New school nurse...bummed out already

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I've been an LPN for the past 22 years, however Tuesday was my first day as a school nurse. I spent that day with the nurse (RN) I was replacing in my school. She spent most of the day complaining about the fact that she was being transferred to another school or surfing restaurants online. Anytime a child came to the clinic, the first thing she would do was take the temp. If it was over 100, she gave them an excused sign out slip and called for pickup. (That's per policy.) If afebrile, she sent them back to class with a peppermint (if c/o sore throat or tummy troubles). That was it. I asked her where the AED was, and she told me there was not one on the premises. She said if she doesn't see puke, it didn't happen. I totally get that. I hated school as a child and that was my #1 excuse to miss.

The second day, I spent the morning with a nurse at an elementary school. If a child who said they "don't feel good" claimed they puked at home before school that morning, or the night before, she immediately sent them home. That same day, I spent the afternoon with the nurse at a high school, but the only thing she saw during that time was kids coming in for routine meds and girls wanting tampons.

That was all the training I received. Yesterday was my first day solo. I had to wander around the school to learn where things are, and I found the AED I was told we didn't have! I still have no idea about disaster plans or drills. I guess I will have to ask the front office staff about that.

I just feel totally lost and thrown to the wolves. There doesn't seem to be anything else specific like the temp policy. Everything else is follow your gut, but then there is no uniformity between nurses. I'm just feeling completely overwhelmed! There is a SpecialEd classroom LPN there, but she is one of those "eat their young" type of nurses, and is the one who griped me out over sending a child home yesterday who c/o puking at home that morning. And the few times I've had to ask her a question, she's been very snarky.

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Specializes in school nursing, ortho, trauma.

you need to find your own groove. You'll get your own way of doing things. I'm not a big one to send kids home. Kids are supposed to be in school. A kid i hardly ever see come into the office looking terrible and c/o feeling poorly, sure, i'll send them out, but the kid that's constantly in there and telling me they threw up at home - i'll call their bluff and call home with no promises that i'm necessarily sending them home. if they're caught in a lie then they're quickly shown the door. You'll get a feel for how truthful the kids and the parents are being with you pretty quickly.

Take each day and each issue one thing at a time. If you start thinking about all the unknowns you'll keep yourself up at night with anxiety. You'll have to depend on your fellow district nurses a bit to answer some of your questions, and they will have to be patient with yuo - they need to remember they were new once too. But in the mean time, feel free to reach out to us if you have and general questions, anxieties or concerns... consider us your virtual Greek chorus

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You are in a tough situation. I am in a private school so I also started with very little guidance and no other nurses to call on. I agree with Flare in that you need to take it one day at a time. You will quickly learn your "frequent flyers". I am really stubborn about not sending kids home unless they really need to go. Almost throwing up or feeling like they are going to throw up is not a ticket home. Same with headaches, low grade temps, etc. I don't think kids really think about the burden of a parent leaving work to stay home with a sick kid who really isn't sick. Spend some time going through past posts on this forum. It will help you a lot ;)

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I know how you feel. I started almost 4 months ago and still feel like you do (I have 5 schools) as a district nurse. My first day I was handed a laptop and a map to my schools, no procedures, no protocols, nada. To top it off, all of my schools do things a bit differently and I replaced an OCD type nurse and a really easy going nurse...so I am trying to find a middle ground.Thankfully, I have finally stopped worrying about everything I do not have a clue about, and are just taking it one day at a time. It is still frustrating though, and I continue to look for other employment...sigh

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Unfortunately, this is the norm for school district nurses. I was very fortunate that a local nurse who had recently retired decided to put together some training where the new nurses would meet once a month. She was determined that the nurses would be trained so they didn't quit 6 months after being hired.

It is sad that we have all these mandates from the government to get done, but no training to do them. I had to find my own class to get certified to do hearing tests.

Plus, most school nurses don't have enough hours to get everything done. The nurse I replaced told me to focus on the Kindergarten Hearing and Vision screenings and the IEP/504 stuff.

I have a friend who is a teacher in a big city - their district hires a company to come in and do the H&V's . . . .that would be heaven.

As to kids who come in sick, I have too many campuses to address that and it lands in the lap of the school secretary. Mostly, if they come in with a tummy ache we ask if they've eaten breakfast. Many say no. So, we get them a bowl of cereal and most of the feel better and go back to class. If someone throws up - they go home. If they have a fever, they go home.

I feel for you . . . . I've questioned many times whether I want to stay and the deadline for signing up for college classes to get my credential is looming. In my state, they give you 5 years to get your school nurse credential which costs about $15,000 and they don't help you pay for it. I'm 55 . . . not sure I want to get more student loan debt.

Check out the National Association of School Nurses for lots of great info:

NASN - National Association of School Nurses - NASN.org

Your state should have it's own offshoot of this great group as well. Our state group is having it's annual meeting soon and I went to the national meeting in SF last year. Lots of great nurses and advice!!

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Welcome to school nursing! Yep that's how it is. Different nurses run their schools different ways. It's really up to you. In my experience if I let every kid go home that complained of feeling yucky then half the school would be gone by lunch time. If they "claim" they puked last night and before school I call a parent and just ask-if they didn't they stay.

In recent years I've also adopted the "have to see it to believe it" policy on puke because there are many grade schoolers now that will lie to go home. Fever over 100 automatic home. Signs of ear or throat infection (not just complaining-there has to be redness, swelling, drainage, etc) or injury that I feel needs a doctor to check it out I send home. Obviously lice goes home. If they student has never been in the nurse's office all year and is extremely pale holding their stomach I usually give them the benefit of the doubt and call mom. You'll learn the signs to look for.

Schools rarely use an AED and if they do it's usually for the staff. Anything life-threatening you have to call 911 and thankfully it rarely happens so don't lose sleep over what could happen.

You don't have many supplies either so you just have to make do with what you have. The goal is to keep the student in school if at all possible which means sometimes finding a change of clothes, using string for a belt, using five bandaids to cover one area because you don't have the right size, use ice for headaches, etc. Sometimes just sending a note home will make the kids feel better that you saw them that day. You have to keep up on state policies re: screenings, immunizations, medications at school,etc and that info should be somewhere in the school. Good luck!

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Unfortunately, this is the norm for school district nurses. I was very fortunate that a local nurse who had recently retired decided to put together some training where the new nurses would meet once a month. She was determined that the nurses would be trained so they didn't quit 6 months after being hired.

She should put these on the internet and charge for access. There is so little info out there for school nurses!!!!

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Specializes in Nursing Education.

I am new to school nursing and today is my last day. I lasted 1 year. It has been tough and I can identify with many of your above comments. I miss working with medical people and people who share a common goal. I hope you find your niche....hang in there and give it time. It does get better, but in the end you must enjoy your job to be happy professionally! Good luck!

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Still hating the job. It hasn't gotten any better, and my clinic is full of the same frequent flyers with the same BS complaints just to get out of class. I'm actively seeking a real nursing job and praying something comes along quickly!

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Specializes in school nursing, ortho, trauma.

i appreciate your frustration, but please don't discount our profession as anything less that "real nursing"

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So you feel that school nursing isn't real nursing, does that mean you are I,plying I am not a real nurse?

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Ignorance kills, just FYI.

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