped up. We called mom and advised her to take him to the pediatrician.
My advice is to jump in with both feet. If the preceptor isn't letting you do stuff, offer. S/he probably has a pattern to how to manage the day, and you will need to fit yourself into it. I observed at first, then took a percentage of the kids or alternated with my nurse, and then finally had a few weeks where I basically ran the show and delegated to my preceptor as needed. Even more importantly, talk
to the kids. Middle school kids scare me to death, but my classmates assigned to middle schools loved
their middle schoolers and developed a good rapport with them and a greater appreciation for what they are dealing with.
My experience as a school nurse was awesome, and I think you will learn a lot more than you expect about caring for kids! You can learn skills at the bedside when you work acute care, but this type of experience is extremely important, too.