Experienced RN afraid to be a solo school nurse

BeckyESRN · Oct 30, 2018

It was absolutely terrifying at first! There is a huge shift that has to happen in your thinking because the setting is so different. Strong assessment and a good BS detector help. This site is fan-freakin-tastic for questions/weird situations/ and just venting. You are the only medical person in the building, but you are not the only medical person these kids will ever see(in most cases). And the majority of our students are healthy, whereas you're used to a very sick population. I vote you sign up to sub in a district and get a feel for it! Oh yeah, and on Wednesdays we wear pink!

loreali12 · Oct 30, 2018

Thank you so much! This makes me feel a bit better. There are a ton of substitute openings in my area, is it possible to do that and also keep my 36hr inpatient hours in the meantime?

ruby_jane, BSN, RN · Oct 30, 2018

I don't know if you could work full-time AND sub. Only you know if it's possible. Also realize that subbing occasionally is different than doing it for reals, much like floating to a floor is different. Sometimes people are extra-nice to you and helpful....but sometimes everyone gets sub-nurse-itis. Subbing would also be good to see which grades you prefer.

pedi_nurse · Oct 30, 2018

Knowing you are the only medical professional in the building can definitely bring out the anxiety in the best of us! However, your training and more importantly, continuing education, really does kick in! I've never seen anaphylaxis, but was able to easily recognize it in a student with no known allergies (and no resp compromise, interestingly enough). Emergencies get your adrenaline running, but it's very similar to my experience with emergencies in the hospital. You do what needs to be done.

Also, something to consider, barring any true emergencies (anaphylaxis, cardiac arrest, etc), most issues that arise are easily managed or handed off... Aside from providing basic treatment, you are predominantly triaging. Stomach ache from eating Takis for lunch? Drink some water on your way back to class. Possible ankle sprain, but patient can ambulate with minimal issues? Ice 20 min, wrap, send to class, call parent to give a heads up. Student with wheezing in all lobes, no medication in the clinic, parent can't be there in less than 15-20min, sats start dropping to 93/94? Call 911. Kid with mild wheezing and good sats, but no meds? Call parent to bring meds and/or monitor kid until symptoms improve. Obviously, these are simplified examples, but you get the idea.

Anyone who dismisses the concern of being the lone nurse in a school of hundreds of people shouldn't be a school nurse. But when you take these things seriously, as you obviously are doing, you will do the work it takes to keep up with your assessment and emergency response skills and provide care to the best of your ability.

JenTheSchoolRN, BSN, RN · Oct 31, 2018

Anyone who dismisses the concern of being the lone nurse in a school of hundreds of people shouldn't be a school nurse. But when you take these things seriously, as you obviously are doing, you will do the work it takes to keep up with your assessment and emergency response skills and provide care to the best of your ability.

This is so true.

I encourage you to sub and get a taste of it. That is how I fell into school nursing (as a new grad, but I am a rare one) - was a sub that basically covered for a nurse on an extended medical leave. It was terrifying the first day I showed up to sub, especially since I got zero training for the job, just a basic show up and this is where stuff is kinda deal. But the office I ended up in staffed two nurses (1300+ kid, middle and elementary school building) and the seasoned nurse there took me under her wing.

I second guess myself still sometimes 6 years in - I think if you don't, you aren't on top of your game. I mean, I learn new stuff from working with students each year, especially with the growing number of medical needs in schools now with inclusive classrooms. But I also feel very confident in my role and can't imagine myself in any other area of nursing.

And this board is the BEST nurses' station ever.

Guests · Oct 31, 2018

Finally! Someone who understands we don't just give out band aids and do lice checks!!! All too often we hear "I am sure I will be bored and lose my skills if I take this school nurse job...". You already have been given some great advice, so ditto what everyone has said. I am in my fourth year as a school nurse after MANY (see my signature below) years of pediatric and community nursing. My first year was really hard, mostly realizing how much I did not know. Not clinically, but administratively. I was constantly having to look stuff up to figure out what the "rules" for my district and state were. It is scary when you realize there is a lot you don't know. I also did not have the good fortune to find this forum my first year. If I had, it would have been very different. All that said, you learn as you practice, and the fact that you recognize the magnitude of the responsibility tells me you will be a safe practitioner :) Good luck! It is an awesome gig!

Flare, ASN, BSN · Oct 31, 2018

It can be a little overwhelming at times especially because we are the only ones here, but as you will find school nurses are very happy to help. Pick up a phone and call a near by school if you are alone in your district and ask a neighboring nurse what they are doing for a policy or jump on this board - as you see we are really active during the school year (summer, not so much!) And if it's something you are not comfortable dropping in threads, you can always shoot one of us a PM. I also vote for dipping a toe in by subbing. You should be able to sustain your regular job and pick up a shift or two a week if you balance your schedule right, but you may have you extend your offer to sub to a few districts to get enough exposure to office work.

OldDude · Oct 31, 2018

As always from this group - advise of the utmost excellence. I love em all like a sister with a few brothers thrown in. Good luck and keep us posted!!

Amethya · Oct 31, 2018

If me, a lowly CMA with only 1 year of experience and suddenly dropped in this job, and has been keeping this job for the last 3 years, can do this. I'm sure you a actually experienced RN, can do this job way better than me.

I would say sub first and see if you like it. If you do, try Districts around after May or June, that's when the nurses that aren't coming back leave and they start looking for new nurses.

beachynurse, ASN, BSN · Oct 31, 2018

I absolutely love being a school nurse! My school division is rather large and I had the opportunity to sub in all levels of schools to see what level I liked the best, and to see how different nurses ran their clinics. I found that subbing was an invaluable experience and gave me great insight about what the job entailed, what I liked, disliked, and how I wanted to run my own clinic once I was able to get one. It certainly can be intimidating at first being on your own, but as long as you have solid nursing experience behind you, and you are independent, you will be just fine! You can always call other nurses in your school district, I love to arrange get togethers with the other high school nurses since our problems and issues are fairly similar we can problem solve together as a group.

nursekoll, BSN, RN · Oct 31, 2018

I started out by dropping to part-time at the hospital and took this position part-time as a school Nurse. I was also hesitant to "give up" my hospital job, it's security, my coworkers. I did both for about 6 months before I really knew that school nursing was my calling! The lack of support departments is a big adjustment as well as figuring out what you can/can't/should/shouldn't be doing as a school nurse in the first year. I was handed a set of keys and told "good luck" by the previous nurse. I took it upon myself to contact my state school nurse consultant for educational training workshops/conferences which was very helpful. I also needed a network of school-nurse colleagues so I contacted several schools in neighboring districts and spent a day shadowing several of them. Those relationships have been vital to me "not feeling so alone in this". I didn't find this group until several years into it, but it is a great sounding-board, as we can learn so much from each other! Good luck with your decision. I know there are old threads on here about the benefits of being a school nurse if you want to search them, it might help you make your decision.