Today....

  1. ....today I'm feeling overwhelmed with everything... .

    ***ADMIN, PLEASE DON'T POST ON FACEBOOK***

    When you were hired, was it just assumed that you knew everything there was to know about school nursing? I feel like that's how it was when I was hired and to be quite honest, there's A TON that I'm realizing that I don't know and am frankly, just not aware of. And I don't know how I'm supposed to know about these things if I'm never told about them. Does that make sense? Everyday it feels like I learn about something that I was SUPPOSED to be doing but wasn't even aware that it was expected of me.

    For example, apparently I was supposed to do teacher training on epi pens during staff training this past summer. However, I wasn't even aware that there was a scheduled staff training event. I'm apparently not included in those kinds of things and was never told I needed to be there. Had I known about it, I would have been there and the training would have been completed. Now before you jump on me about training and delegating epi pen administration, please know, as it was needed, it was done. Kind of a case by case situation. I just didn't know I needed to do a "mass training" during the summer staff meeting.

    That is just one example of something that has popped up this year but it makes me wonder what else am I missing.

    Am I the only one who wishes there was a clear cut outline of all of the "non hands on nursing" tasks that are expected of us that I can print off and keep as a checklist???

    Staff training? CHECK!
    Immunizations? CHECK!
    Update policies? CHECK!
    Insert other important things for check list? CHECK!

    How did all of you seasoned school nurses learn all that you know? Were you ever in a position where you felt you were probably forgetting to do something but you didn't know how to find out what exactly you were forgetting to do??

    Bleh. Like I said. I feel overwhelmed today and I hate feeling like I'm dropping the ball.
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  2. Visit KeeperOfTheIceRN profile page

    About KeeperOfTheIceRN

    Joined: Apr '16; Posts: 340; Likes: 1,141

    22 Comments

  3. by   KKEGS
    Oh how this resonates with me. I remember starting my first year as a school nurse. The team that interviewed me which included 2 other school nurses in the district knew that I was brand new to school nursing. Not a single person offered to go over anything with me. I had to repeatedly ask. I was told I had 2 prep days before the school year started. Prep what? Emergency care plans. Ok. What are those? Where do I find them? With 1500 children how do I know who has health conditions and who doesn't?

    This is one of the things I have never gotten used to about this job. I feel like most of the time it's just luck if I find out about something important I need to know about. For example I just found out about one of our preschoolers who will be starting K in the fall. He has a G tube and receives bolus feeds during the day. He doesn't currently get them at preschool because he is only here a few hours 3 days a week but in the fall he will. There was a transition meeting scheduled to get his plan in place for starting a full day of school in the fall. Was I invited? Nope. I found out about it from the district PT. But if I hadn't run into her in the hallway I wouldn't have known. How do you leave the school nurse out of the plan for a student with a feeding tube to start school?!? I don't get it. It's becoming increasingly frustrating to me how little thought is given to health services in the schools.

    Phew! Good to get that off my chest. Just know you aren't alone in this.
  4. by   OldDude
    Try not to let it bother you too much. Everybody has been down that road in school nursing. Most of us have were never provided an orientation other than, "here are the keys." You don't know what questions to ask about stuff you didn't know existed. Just add it to your calendar for next year and build your own checklist. Student health and safety is top priority and everything else follows.
  5. by   denstar
    Unfortunately, I think it's pretty common. I remember being (embarrassingly far) through part of my first year and realizing - wait, who checks that the AEDs are working?!? It just hadn't crossed my mind (I think I thought of it as part of the facilities management), and there was no documentation/protocol for it. Sure enough, one of our AEDs hadn't been checked since loooong before my arrival and wasn't working. I think there are so many little (and big) things that can be missed without a proper handoff from the previous nurse and without a policy/systems in place.
  6. by   ruby_jane
    Quote from KeeperOfTheIceRN
    ....today I'm feeling overwhelmed with everything... .

    When you were hired, was it just assumed that you knew everything there was to know about school nursing? I feel like that's how it was when I was hired and to be quite honest, there's A TON that I'm realizing that I don't know and am frankly, just not aware of.

    Am I the only one who wishes there was a clear cut outline of all of the "non hands on nursing" tasks that are expected of us that I can print off and keep as a checklist???

    Staff training? CHECK!
    Immunizations? CHECK!
    Update policies? CHECK!
    Insert other important things for check list? CHECK!

    How did all of you seasoned school nurses learn all that you know? Were you ever in a position where you felt you were probably forgetting to do something but you didn't know how to find out what exactly you were forgetting to do??

    Bleh. Like I said. I feel overwhelmed today and I hate feeling like I'm dropping the ball.
    I did not know I had to do monthly checks on the audiometer, or report influenza, or how to run the EHR for data collection. The first "policy manual" I received was in a binder AND the papers had fallen out and gotten out of order.

    Thankfully we have the P&P on computer at this point. Is there a seasoned nurse in your district you can talk with about those yearly deadlines?

    You're a good nurse. You know what you need to about nursing. This P&P stuff.....you'll get it once it's shared with you and you can make a calendar or whatever tool you want. Breathe!! Hang in there.
  7. by   KeeperOfTheIceRN
    Quote from OldDude
    ...You don't know what questions to ask about stuff you didn't know existed. Just add it to your calendar for next year and build your own checklist. Student health and safety is top priority and everything else follows.
    This. This right here is exactly what I was trying to say and clearly took the scenic route getting there! HA! And thank you, OldDude, for suggesting something that, now that you've mentioned, seems so simple!! I will for sure be compiling my own check list so that I can try to stay on top of the game.
  8. by   KeeperOfTheIceRN
    Quote from denstar
    Unfortunately, I think it's pretty common. I remember being (embarrassingly far) through part of my first year and realizing - wait, who checks that the AEDs are working?!? It just hadn't crossed my mind (I think I thought of it as part of the facilities management), and there was no documentation/protocol for it. Sure enough, one of our AEDs hadn't been checked since loooong before my arrival and wasn't working. I think there are so many little (and big) things that can be missed without a proper handoff from the previous nurse and without a policy/systems in place.
    Our facilities department does manage our AED's. BUT! I didn't find that out until earlier this school year when it dawned on me that I should probably ask about that!! See, I made it a full year and a half before I thought to ask about them!
  9. by   KeeperOfTheIceRN
    Quote from ruby_jane
    I did not know I had to do monthly checks on the audiometer, or report influenza, or how to run the EHR for data collection. The first "policy manual" I received was in a binder AND the papers had fallen out and gotten out of order.

    Thankfully we have the P&P on computer at this point. Is there a seasoned nurse in your district you can talk with about those yearly deadlines?

    You're a good nurse. You know what you need to about nursing. This P&P stuff.....you'll get it once it's shared with you and you can make a calendar or whatever tool you want. Breathe!! Hang in there.
    Our audiometer is another stressor for me right now too!! The "monthly check" snip-it was BRIEFLY mentioned when I was hired but, at the time, we didn't own our audiometer. We borrowed one from our local health department and it didn't really make sense to me why I should run a monthly check on something I borrowed....Now on the flipside, I purchased an audiometer last school year because I was tired of borrowing and it JUST dawned on me (like, last week) that it needs to be calibrated....which has lead to a whole slew of other questions that I can't seem to get anyone to help me answer!! And my audiometer has still not been calibrated because I can't find anyone who knows where I need to send it....

    As far as the "seasoned nurse" in my district....its just me. I'm all there is. I am THE health services department for my whole district. Really. Its awesome...until I don't have anyone who can help me with my questions...then it kind of sucks!
    Last edit by KeeperOfTheIceRN on Mar 21 : Reason: typo
  10. by   KKEGS
    Do you have contacts in other districts for when you need advice? We have a group of school nurses in our surrounding districts who constantly keep in touch with each other to share resources and answer questions. That group and this board have helped me so much!
  11. by   ABRN2012
    They never had a school nurse at my first school. They literally told me to show up at the school the next day and did not even give me a certain time. One person said 7:30-3:30, but the teachers work 7:20-3:20. They told me the first semester I had to be there anytime the teachers were so I sat thru several parent-teacher nights and saw no one! I quickly learned I am not considered a certified staff so I dont have to go to everything the teachers do. For months I thought I reported to the prinicple and he was AWFUL. Then I realized he wasnt my supervisor. I walked into a room with no privacy, no supplies, and no health forms. I didnt even have a desk. The janitor finally found me a student table desk that I used. The teachers and office staff sent me everything! I was so bogged down with bandaids, headlice and temps that didnt have time to do careplans so I did them at home. I didnt know to check the AEDs either. I mean who had been checking them before they got a nurse? Who did the trainings? The principles would last minute say hey tomorrow at staff dev. we need you to do some kind of training and talk about 2 hours. Um talk about what exactly???
    I went to my states dept of ed website and found the roles of a school nurse. I went by that. If it said I was "responsible" for seeing that it was done then I made sure it was done. We have to make sure the abstinence education is done yearly. We dont have to teach it but just make sure its done. We have to make sure that all seniors have had hands only CPR before they are allowed to graduate so I made sure of that. Check and see if there is a school health audit rubric on your dept of ed. It will tell you things that you need to make sure are done. The other stuff is well up to interpretation. Can someone else check the AED batteries-yes. The principle or training coordinator should have let you know you needed to do a training so dont feel bad about that. But yeah unfortunately most of us have been there. I finally realized that I am a professional. I am not a teacher but I was the only medical person there. I started standing up for myself. I refused to do things that I wasnt required to do and I let it be known! I gave my principles every thing I found on our Dept of Ed and BON that pertained to me. That helped a lot. Hang in there! It gets better.
  12. by   KeeperOfTheIceRN
    Quote from KKEGS
    Do you have contacts in other districts for when you need advice? We have a group of school nurses in our surrounding districts who constantly keep in touch with each other to share resources and answer questions. That group and this board have helped me so much!
    I have tried to establish contact with some through our Regional Education Center but so far, the contact liaison there either hasn't forwarded my requests for contacts or they just don't want to participate?? I really don't know the reason, but I haven't gotten in touch with anyone via that route so I have started personally reaching out to some nurses in surrounding districts. I met with the nurse at my son's school and she was SUPER helpful and I'm currently trying to set up another meeting with the district nurse in another neighboring district and will hopefully get some more guidance there. This board has literally been more help than my local Region office and I am so thankful for it!
  13. by   KeeperOfTheIceRN
    Quote from ABRN2012
    They never had a school nurse at my first school. They literally told me to show up at the school the next day and did not even give me a certain time. One person said 7:30-3:30, but the teachers work 7:20-3:20. They told me the first semester I had to be there anytime the teachers were so I sat thru several parent-teacher nights and saw no one! I quickly learned I am not considered a certified staff so I dont have to go to everything the teachers do. For months I thought I reported to the prinicple and he was AWFUL. Then I realized he wasnt my supervisor. I walked into a room with no privacy, no supplies, and no health forms. I didnt even have a desk. The janitor finally found me a student table desk that I used. The teachers and office staff sent me everything! I was so bogged down with bandaids, headlice and temps that didnt have time to do careplans so I did them at home. I didnt know to check the AEDs either. I mean who had been checking them before they got a nurse? Who did the trainings? The principles would last minute say hey tomorrow at staff dev. we need you to do some kind of training and talk about 2 hours. Um talk about what exactly???
    I went to my states dept of ed website and found the roles of a school nurse. I went by that. If it said I was "responsible" for seeing that it was done then I made sure it was done. We have to make sure the abstinence education is done yearly. We dont have to teach it but just make sure its done. We have to make sure that all seniors have had hands only CPR before they are allowed to graduate so I made sure of that. Check and see if there is a school health audit rubric on your dept of ed. It will tell you things that you need to make sure are done. The other stuff is well up to interpretation. Can someone else check the AED batteries-yes. The principle or training coordinator should have let you know you needed to do a training so dont feel bad about that. But yeah unfortunately most of us have been there. I finally realized that I am a professional. I am not a teacher but I was the only medical person there. I started standing up for myself. I refused to do things that I wasnt required to do and I let it be known! I gave my principles every thing I found on our Dept of Ed and BON that pertained to me. That helped a lot. Hang in there! It gets better.
    Wow. Thank you for your insight!! I definitely didn't have it that bad when I signed up. And that's a great idea about looking to see if there is an audit rubric. I'll definitely be checking that out !!
  14. by   Have Nurse
    It's o.k., Keeper, you've got a good head on your shoulders. Just be assertive about what information you should be up on. Ask questions and if the person you ask doesn't know, find out who does. Well done to you!

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