What School Nurses REALLY Do?

Many people think the responsibilities of a school nurse are limited to handing out Bandaids and ice packs all day long. While that's certainly a small part of the job, school nurses actually do a lot more than most people realize. From emergency preparedness (and response!), to keeping track of immunization records, managing concussions, fractures, sprains, and strains, caths, tube feedings, blood sugar checks, or just a little TLC during the day, school nurses do it all. Specialties School Nurse Life

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In response to this comment from a previous thread:

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"Can you tell us what you actually do in detail? That would actually be a more interesting read."

Give out Bandaids and ice packs, that's it.

Just kidding! Although that's what the majority of the general public thinks we do. What school nurses do varies from school to school, depending on student populations, state laws or district policies, etc. I'll get the list started with just a few things I personally do at work and my fellow school nurses can chime in!

Things School Nurses Do

1. I personally cover only 1 school and see 30-40 kids a day, and I know I'm one of the lucky few with such great numbers! It's not unusual for school nurses to see 60, 70, even more on a daily basis---from multiple schools or even the entire district. I assess, monitor, treat students for quite a variety of things: wounds minor and severe, sore throats, headaches, stomachaches, N/V, SOB r/t asthma, menstrual cramps, head injuries that may or may not turn out to be concussions, sprains, strains, nosebleeds, chest pain, many more. You name it, a school nurse has probably seen it.

2. Ensure students with chronic conditions (most commonly asthma, severe allergy, seizure, diabetes---but many school nurses also see students with more specialized needs such as those with cystic fibrosis, spina bifida, etc.) have plans in place that ensure the safety AND success of the student while at school. For example, a diabetic student would have emergency meds/supplies/a plan for hypo- or hyperglycemia. That's in addition to their day to day maintenance plan (e.g., checking in with the nurse before lunch for a blood glucose check and any necessary treatment.)

3. Administer daily and PRN medications, making sure all necessary forms are on file, calling parents when meds expire or run out, monitoring for any adverse effects, etc.

4. Educate students on self-care, healthy lifestyle choices, puberty, or more specific info related to their particular condition or situation.

5. Educate and train staff on common chronic conditions present in our school, s/s to look for, step-by-step response to emergency situations (anaphylaxis, hypoglycemia, etc.) Many school nurses also do CPR training for staff.

6. Working with administration to develop policies/protocols related to school health that ensure all students are safe and have equal opportunities to thrive and succeed.

7. Managing the occasional "special cases"---post-op student for example might need to learn how to use crutches/wheelchair to get around school, pain management plan, special accommodations in class (sitting near the door, needing a way to prop a limb up, etc.)

8. Document thoroughly on EVERY SINGLE STUDENT I see. That alone takes up a chunk of my time.

9. Annual vision, hearing, height, weight, acanthosis nigricans, scoliosis screenings for certain grades as mandated by state law.

10. Being the "safe place" for students with anxiety, other mood/behavioral disorders, and all students really. I'm fortunate to have counselors AND social workers but many schools don't so the school nurse plays that role.

11. Connecting students/families in need with community health resources.

12. Navigating the tricky world of teachers and education. You're the ONLY "medical person" in the entire building, nobody understands your job (but thinks they could do it since you just sit around handing out ice packs and Bandaids all day), if you're lucky another nurse is nearby or a phone call away but sometimes not, you are SOLELY responsible for your students' health needs and outcomes during school hours. It's tough being a nurse in a "teachers' world."

Anyway, I could go on but I know the other school nurses have plenty to add. TGIF!

Specializes in School Nursing.
On 12/14/2014 at 10:09 PM, Windchaser22 said:

Ideally, one could start as a permanent part timer. This way you are mentored and can readily take the reigns when the time arrives.

I also don't recommend school nursing for new grads. As a permanent part timer you would still be working alone. At least in my large school division with 82 schools. You would be splitting the job with another part time nurse. I've been doing this for 18 years now, and definitely could not have handled the position straight out of school. If you respond to an emergency, you must be able to make split second decisions. There is no one there to answer questions, or assist. You are completely on your own until EMS gets there.  Without any experience behind you, you don't have the assessment, or critical thinking skills that are necessary in these instances. I think after a couple of years of nursing experience , then give it a shot. 

Specializes in ER/School/Rural Nursing/Health Department.
On 12/12/2014 at 1:44 PM, Tina, RN said:

 

Perfecting the art of "mommy-ing" balanced with a little bit of tough love. ;)

This right here! I have a certain group of kids at each school that have awful home lives and need a "mom".  Whether that is a middle schooler asking question/talking out issues or an elementary kid that just needs some hands on caring or one on one attention for a minor issue.