what a school nurse does?

MomNRN, BSN, RN · Jan 27, 2003

What does a school nurse do? People are amazed that we can keep busy in a school nursing office. Little do they know the multitudes of things we do.

I am a nurse at a school for special-needs kids ages 6-21, so my school is a little more "intense." I have subbed in "regular" schools and prefer the setting I am in now.

We have 125 children enrolled. During the course of my day, which runs from 8:15 to 2:45, over 75 daily meds are given, approximately 4 PRN meds, 3 kids are tube-fed twice a day, and 1 diabetic student has his BS monitored, insulin given, and diet computed.

This does not include your basic school injury/sickness walk-in's. Add to that a profoundly retarded child who can't tell you where it hurts, but is obviously in pain!

Thank god - I have help! There is another nurse who works with me. We try to split the duties evenly. There is also the incredible amount of paperwork that goes with above-said duties. Medicaid reports, medication authorizations, checking immunizations and physicals, doing weekly weight checks on several kids, and advocating as needed for neglected kids.

I have become quite good at tracking down free food, shoes, clothes, glasses, physicals, immunizations, and medications. We document unusual bruises, doing weekly lice checks as needed, and make sure kids are fed at home.

Although I make less money than I did in the hospital I used to work at, it is a great job for a mother with 2 kids. I can take my kids to and from school, get the weekends and all holidays off, and have the summer off! One day, we I want more money I might go back, but for now this job fits my family's needs. It is also incredibly fulfilling!

Try school nursing - you just might like it!

schoolnurse912 · Jan 27, 2003

i get asked that question alot-as a matter of fact when i left my previous job to become a school nurse alot of my co workers gave me a hard time saying I was going to be sitting around giving bandaides all day-HOW FAR FROM THE TRUTH!!!! I stay busy all day so do all the other school nurses i know. Anyway I am attaching a copy of an article I put in our local newspaper for the monthly school health cloumn. i thought it summarized a school nurses job description pretty well-if thats possible Haha - If youre thinking about doing that I can honsestly say its the most rewarding and at times frustrating thing Ive ever done- Its not for everybody

ARTICLE:

What is one of the first questions that people ask you when meeting for the first time? "What do you do for a living?" Whenever I get that question I always prepare myself for people's reaction -initially its "OH so you're a nurse so what hospital do you work at?" I laugh to myself as I explain that I work at an elementary school. The conversation usually precedes something like " A school nurse! So what do you do all day ?" Or " I bet you see a lot of kids just wanting to get out of class" I chuckle as I think about my "frequent flyers"-those kids you see daily for on thing or another and then I try to explain exactly what my job is. Sometimes it is hard not because there is nothing to do but because there is so much that it is hard to say in 10 words or less. Luckily I came across this article written by a school nurse, Gerri Harvey, of over 20 years and I think it summarizes my job description perfectly. So in case you ever wondered what are those nurses doing -here is your answer.

But Is It Really Nursing?

Recently on the School-RN listserv, while discussing Frequent Flyers, someone bemoaned the fact that these are the kids who often are not really sick. They take up nursing time that kids who are "really" sick might need. The veterans among us said that the FF's may not always be sick, but clearly, if they are coming to the nurse, they need SOMETHING. That "something" might be attention, release from a stressful situation, sleep, food, the bathroom, a sympathetic ear, or even someone who will look them right in the eye, face to face, and ask them non-judgmentally, "How can I help you?"

As we bantered about the reasons teachers send kids to the nurse and the reasons kids ask to come, one weary school nurse said, "Yes, but is it nursing?" I want to respond to that question.

If nursing is ONLY about caring for the sick and the injured, then it's easy to sort out the nursing from the not nursing. I have heard school nurses say that if they do not see blood, vomit or a temp over 101, then the child does not need a nurse and is sent back to class. This is actually medical model thinking. Health is the absence of sickness. Period.

In today's complex world, one in which we understand how sadness, hopelessness and loneliness can predispose a person to suppressed immune function, heart disease and even cancer, nursing is so much more than the old medical model.

Nursing is about caring.

Nursing is about having the skills to assess for the unspoken as well as the spoken need.

Nursing is about prevention.

Nursing is about comfort.

Nursing is about teaching our patients how to achieve and maintain physical and emotional comfort themselves.

Nursing is about empowering patients toward self-care.

Nursing is about giving others the understanding and awareness to deal with whatever hurts instead of substituting a "legitimate" illness to get what they need.

And school nursing is about doing all of these things for persons still in progress, children, who are still learning how to be and stay well.

It is good to have those acute care skills, and be a nurse who knows how to do CPR if a person's heart stops beating, there's no doubt that THAT is really nursing. But it's also good to be a nurse who knows all the ways to protect that heart before it becomes sick.

So yes, the answer is yes. Getting gum out of hair, sewing up ripped pants, inviting a child to eat lunch with you, opening the door for when they might want to disclose some pain you cannot even imagine, being the one to help figure out where the real pain might be coming from. These are all part of nursing in a school.

It is harder to see those internal wounds, harder to measure how your attention might have prevented the development of something big and scary and physical, but yes, it is really nursing.

katscan · Jan 27, 2003

Excellent post! I have been a school nurse for 20 years and would have it no other way. I donot make what I would in a hospital-I make 52,500 for 184 days a year. I LOVE my job in this jr. school of 7th and 8th graders. Lets see, One 7th grader threw up all over my floor, then walked into the bathroom and threw up allover the toilet: I saw 2 who were potentially going to throw up-2 possible strep throats, sent 6 home for other reasons, checked 4 incoming students, interacted with a pregnant teacher and took the blood pressure of another; talked with 7 parents about their kids, spoke with the principal and evaluated the plan for implementation of our artificial defibrillator, helped out in the office, did a hearing screening, 2 vision checks, 3 small paper cuts, 1 splinter, 2 asthma treatments, 9 adhd kids' medicine , sent notes to teachers to 3 kids who forgot their meds, 2 notes to teachers for kids with new problems, 5 phone calls, all the documentation on my computer for all I hve done so far, and I still have 2 hours to go in my 7.5 hour day. This was a very easy day.

MrsK1223 · Jan 28, 2003

I want to be a school nurse....it's driving me crazy that there are no openings around me. I'm getting started on my bachelors and if i have to relocate to find this job i'll do it.

bergren · Jan 28, 2003

There are a couple of ways to put yourself in a position to get a school nurse job when it comes open:

1. Sign up as a substitute school nurse

2. Volunteer to help with annual screenings. Most schools use parents to help with vision and hearing screening.

3. Join your local school nurse organization. Some of these groups require that you have a school nurse job or license before becoming a full member, but most have associate member categories. The job openings are put on local listservs the minute they come available.

4. Attend you state's annual orientation for new school nurses. They are usually in August. I did this and got a job at the event and started the following Monday. You can find your state's association on the national organization's web site: www.nasn.org

5. Attend the annual state school nurse conference - depending on the state, fall or summer.

6. Do a stint as a camp nurse - there are some similarities.

7. Get as much pediatric experience as you can, including some basic ventilator, GT feeding, catheterization, etc skills that are needed with the special education and medically fragile population. Home care with medically fragile children would be great experience.

Good luck!

bergren · Jan 28, 2003

As one of the School Nurse Board Moderators, I just need to remind posters to be careful about copyright. Gerri Harvey very generously provides her material on her website to be shared if she is asked permission, she is cited (which was done!), and there is a link to her web site, School Nurse

Perspectives (http://snp.homestead.com )

Thanks!