Hi! I need to provide some history before my question, because I'm looking for a little peer support/counseling/advice:
So I've been a nurse for about 8 years now but not really as a practicing one. While I was in nursing school, I became a Healthcare administrator (for a medical plan) and have basically just been in administration ever since.
A few years ago during a slump with my day-job I worked on a Medical-Surgical floor for about 6 months.
I did OK but the hospital was dangerously understaffed (I was supposed to have 4-5 patients every night but I'd usually have 7-9, and a few times I had 11).
I left because, as a full-time-administrator, I knew exactly how the hospital was gambling with everybody's license and it made me deeply uncomfortable.
Now, as a side gig, I work at a elementary school for children with disabilities one day a week.
MANY of these kids have significant medical concerns (Anaphylactic reactions, seizures, etc)
I find that most of what I do is just record review, first aid, etc.
I really like it... Sort of. I like the record review... the first aid... keeping everything organized... But when I first started I was petrified, all day long, that one of our 8 students (of 72 -- so 11% of the students) was going to need emergency care (Epi-pen, diastat, etc). A few weeks went by and that subsided.
BUT this morning I was just alerted that one of our kids that had a seizure once, three years ago, had a seizure a few days ago. Staff are on alert that he may have another seizure, and I'm back to square one. Not only am I petrified, but I feel less prepared now than I did before. I haven't ever done this stuff. I went to school like everyone else here but I don't do this in my day-to-day.
How does everyone else deal with the fact that any any second someone might enter a life threatening situation?
I'm also concerned about making mistakes during an emergency... I'm the only school nurse here... but I feel like there ain't any good advice for that other than "Be prepared, do your best and have malpractice insurance paid up!" haha ?
I am going to lay it out realistically, I apologize if it seems harsh in advance. Nursing is all about critical thinking, a skill that takes education and experience. More education can never replace more experience and experience alone can not make up for education. Your floor experience is too short to really gain experience, therefore your critical thinking skills for emergencies are deficient. It is one thing to develop experience where you have more experienced nurses to bounce things off of and help to debrief after situations, but you have put yourself in an isolated position without oversight. You may luck out and never experience that emergency you are not prepared for, but you are putting yourself and students at risk. Sometimes the right job comes at the wrong time, and your choice to take another track in nursing means that there are certain positions that you should shy away from, like this. There are many nurses that would be salivating over the choice you made for administration and would read your resume with great envy. This isn't a critique of you as a person, it is an analytical assessment of your nursing career until now, and is only a snapshot of where you are now. I suggest you take a step back, get your acute care experience over the next two to three years and develop those critical thinking skills that allow you to function independently and then dive into this.
Specializes in Geriatric Home Health, High School Nurse.
On 1/27/2020 at 8:33 AM, Flare said:
Quote
We act as a virtual nursing station for one another
This. I was at the hospital all day yesterday with my dad for a shoulder replacement and I found myself feeling a little sad and envious of the nurses. They were eating lunch together, grabbing coffee on a break, just being nurses doing their regular things side by side and I realized how much I miss that. I appreciate the image of a "virtual nursing station" because it got my out of my pity party a little bit. ? Thank you for that!
Specializes in school nursing/ maternal/child hospital based.
5 minutes ago, SchoolNurseK said:
Absolutely! I miss working side by side with other nurses, for a number of reasons. Mainly, so other people can understand my sense of humor. I think the teachers see me as loon or mean when I laugh about some things. Take the great Poop Apocalypse of 2019. Explosive diarrhea all over my bathroom from a Kinder. There is nothing I could do but laugh when it was all said and done or I would have cried.
Absolutely! I miss working side by side with other nurses, for a number of reasons. Mainly, so other people can understand my sense of humor. I think the teachers see me as loon or mean when I laugh about some things. Take the great Poop Apocalypse of 2019. Explosive diarrhea all over my bathroom from a Kinder. There is nothing I could do but laugh when it was all said and done or I would have cried.
I appreciate you all more than words can say!!!!
I'm lucky in that I have a few staff members that appreciate my nurse sense of humor.
Like when I helped with the school musical during a stomach bug a few years ago. Legally Blonde became Legally Vom and me and two staff members still laugh about it to this day.
I am going to lay it out realistically, I apologize if it seems harsh in advance. Nursing is all about critical thinking, a skill that takes education and experience. More education can never replace more experience and experience alone can not make up for education. Your floor experience is too short to really gain experience, therefore your critical thinking skills for emergencies are deficient. It is one thing to develop experience where you have more experienced nurses to bounce things off of and help to debrief after situations, but you have put yourself in an isolated position without oversight. You may luck out and never experience that emergency you are not prepared for, but you are putting yourself and students at risk.
I am afraid I am going to have to agree with Mr.NurseX2 on this one. Being a school nurse for the last 16 years, this is definitely not a job that I would reccommend going into with no or limited experience. We are usually alone, and when there is an emergency, we have to handle it on our own. Not having been able to sharpen critical thinking and assessment skills it is very possible to miss something while assessing a student if you don't have the experience behind you. I think that it would be a good idea to get some strong med surg experience and then come back to school nursing. I think this will give you the confidence that you need to handle the emergencies that you may come across. I do wish you the very best.
I am afraid I am going to have to agree with Mr.NurseX2 on this one. Being a school nurse for the last 16 years, this is definitely not a job that I would reccommend going into with no or limited experience. We are usually alone, and when there is an emergency, we have to handle it on our own. Not having been able to sharpen critical thinking and assessment skills it is very possible to miss something while assessing a student if you don't have the experience behind you. I think that it would be a good idea to get some strong med surg experience and then come back to school nursing. I think this will give you the confidence that you need to handle the emergencies that you may come across. I do wish you the very best.
I would argue that pediatric experience is also extremely valuable. I didn't really review diabetes care in the real world (vs hospital sliding scale at the time) and didn't get any asthma care during my med surg time in nursing school. (Breath sounds, yes.)
However, I was a nurse who went into school nursing as a new grad. Another but - my first job as a long term sub I got to work directly with another seasoned school nurse who took me under her wing and taught me so much. This is was SO helpful. I spent six weeks with her and it was was like the most amazing orientation ever.
I am the exception to the rule.
And I am still learning every day. I review a lot.
At my first job orientation (private duty/home health for vent patients) we had a lesson called "What could go wrong?" where we were given increasingly ridiculous scenarios. "Your vented patient is asleep when you discover the kitchen has burst into flames. You go to evacuate the patient but realize you need their back up batteries. After grabbing the back up batteries you see the fire has spread and you're unable to get to the patient without walking through the inflamed area. What do you do?" We were all coming up with ways to save the patient, put out the fire, jump over the fire and shove the patient out the window. Then our instructor says "you're all wrong. The right answer is call 9-1-1. If you haven't been trained on what to do and the situation is dire you call 9-1-1."
That sticks with me. We can only do so much. We know what we know, we should keep our emergency supplies handy, we should create an efficient system for getting around our school in an emergency, learn about all the situations, but sometimes we'll just have to call 9-1-1.
Such good advice!!! We only have limited supplies / equipment. Just remember your ABC's, have your go bag ready, do the best you can, call for help when you need it and stay calm (becuase those around you are sure to freak out - it's just the way it is in the school setting).
Unfortunately, it takes being called to an emergency and getting that experience under your belt to make you feel better.
MrNurse(x2), ADN
2,558 Posts
I am going to lay it out realistically, I apologize if it seems harsh in advance. Nursing is all about critical thinking, a skill that takes education and experience. More education can never replace more experience and experience alone can not make up for education. Your floor experience is too short to really gain experience, therefore your critical thinking skills for emergencies are deficient. It is one thing to develop experience where you have more experienced nurses to bounce things off of and help to debrief after situations, but you have put yourself in an isolated position without oversight. You may luck out and never experience that emergency you are not prepared for, but you are putting yourself and students at risk. Sometimes the right job comes at the wrong time, and your choice to take another track in nursing means that there are certain positions that you should shy away from, like this. There are many nurses that would be salivating over the choice you made for administration and would read your resume with great envy. This isn't a critique of you as a person, it is an analytical assessment of your nursing career until now, and is only a snapshot of where you are now. I suggest you take a step back, get your acute care experience over the next two to three years and develop those critical thinking skills that allow you to function independently and then dive into this.