Becoming a School Nurse right out of school??

luvschoolnursing, LPN · Aug 15, 2009

Just speaking for myself, I was glad to have clinical and assessment skills before starting school nursing. You are on your own. Major things don't happen that often, but when they do, you're the lone medical person there. Perhaps others will have different opinions.

bergren · Aug 20, 2009

I agree - do a year in Peds if you don't want Med Surg while you work on NJ certification. You will gain a lot of confidence and fine tune assessment skills that are so needed when you work in isolation and when kids cannot articulate how they feel. Go ahead and sub and volunteer for screenings or just volunteer in schools in general to learn the school evironment. Are you an athlete? Become a coach of a sport to get your foot in the door of the schools.

Good luck! I knew in college I wanted school nursing, but worked for several years in NICU and peds and it was a great foundation.

elkpark · Aug 20, 2009

I think it's a big mistake for new grads to take positions like school nurse or home health fresh out of school, where you'll be working on your own, without more experienced RNs physically nearby who can look at things and answer questions for you. I would also be v. suspicious of any agency/school that would hire someone with no other experience into a position like that -- IMHO, it shows poor judgment and understanding on the part of the employer. They're putting you in a dangerous situation.

You cannot go wrong starting out a nursing career with some solid, basic med-surg experience, whether with adults or kids. You can always move into any other specialty from there, but the reverse is not always true -- if you manage to start out in a specialty like school nursing and find later on that you want to (or need to) move into another specialty/area, esp. a hospital-based bedside nursing position, you may have a v. hard time doing that, because of your v. limited, specific skills and experience.

geocachingRN · Aug 21, 2009

OK, that being said and I can't get a pediatric, med-surg or any other position in a hospital because there are none available and I'm not interested in LTC. The market is different now and the standard line of "work in a hospital" advice is not an option although many of us wish it were. So when I was offered a job in a school, I took it. I'm doing mostly a 1:1 though and she's very easy. I get a couple of hours during the day to learn the job and I'm only at one school. This is a great way to learn the job. There is a great aide who does the first aid and the other nurses in the district are awesome. I did spend 2 years volunteering in a free clinic which helped. Here is a link to the SJSU video archive. 147b is a the school nurse rotation, have alook, these helped me a ton. http://www.sjsu.edu/atn/delivery/webcasting/archives/fall_2008/sn/index.htm

geocachingRN · Aug 21, 2009

PS don't be afraid of losing your skills. There are three week refresher courses that you can take to renew them.

bergren · Aug 21, 2009

Ahhh OK - given that scenario, an 1:1 it a good option. Is there a back-up RN too? If you can get a weekend position at some point that would be good too.

If your state holds a school nurse orientation it is a great immersion into school nursing legal issues and practices.

Link ot state school nurse organizations:

http://www.nasn.org/Default.aspx?tabid=60

OTconsideringBSN · Sep 3, 2009

Hey everybody, thanks for all the great advice and thoughts on this topic. Will schools or companies hire a new grad to be a 1 on 1? Or does everybody require the year hospital experience or peds experience first?

geocachingRN · Sep 3, 2009

I was hired as a 1:1 right out of school...but then I did 2 years of volunteering at a free community clinic.

bergren · Sep 4, 2009

I was the school nurse in a school where a new grad was a 1:1 nurse for a very very very fragile kid. She gave excellent care, but in emergency situations, she panicked. Once she was so upset (yelling "call 911" and I kept trying to calm her down telling her we had a few options we needed to try first - we did not need to call yet = he was pink and PO2 was still in the 90s) that she seriously frightened the child. So I would say that it depends on how stable the child is and whether there is another RN very close by. Having had a nurses aide job and or a senior internship would also help.

geocachingRN · Sep 4, 2009

I'd like to take Martha's post one step further and say that it will also depend upon the nursing program you went through and how comfortable you are being on your own. Some programs required 2 years of med/surg in addition to specialty rotations. Some programs require only one year med/surg. If you were an EMT, then you might be more comfortable.

I have orders and was trained on what to do if there is an emergency with my 1:1 student. It's the rest fo the school I'm learning what to do, in what little time I have available.

I just went to county wide H1N1 meeting and some districts have only 2 nurses for as many as 17 schools and in our cash strapped state, this seems to be the wave of the future.

Purple_Scrubs, BSN, RN · Sep 4, 2009

I started school nursing after less than a year nursing experience. I think it is not easy and not everyone can make it work. You have to have strong assessment skills, confidence and be comfortable working alone, and you absolutely MUST have an experienced mentor available at any moment.

Other than polishing assessment and time management skills, I am not sure how much I would have gained by finishing out my year in the hospital that I would apply to my current practice. That setting did not allow me to assess fractures, identify rashes, or differentiate "school-itis" from a more serious issue. School nursing is a specialty, and I see no difference in a new grad going into that specialty versus another, like OB or psych, IF that new grad is suited for that specialty (ie with the strong assessment skills) and has the proper guidance and mentorship. I realize not all districts have this and therefore a new grad might struggle more. While I am the only nurse on campus, my mentor was never more that a phone call away and another experienced nurse was a couple miles down the road if I was in a real pinch (and I never have needed to have her come to my school).

That said, no experience is wasted experience. I am glad that my short time in the hospital was on a cardiac floor, as last year I caught a heart murmur in a student that none of her docs had ever noticed. Would I have caught it without the cardiac experience? Maybe, but probably not.

I guess what I am saying in a long drawn out way is that if the new grad is right for the job and has the proper orientation and mentoring, school nursing CAN be a specialty that a new grad can excel with. Unfortunately, many districts are not set up to orient a new grad in that way, so any new grad considering this specialty MUST do their homework and be very careful in choosing their district.