Day in The Life of an Elementary School Nurse

[M.J.S.]

A day in the life of an elementary school nurse is very busy. The day starts about an hour before the school day begins. As students arrive any that have existing medical conditions come to see the nurse first before going to class. There are usually multiple diabetic students, that will need to have their glucose checked before heading to class. The diabetic student eats breakfast at school then they may need insulin administered. There are also students in the morning that must take medicine after getting off the bus before going to class. Students are also sent to the nurse when they don’t have on clothing that is warm enough or doesn’t fit to see if there is anything in the clothing closet that they could wear that would make them more comfortable.  The nurse of an elementary school wears many hats.

After all the students are settled in their class, the nurse must head to the special education classrooms. There are multiple students in this room that will need tube feedings and daily health checks.

There will also be contact tracing and reporting that will need to be done on any new COVID cases at the school. The school nurse will have to contact the health department to notify them of any new cases. Next the parent or guardian will need to be called to ensure that they are following the correct steps in the quarantine process. It is not uncommon for them not to be following the protocols. There have been multiple instances where there is one child or parent at home sick and has not been isolated from the others and a sibling or child that has been exposed is at school. The nurse is required to educate them on the quarantine guidelines and if there is a child at school that has been exposed the child will need to come to the nurse’s clinic and be placed in the quarantined area until someone has arrived to pick them up.

The school nurse also oversees keeping up the health records of all the students at the school. There is a lot of contacting doctors’ offices and parents to ensure that the students have all the required vaccinations. If the student is exempt from getting the vaccinations, then the nurse needs to ensure that all the proper paperwork is in place. This process usually starts over the Summer and continues daily. The nurse also does yearly vision and hearing screenings on all of the students at the school.

Any child that does not feel well or has been injured is sent to the nurse for evaluation. The student is cared for and is returned to class or home is called for someone to pick them up. If someone is called to pick them up the sick child will stay in the nurse’s clinic until the person picking them up arrives.

Before lunch all the diabetic students return to the clinic to have blood glucose checked before eating. Some students may require urine ketones to also be checked. The nurse has a copy of the lunch menu and discusses with the student what they should eat depending on their glucose reading.  After the students finish eating, they return to the clinic. Any students that require insulin usually has a carb count and a sliding scale insulin order from their doctor. Most of the students that at this age do not know how to do the sliding scale or the carb count themselves.  The student that can do this themselves still require supervision. The student that feels comfortable giving themselves insulin can do so with the nurse’s supervision. There is also student that require by mouth medications at lunchtime. These students usually come to the clinic either before or after their lunch depending on the time the medication is ordered. Lunchtime is a very busy time for a school nurse sometimes there will be student lined up down the hall waiting to come into the clinic. Any student that has a medication order that doesn’t come to the clinic. The nurse will have to go and get them or have the teacher send them down. Many students do not like taking the medication, so they attempt to avoid it when they can.

After the lunch time rush the nurse heads back to the special education classroom to administer afternoon tube feedings.  

Before the students are discharged home all of the diabetic students return to the clinic to have their blood glucose rechecked. This is to avoid their blood glucose dropping on the ride home. If needed they are given a snack to take with them.

As you can see the day of a school nurse is a busy day even if everyone is feeling good. The school that I work has over 400 students so that is over 400 students that the school nurse is responsible for caring for.

[MegP]

I'm a inpatient bedside nurse very interested in transitioning to a school nurse. Do you have any tips or advice for us new school nurses that are unfamiliar with this type of work? Anything you wish you had known when you started? Would love any insights you may have. Thanks!