Concerns about Transition to School Nurse

pedi_nurse · May 23, 2018

I wasn't in adult care, but wanted to encourage you to review the primary pediatric ailments you see in a school clinic, such as asthma, adhd/add. About 80% of pediatric codes are due to respiratory failure, not cardiac issues. Honestly, 6th-8th is a great age and a lot of what you see in a school clinic is basic first aid/emergency response, meds, asthma, colds, "someone accidently stabbed me with a pencil," social/emotional issues and more. Clinically speaking, the cases you typically see are not that challenging and any good nurse should be able to handle them with a little pedi review. What some of the biggest differences may be is dealing with parents, administrative work, screenings, being the only medical professional in the building, and just learning the ropes of the educational system vs a healthcare system. They are very different. I'd stress your experience working with families, patient education, and heart for community health, along with any experience you may have with children outside of nursing. Good luck!

ETA: You also will be triaging the adult staff as well, so your adult experience will come in handy as well!

ruby_jane, BSN, RN · May 23, 2018

You said the magic word - TRAUMA!! You're going to do great!

Pediatric assessment is easily learned. Just get yourself a cheat sheet with the appropriate vitals and what's normal/abnormal by age. If you can, see if the local hospital offers a "school nurse training course" where you will get up to speed on asthma, concussions, derm conditions and some other stuff. If they have nothing like that, it'd be worth searching for a computer-based course on line.

Honestly the biggest gear shift for acute care into ambulatory care is 1) Limited interaction with prescribers. You are autonomous and you make a lot of nursing judgment decisions; do nothing to endanger your license even if that's unpopular; and 2) the transition into how things are done in a school environment. There's a lot of PR and finessing that happens here, which may make your life easier. Make sure you know the district's policies/procedures (hopefully this is electronic for you and not in a binder).

OldDude · May 23, 2018

Other than raging hormones that age group wouldn't be a lot different than adult nursing. Best of luck!!

pedi_nurse · May 23, 2018

do nothing to endanger your license even if that's unpopular;(hopefully this is electronic for you and not in a binder).

REALLY good point here. You have to say "no" a lot more often in this setting. People will ask you to do all sorts of things outside your scope without any understanding as to why you can't. And it's usually simple things like:

"Is this pink eye?"

"Can you get this [deeply embedded] splinter out?"

"Can you give my kid their morning dose [even though your order is ONLY for the lunch dose]? - I forgot."

zurie · May 23, 2018

Wow, thanks for the quick replies guys! I do know I can learn most of what I am missing, I just needed to have more confidence in what I know already. I'll let y'all know how it goes. Thanks again :)

MrNurse(x2), ADN · May 23, 2018

I came from a quarter decade of adult care. I came into a private without any school nurse. I had to develop protocols, policy with no experience. This community was my saving grace. I relied on my intuition way too frequently that first year., luckily it was backed up with solid experience. No offense, two years isn't experienced yet. Rely on the experience of these great nurses, they got me to a point of comfort after three years.

WineRN · May 23, 2018

You said the magic word - TRAUMA!! You're going to do great!
Pediatric assessment is easily learned. Just get yourself a cheat sheet with the appropriate vitals and what's normal/abnormal by age. If you can, see if the local hospital offers a "school nurse training course" where you will get up to speed on asthma, concussions, derm conditions and some other stuff. If they have nothing like that, it'd be worth searching for a computer-based course on line.
Honestly the biggest gear shift for acute care into ambulatory care is 1) Limited interaction with prescribers. You are autonomous and you make a lot of nursing judgment decisions; do nothing to endanger your license even if that's unpopular; and 2) the transition into how things are done in a school environment. There's a lot of PR and finessing that happens here, which may make your life easier. Make sure you know the district's policies/procedures (hopefully this is electronic for you and not in a binder).

All of this!

I did tele and home health prior to this so switching down to a k-5 population was a big transition at first. But I will never go back. I hope you get to have the same love of the job that a lot of us on here have :)

RobotechTD · May 24, 2018

You are like me. I was in med/surg then emergency but I longed for the M-F work week in my previous career. I had no peds experience but the hiring manager said that I have two kids so it's good enough for her. You'll do great!

jess11RN · May 24, 2018

You'll do great!

I came from a background in adult oncology/outpatient infusion (is it sick that I REALLY miss starting IVs and drawing blood?). Working in a school is a different world, you are on your own and you will have to tell administration and staff no and defend your answer because something so commonsense to you and your professional background is not to them. KNOW your state's Nurse Practice Act and stick to it. Print it out for reference.

The biggest difference I had when I made the move was having a preceptor in the district who was there for me to answer my many questions. My advice to you would be to find someone in either your district or your area who would be willing to take you under their wing. Maybe you can shadow them for a day (or maybe a week)?

scuba nurse, BSN, MSN, RN · May 24, 2018

I came from oncology/bone marrow transplant for adults with a few peds here and there, and did fine. I also have 4 kids, so if you have children of your own...you will be fine!! Good luck and ENJOY!

Amethya · May 25, 2018

Be kind with students, but as well stern with them. Sometimes these kids need someone to show some attention because they don't get it at home. That's where we come in a way to give that love. But always be careful with FF (Frequent Fliers) they will LOVE YOU TO DEATH!