Crazy new school nurse sub situation

[photomom]

Working this week in an inner city alterniative middle/high school as a sub. They actually haven't hired a FT nurse yet (and I heard rumors they're looking, but the way I've seen this place run, who knows when that will really happen). After this week there is another nurse who will work the next few weeks (and has more experience than I do in school nursing - I've only ever worked one day as a sub in my life before this week!)

My problem is that it's a new school and so there is NOTHING established, and I keep running into problems because I'm only a temp. Additionally, because it's an alternative school, only discilinary records are sent from their home schools. This means I have NO information about the kids. I have sent home health history forms with the students, but when we only have about 1/3 of the enrolled students show up, and not the same ones everyday, I'm not sure which kids now even got the forms and which haven't! Working with the office is a struggle because the nurse is the farthest thing from important on their list. I have barely enough supplies in my room (mainly a first aid kit and some really OLD 4x4s, and finally got a thermometer) in case of an emergency (I hope?!). I found out yesterday that there's a diabetic but she won't return the paperwork for the insulin she needs at school, and I hear rumor there's a kid with a serious heart condition who takes daily meds at lunch time and another kid who takes daily adhd meds at school. Nobody seems to know the names of these kids and I don't have their meds in the office.

My next attempt for information was to request a list of the students and where they came from so maybe I can call and request their health info be faxed?! The secretary's response? "Oh, it should be in the system" - yeah, I don't have ACCESS to the system! So, she'll try to get me a list, when she has time. The counselor did just offer to let me use the system in her room to look up kids and then call, but I need to wait until after lunch. Meanwhile, the VP is jumping on me because I don't know anything about this kid with the heart condition or if anyone else has serious problems (yeah, that's what I've been hounding everyone about since Monday, but everyone's too busy with trying to get their areas in order and disciplining kids that it went in one ear and out the other!)

I'm so frustrated and wondering what I could do later today or tomorrow (since thats my last day here, for now) and suggestions on what i should have done, or should do if in this situation again. Once I *DO* get their histories, I need to create care plans or something for all the kids with problems, right? What else needs to be done? What should I pass on to the next sub to get her going in the right direction? I feel like such a failure right now because it's thursday already and I still know nothing about most of these kids and don't feel like I've accomplished much, since I run into a brick wall at every turn!

I would love any advice from anyone who's ever been in a crazy situation like this. Thanks so much!

[wearingmanyhats, RN]

I think you are doing as well as expected under the circumstances. I haven't run into this in school, but I have worked a camp situation where good information was lacking. All you can do is operate based on what you DO know if a particular situation arises.

Do you have a "supervisor" up the chain of command that you could call... (for instance, in our district, there is a nurse at the high school who sort of oversees the whole district)

Good luck... and I thank you on behalf of the nurse to follow you, for trying your best to do what you can...

[photomom]

Yes, I am in touch with the supervisor several times a day but she is also new to the district and rather at a loss of what else to do. Ended up sending a student to the ER today - oh what a mess!! When is rains, it pours, right?

[Nurse ABC]

What a mess! I think you're doing the best you can and you are taking the right steps by trying to find histories and info. Try to remember you're in a school system and not a hospital so for the most part, even with conditions, these kids are relatively healthy. When emergencies do crop up if there is anything major just call 911 or the parent. If you know for sure that a certain student has a heart condition and is on med then maybe call the parents and ask for clarification of what exactly it is and try to get a dr's order for the student to take the med at school and set it up for him to come to you to get his med everyday if that's your district's policy. If it's not then maybe just monitor the situation and let the teachers know who has what problem. Does your disctrict even have policies in place for meds at school? If so find them so you'll know what to do. I don't know that I'd want to continue working in that type of situation with that much disorganization. Just take lots of notes about what's being done for the future nurse.