Updated: Mar 2, 2020
Published Feb 22, 2014
I have been an RN since 1993 in the ICU. I am thinking about changing career paths and going into school nursing. Overall, do you like your job? What is your average day like? What are the things that bother you the most about your job? Any advice you can share that will give me an accurate picture of school nursing? I am used to a stressful environment, but have never been in a role that is so autonomous. I would appreciate any advice!
I recently began as a school nurse. I love it for the following reasons : It allows me a relatively stress free environment, I am in the same school as my daughter (so schedule follows hers), I have a wonderful administration who is open to ideas and suggestions regarding the school environment, and, finally, a wonderful student body, who though they don't provide acuity in terms of assessment, they do provide endless joy and excitement watching them evolve in the educational process. Just my two cents.
Additionally, the schedule allows for further pursuit of education. That's another huge benefit.
I have been a school nurse for 12 years. I've been a nurse since '92 so I've come and gone from school nursing over the years. I've worked full-time, part-time, and subbed as a school nurse. If all my experiences (or any) were like tallgirl's I may not have ever left. I want to work where she does!! If you look through this board you'll find lots of answers to your questions!
Overall it's a good job, less stress, nice to be in charge of your own office, nice to have all the weekends/holidays/summers/snow days etc off. If you have kids it really is ideal! I do enjoy working with kids and making them feel better.
No job is perfect however. You will take a pay cut most likely. It may be huge. Only you can decide if it's something you can live with or make work somehow.
School nursing has it's own stressors but nothing like the hospital. If you thrive on making life and death decisions this job is not for you. It can be quite boring and monotonous at times. Lots of paperwork, charting, checking immunizations, and entering stuff on the computer. That stuff doesn't bother me too much.
I feel more like a social worker sometimes. There are more poor children whose parents don't provide what they need than you can imagine so you will have to encourage parents to take their kid to the dr, get immunizations that are required and then threaten social services or exclusion to get them to do it sometimes. This is very frustrating.
You will have many teachers that try to tell you how to do your job. Many will not respect your opinion. Many think you should just do as they say. You have to learn to stand your ground. You are the only medical person and sometimes they just don't get why you freak out over stuff like low blood sugars or a dizzy child that just got hit in the head but they freak out over vomit and lice and don't understand why you don't. There's A LOT of lice. It truly never ends.
A typical day involves seeing kids for illness/injury (many just want out of class or to go home so they fake it), passing meds, blood glucose monitoring, etc. We are also responsible for making sure kids have the correct immunizations, Medicaid billing, care plans, teaching staff, educating students on issues like dental health/hygeine/puberty etc, screenings, staff wellness programs, getting dr orders needed, and other things.
I always suggest subbing to get a taste of it before jumping in full-time. I think it's worth a try because you may love it!!
100kids, BSN, RN
I love my job but I have found that being the School Nurse means different things in different schools. At my school I see sick kids, give daily and prn meds, keep track of injuries and gym/recess participation, do care plans, attend 504/IEP mtgs, manage Student Attendance, Coordinate dismissal and changes, maintain student health records and keep track of immunizations, do screenings, teach Health classes and more but I am in a very small district. I find I enjoy the non nursing part of my job a lot but previous nurses here did not and have moved on. Subbing where you think you may work is an excellent idea if you can make it work. This way you know exactly what your situation will be like. I went from being a SAHM to being the School Nurse and it has been a great transition for me. I love having summers off with my kids and I'm home each day as they get off the bus. It's a great fit for me but I can see where it isn't for everyone.
Nurse ABC said:I feel more like a social worker sometimes. There are more poor children whose parents don't provide what they need than you can imagine so you will have to encourage parents to take their kid to the Dr, get immunizations that are required and then threaten social services or exclusion to get them to do it sometimes. This is very frustrating.You will have many teachers that try to tell you how to do your job. Many will not respect your opinion. Many think you should just do as they say. You have to learn to stand your ground. You are the only medical person and sometimes they just don't get why you freak out over stuff like low blood sugars or a dizzy child that just got hit in the head but they freak out over vomit and lice and don't understand why you don't.
I feel more like a social worker sometimes. There are more poor children whose parents don't provide what they need than you can imagine so you will have to encourage parents to take their kid to the Dr, get immunizations that are required and then threaten social services or exclusion to get them to do it sometimes. This is very frustrating.
You will have many teachers that try to tell you how to do your job. Many will not respect your opinion. Many think you should just do as they say. You have to learn to stand your ground. You are the only medical person and sometimes they just don't get why you freak out over stuff like low blood sugars or a dizzy child that just got hit in the head but they freak out over vomit and lice and don't understand why you don't.
So well said!
Flare, ASN, BSN
I think Nurse ABC summed it up best! Well except for the billing in my case! I don't do billing!!
JenTheSchoolRN, BSN, RN
I don't do billing myself. But I always tell people that most days, I feel like a social worker, but you know what? I love it. My responsibilities are very similar to 100kids and I am exhausted at the end of most days, but I also enjoy getting to know the kids, see them grow and mature, and feel like I actually have an impact to some of them. Plus, I love the hours and set schedule! Sure, the pay is less than the hospital, but never working holidays and having my summer for me is just lovely.
That being said, I agree that Nurse ABC did sum it up best; there are pros and cons to the work. I actually really enjoy the non-treatment (so to speak) parts of my job, but I was an academic administrator in my life before nursing, so that is probably why :).
i LOVE it. For all the reasons others have said. It was a significant pay cut though, which I don't like. I am givena 2.5% raise a year though at least. I had only been a nurse for 6 months when I was hired though, so I hadn't gotten used to making good money at least LOL. Money is tight but I am much happier on a day-to-day basis.
I hate it. I hate the endless peed in the pants and pooped in the pants visitors whose parents never come and they stink up my life. I hate it when every vomit and every headache is treated as an emergency and I am overridden and receive a phone call from the principal to send the child home. Then mom arrives you and tells you what you already know. "She is faking it." And I hate being told to care for people after I have signed off and about to step out of the building and the principal pages me to come back. Hate it.
Spidey's mom, ADN, BSN, RN
I agree that ABC summed it up well.
My personal difficulty is my son is in this school district and I find it hard sometimes to be the mom and the nurse. I always choose "mom" though.
I have many frustrations as a parent with District Zero Tolerance Policies. I have a problem with pulling kids out of class to sit outside the principal's office and miss class instruction time. Most of the time the kids who get in trouble are also kids who are not doing well with academics. Missing instruction time is wrong. Use recess or lunch or after school to address issues.
I have a problem with giving a kid a "major referral" for things that are normal school yard behavior. Yeah, go intervene if there is an argument about the football game or soccer game happening over on the field by the playground but don't throw a "major referral" at kids who are being kids. Don't give a kid a "Major Referral" for turning a cap around on the kid in line in front of him and putting it on backwards.
There are many examples of Zero Tolerance in the news right now. One today is of a Honors High School Senior who drove Dad's car to school. The local Sheriff does random searches of the cars in the parking lot. They chose his dad's car that day. Called the kid out to the parking lot and asked him if there was anything they needed to know about what was in the car. The kid said that his dad used "snuff" so they might find that in the car. As they searched, they came across a knife. Dad is a commercial fisherman. It's a knife used for that. The kid didn't even know it was in the car. Now, this kid has been suspended and all kinds of other unfair things might happen to him. Even though y'all might have read about it.
That's my frustration - that and the teachers and some admins do not give you any credibility when it comes to medical things. You get called for silly stuff too.
I have been a school nurse for 15 years....and I'm growing to dislike it. In my case, it's perhaps because I'm retiring this summer and have begun humming my "'We're not gonna take it" song...
School nurse here for 1.5 years and I love it. Best job I ever had. Former med surg/telemetry RN for 5 years. I enjoy being my own boss, I run the health office, I like the minimal interaction with adults. I mostly talk and see only elementary children all day. My principal is great and so is the office staff. I make a lot of calls and talk to parents, but usually they are quick calls to come pick up your child, etc. Most people (parents and teachers) trust my judgment and don't argue with my decision. My stress level is very low - so different from the hospital which was literally life and death on a daily basis.
I work from 8:15 to 3pm. What's not to like about that? - I am home as soon as my children are. I miss nothing.
Every weekend off, no holidays, no summers. 3 personal days and 10 sick days a year if needed. No mandatory overtime. No patient emergencies at the end of your shift in which you have to stay late to give report/chart/etc.
I look forward to the new school year and then, in June, for that school year to end. There is a sense of accomplishment and completion with each school year. There is a beginning and an end. And then your 8 week reward of summer.
I am never bored. Probably because I work in a busy elementary. I see about 40 kids a day. 5 daily meds. No diabetics. I laugh when I think about my former med passes in the hospital - the grind/stress of pulling 15 meds per patient (3 times a day each patient!) crushing meds, cutting meds, applesauce, waiting for your elderly patient to swallow, insulin, tube feeds, IV fluids, blood trans., 5 patient load, discharges, admissions, rapid responses, codes...My current med pass is a total of 5 meds a day - the kids are so sweet they swallow them in 2 seconds and are then off to lunch.
I have plenty of time to get things done in between seeing students. I put my radio on, enter my immunizations in the computer, do paperwork, organize stuff, do screenings, etc.
I make $47k a year for 35 hours a week. But only 40 weeks a year. I will eventually max out around $80k a year - not too bad!
I have GREAT health and dental benefits.
I will retire with a pension of 80% of my 3 highest years of work. So, around $65k a year every year after I retire. I will retire at 62.
There are PLENTY of opportunities to make more money as a school nurse - you can do camp nursing during the summer, you can do afterschool programs, you can do per diem pediatric home care in the evenings. per diem weekend work, etc. I have my masters now and could be a nursing instructor.
Leaving bedside hospital nursing was a great decision for me and my family. It was a good job to get my "critical care experience". However, it is not worth the $, stress, my health, missing my children, the liability, etc.
Good luck w/your decision.
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