The Good and Bad

[QTNurseBSN]

I have been a RN for 6 years and this is my first year being a school nurse. I work at a high school with approximately 1100 students. I thought from my experience as a Public Health Nurse that school nursing would be a great change of pace for me with a familiarity of providing community based nursing care in a clinical setting.

(I have also worked in the hospital setting-weekends, holiday, nights).

One positive thing I can say about my job that I love would be my hours, the fact that I don't have to work weekends or holidays and summers off WITH pay because even though I only work 10 months, I did a 12 month contract that stretches my pay over the course of a year. I mainly took the job because my 5 y.o. was starting kindergarten and I wanted to be on the same schedule as him...my older two children (ages 12 and 16) had to endure my crazy work hours when they were younger, so I wanted to try something different.

I have come to the realization that this is NOT the job for me and I will NOT be returning next school year. The high school kids have attitudes, drama, and EVERY excuse to come to the clinic to go home because they don't want to be at school. I don't feel like I do a lot of nursing stuff especially now that the vision/hearing screenings are over as well as the seasonal and H1N1 flu clinics we had at the school. I do get the respect from the teachers, students and administration in regards to my nursing expertise, but I do get peeved by a lot of things.

A teacher sent a student down for a toothache and told the student I could possibly recommend a dentist (the same thing the teacher could've done), but I politely told the student that I was not in a position to recommend a dentist because if something went wrong with that dentist, I was not going to be accoutable. I told the student that there were a list of dentist in the phonebook....pick one! A senior student wanted me to put his contacts in his eyes. I told him that was not my job and he should have not bought the contacts if he was not capable of putting them in his eyes. And lets not forget about the old monthly "friend" that visits the females every month. I tell the girls that they are going to be dealing with periods for the next 40 years or so and they need to adapt. Your employer will NOT send you home every month because of cramps nor will your employer supply you with maxi pads. I am NOT a dispenser and what I have in the clinic are for emergencies, not convenience. These girls should always have an extra pad/tampon in their purse, locker, bookbag because you just never know when that "friend" will come early. I try to have compassion for the kids, but they are in HIGH SCHOOL...they are mini adults and I refuse to baby them along. And let's not talk about the parents who refuse to pick up their kids who are sick (fever, vomiting, diarrhea). I am sorry but if your child is that sick, they can not remain in the clinic, YOU are the parent and it's YOUR responsibility to pick up YOUR child. I would hate to get Social Services involved because you are neglecting your child.

I am not a 1)social worker 2) cafeteria because you forgot your lunch money and you are hungry or because you didn't eat breakfast 3) drug store for deodorant or lotion that you failed to put on 4) clothing store because you forgot your belt or your shirt does not meet dress code compliance 5) or your friend (I am an adult, you are a teenager-we have NOTHING in common)...I am there to provide nursing care as needed during the school day so that you, the student, can continue to be successful and remain at school during the day and attend all of your classes.

Hope I didn't sound harsh, but I am just speaking the truth. I think the nurses that work in the elementary and/or middle school level might feel a little more appreciation for what you do and your tolerance/patience may be better. But when dealing with teenagers that are in high school..it's a whole different world.

[Flare, ASN, BSN]

It's not for everyone. Though have you considered trying to get a job in a school with a younger and somewhat (note i said somewhat) less dramatic population?

Bottom line is that's pretty much everyone's day on here. You tried it, you gave it a shot, don't feel bad about moving on. I tried home care for a year and it wasn't for me - so i know where you are coming from.

[QTNurseBSN]

Well I am going to finish out this year at the high school level. In this school district RNs are required in the middle and high school level. Health assistants are utilized in the elementary school level..which in my opinion requires more of the expertise of a Registered Nurse. Especially with a lot of those kids taking psychotropic or mood altering meds (i.e. ADD, ADHD), not to mention the asthmatics that do NOT self carry inhalers and may need neb treatments during the school day and the diabetics that do NOT self administer insulin. I like my autonomy and being "left alone" by the staff and administration. Their focus is education and mine is healthcare, so they trust my opinions and observations and pretty much just let me do my own thing. I think I would enjoy my job more if I could do more "hands on" nursing care, but I am so limited to what I can do because it is a school clinic and not an outpatient facility; it gets rather boring at times and there is nothing challenging in my school nurse job.

I did home visits as a Public/Community Health Nurse to complete nursing home screenings unlike what an actual home health nurse does. I guess since I started my nursing career in the hospital setting than that's where my gears turn the most. Sure the hours are not the best and I dont mind working the holidays or weekends, just seems no fun when your family and friends are at home and I am working.

[luvschoolnursing, LPN]

"I am not a 1)social worker 2) cafeteria because you forgot your lunch money and you are hungry or because you didn't eat breakfast 3) drug store for deodorant or lotion that you failed to put on 4) clothing store because you forgot your belt or your shirt does not meet dress code compliance 5) or your friend (I am an adult, you are a teenager-we have NOTHING in common)...I am there to provide nursing care as needed during the school day so that you, the student, can continue to be successful and remain at school during the day and attend all of your classes."

In many ways if you are a high school nurse, you are all of those things (although the food thing gets on my nerves a lot-I get really sick of supplying breakfast) I am a social worker in that I refer to local agencies and try go make sure kids get meds they can't afford as well as refer to our district social worker when I am in over my head. I do keep deodorant, pads and tampons-although I lecture about responsibility when I give these things out repeatedly. I have been known to dip into the stash because my monthly "friend" showed up when I was not expecting it. I have given out quit a bit of Kling wrap to tie up pants and I am a friend to some of the kids who do not have peer friends. The thing is, High School kids are a different breed. You either love them or you don't. It sounds like you don't. That's OK. I worked in a K-2 school and did not like it. I like the drama, the chaos, the hormones, at least to the extent that I feel like I make a difference in these kids lives. That's why I did not like the hospital. I felt like a warm body going through the motions. That's the good thing about nursing-one degree is the starting point for so many different options. Follow what you love!

[QTNurseBSN]

Hey luvschoolnursing:

You made some good points..I am glad to know that you are the nurse that those kids need. I just simply can not do it. I have a problem with some parents not being accountable and expect me to solve it for them, but I guess that's nursing in general..depending on the patient population you are dealing with...we are suppose to FIX it! The nurse there before me provided tampons, deodorant, oragel, cough drops, snacks, and was more of a friend than I am. I am NOT buying anything with MY money for the clinic. I am not required to provide cough drops, bring your own. I do have pads that are supplied, but they are not to be dispensed on a regular basis to the girls that know "oh I don't need to bring my own, I will just get one from the nurse"..sorry..be more responsible and bring your own. If you prefer a tampon vs the school supplied pads, then don't get an attitude with me, call mom and ask her to bring you some because this school nurse will NOT be buying any. I am sorry that you didn't eat breakfast..wake up a little earlier so that you have time to eat before coming to school. I have peanut butter crackers, granola bars and juice that I had to beg the secretary to buy out of the budget, but that's only for the diabetic child or the child that is feeling lightheaded because they have not eaten NOT for the hungry child who thinks I am suppose to feed them (we do have free and reduced breakfast/lunch if you qualify)

If a student comes to the clinic with an issue, like thinking they are pregnant or wanting to get on birth control, I don't call any agencies for them..I will give them a number to the local health department and they can call themselves. Sure I don't mind listening to the gossip and the drama..brings back memories of when I was in high school..it can be quite amusing at times. But if you have some other issues at hand..that might require the experise of a psych nurse, then you have came to the wrong place, but I don't mind writing you a pass to the guidance counselor..that's what they are there for.

I am caring and empathetic and sympathetic when need be, but I am not going to treat high school kids like babies. If they have a cut or scratch, I instruct them to clean the wound, I give them the antibiotic ointment and bandaid to apply themselves..they have to learn somewhere how to do it. One girl came in and wanted an ice pack for her leg. I gave her the baggie and instructed her on where the ice cooler was located in the clinic. She asked "I gotta get it myself?"...my reply was "yes, your arms and hands work fine don't they?"

Honestly, I thought I could relate more with the teens because I loved working with the teens when I was a public health nurse...but I guess I like the more mature, self sufficient teenager. And I know I could not do the elementary school level because the whining child drives me crazy....

I am just looking forward to June when my contract is up..sad but true!

[mustlovepoodles, RN]

I could have written your post last year. I was in an urban/suburban middle school with 900 students. I had all the same issues that you're having and after 2 years I knew I couldn't do it anymore. I stopped working for several months, took a Spanish class, volunteered at a food bank and then a new job opportunity fell in my lap like magic. Now I'm working in an elementary school with 350 students, still the same home issues of poverty, transience, broken homes, welfare, but the whole atmosphere is different. Rather than constant drama and daily chaos, gangs, guns, and violence, now I'm working in a calm, caring place. I have two little diabetic students, one on a pump doing well, one in kindergarten and she's clueless. I have a boy on tube feedings, the usual crop of ADHD kids, a couple with sickle cell. The kids are polite to a fault. SUCH a change. I could really see myself staying here for a very long time/

You know, I thought it was school nursing that I disliked. Turns out, it was my school that I didn't like. Now that I"m in this little elem school I'm so much happier and much less stressed.

[QTNurseBSN]

Mustlovepoodles:

Sounds like you made a great change that you are really happy about. I don't have the gangs and violence (thank goodness) just a few fights here and there that I do NOT even attempt to break up. Change is always good and I do think at the elementary level, the kids are easier to nurture and love because they are little VS the high schoolers that think they are grown...until they get a splinter and then they are crying like babies. Not sure what my next venture in nursing will be..all good things come in due time..you were able to see that first hand!

[Mrs. Healthy]

I have to say, I am SO glad that you are leaving the school nursing facility behind. I would never want a callous, unfeeling, selfish person to be the school nurse for my children. Not when I am spending so much time and money for the children at my own school. I buy second hand clothes to have ready for the kindergartners who still have "accidents. " I keep maxi pads (never tampons) for my 5th grade girls who are sometimes frightened and confused about their changing bodies. I have a stash of small gluten free and nut free snacks for kids at my school. I do not provide breakfast often, but I will do so if I know that the child is not a repeat "breakfast skipper." I listen to the kids and I CARE ABOUT THEM. I have been through some of the most trying situations with my students, referring issues for everything from child-sexual abuse to parental neglect. I have to help them. THAT'S MY JOB AS THE SCHOOL NURSE!!! I have never understood why a selfish, mean person would ever become a nurse OR health assistant.

Of course there are students who exhaust your patience using every possible trick to go home. But a skilled eye and years of practice can tell the fakers from the genuinely sick children. We are running a clinic in our respective schools. Sometimes our hands are tied by policies and legalities, but there is still a lot of care and compassion that we can share with our children. And just so you know, young people can sense when a person such as yourself doesn't care about them. I hope some of the parents get wind of your arrogant and mean-spirited behaviors and share it with the school principal. If parents are good at anything, they are good at complaining. I know if you spoke to my child such with high-handed ignorance I would have a thing or two to say to you and to the principal.

Perhaps you would be better as a Correctional Health Provider in a local prison. Though your mentality seems more similar to that of the heartless criminals.

[bsyrn, ASN, RN]

School nursing isn't for everyone. It sounds as though you made the right decision. Good luck...

[QTNurseBSN]

Mrs. Healthy, You are a day late and a dollar short honey! This post is 2.5 years old and once my term was up in June of 2010, I was DONE with school nursing! I am definitely not a mean or selfish nurse by any means. I always get excellent reviews from my patients. However as a High School nurse from 2009-2010 I focused not only on the health of the students but also making them accountable and responsible mini adults, which a lot of the frequent visitors were seniors who were sick of school and eager for graduation. They would use the clinic as a way of skipping class with the complaints of a headache or menstrual cramps. My advice to them was about being prepared. After high school they would be venturing off to college or the work force, where their boss or professor was NOT going to send them home or back to their dorm because of having cramps, headache or runny nose. I know this personally first hand. Also for the record, it was the parents that were negative to me most of the time because I would call them expressing my concern about their child who is starving or their daughter who continually comes to school without pads or tampons or their child who came to school with a fever greater than 101 or even pink eye. These parents felt as if I was inconveniencing them by letting them know their sick child is contagious and should have NEVER came to school in the first place or that it's THEIR responsibility to provide food or sanitary protection. In regards to the principle, he was fully aware of the circumstances and regretted to see me leave because I did NOT let the students take advantage of me or manipulate me like a lot of school nurses do! There is a TRUE difference in working as a school nurse in the elementary school vs the high school. So maybe you should make your next school nurse job in the High School and report back to this forum so I can read about your rant. It's a different world in every way!

[Nurse ABC]

We do deal with all that at the elementary school/middle school level and I agree that as high schoolers they need to be more responsible but kids are kids so they do forget. Also a lot of kids don't have any parental support and haven't been taught how to be a responsible person because their parents aren't. It's our jobs as school nurses to fill the gaps as needed so they can stay in school and get their education. It's our job to facilitate eye dr and dental appts. because for whatever reason the parent isn't taking it upon themselves to do it. Also, what about the kids that don't qualify for free or reduced breakfast and lunch and their parents don't have any money until payday and all the food is gone? Those that qualify get lots of help but those that just miss the mark may be just as broke and it's not the kid's fault. Kids that age have pride and they aren't going to just admit their home is out of food. Maybe the kids that complain of cramps, headaches, or runny noses are hoping the nurse can help them in some way because they already told their parents who opted to ignore them or didn't have money for Tylenol. You have to have a certain perspective of this job to make it work and you have to enjoy the social work aspect of it because you do more of that than actual nursing I think. It's not for everyone. I've learned over the years that even a simple smile or taking the time to actually listen can make a huge difference to a student whose parents never give them the time of day. It can become quite disheartening the number of kids with really crappy parents and quite exhausting trying to be everything to everyone. I didn't feel the OP was heartless-I think she was just burned out with all the non-nursing stuff she had to deal with. Lets face it-who knew that as a school nurse our jobs would include a lot of the things we have to do?

[caregiver1977]

I never could understand the high school girls who would have to go home every month because their monthly "friend" visited. My periods were very, very irregular when they first started, and I never had to go home because of it (even though my periods are not very heavy on the first day).