District RN vs. Special Ed RN

[Elle71]

Help!

I just received two job offers, and I need to make a decision soon. For the district RN position, I would be the only RN for 7,000 students. They outsource health screenings and have LVNs or health aides at the 9 schools. Now, I am a new grad. I may not want to be the ONLY RN in the whole district.

The other position is to serve the special Ed population at 6 schools, I want to say. Higher acuity, but less overall population. And at least their are other RNs within the district, should I want to call one.

And then the job that is further pays much more, but I'm going to try to make a decision based only on the actual job.

[Jolie, BSN]

I don't believe that a position as the sole RN for 7000 students is a good choice for a new grad. Screenings are undoubtedly one of the most time consuming aspects of school nursing, and while they may be "outsourced", I suspect that means the actual screening process only. You will probably be left to write referrals, do follow-up, rescreenings, etc. Also, as a supervisor of health staff at several buildings, you will likely be the designated professional to attend care-planning conferences, 504 conferences and other multi-disciplinary meetings for all students in the district, most of whom you will not know, or know only in passing. Not a good situation for any nurse, but especially not for a new nurse who is learning these processes.

If you enjoy working with special needs children, that sounds like a better option. You will have a smaller population, and while they will have more health needs, they are relatively "healthy" students attending school, not critically ill patients in an ICU. They also tend to have well established relationships between their families and consistent teachers at school, so you have a strong pool of consultants to call upon for information and assistance.

I once got an emergency phone call to replace a mic-key button that had become dislodged from a young boy at a school distant from my usual assignment, where I had never been before. I was the only nurse available for miles around, due to a conference that day. The teacher had all the equipment set out for me before I arrived, had the child resting on a clean mat on the floor, and had Mom on speaker phone to answer my questions. You will never find that kind of support and expertise in a general school nursing position :)

Good luck in your decision.

[Flare, ASN, BSN]

well, far be it from me to decide your career path, but... if i were in your shoes as a new grad, the prospect of being the RN in charge of 9 schools and 7k students would put me off until i had more experience. At least with the special ed job, you can get some form of mentoring or guidance.

[Elle71]

Thanks for the feedback. This validates my concerns with the regular Ed. I would definitely get more support from the Special Ed teachers and the Paras. I wouldn't get phone calls for silly stuff from the general population. And yes, I'm going to need that mentor!