Freaking out

[Nursemomo3816]

I just took a job as a school nurse, mainly for the better schedule while my son is young. I honestly didn’t know the extent of what I signed up for. I have five schools - 4 elementary and 1 middle school. I have 8 diabetics, countless other SAR, seizure and asthma kids. I probably have over 4,000 kids. I have 4 part time health assistants, they are not trained by me and have a different employer, so they are very territorial of the health rooms. I don’t have a preceptor and only had 3 days of orientation offsite in a classroom. I honestly don’t know what to do. I’m beyond overwhelmed and school hasn’t even started yet. I’m supposed to train 6 uninterested busy secretaries to give emergency meds and insulin. I want to quit! I don’t want to be a jerk by quitting the day before school starts, but this is insane to me. Any advice is appreciated.

[LikeTheDeadSea, MSN, RN]

Firstly, welcome to the School Nurse forum! ONE OF US! ONE OF US! ?

Secondly, holey moley! Many states ratio school nurses 1:1500, and that is regularly us being pushed to our limits. That you would be expected for 4k with non-nursing assistants sounds impossible to me. I come from a state/area that does not utilize unlicensed personal for Diabetic care.

What state are you in? That information can help us give advice!

[Nursemomo3816]

Thank you! Im in Oregon ?

["nursy", RN]

It sounds kind of crazy...but, take a deep breath. I'm assuming SOMETHING was in place before you got there...the HAs must have some kind of routine, so you need to make them your best friends. You mentioned the HAs are territorial, but most people are territorial when they feel threatened, and a new boss/supervisor tends to feel threatening (fear of the unknown). So, use them as resources, start out gently, get to know the routine, or at least what the priorities are. Once you've figured out the basics, you can reorganize as needed. As far as teaching uninterested, busy secretaries, you need to have the principals on board, because they answer to the principal, not to you. It shouldn't be too hard to make the principal understand that a child dying on school grounds from anaphylaxis or hypoglycemia is not exactly what they want to have to answer for.

[Nursemomo3816]

Unfortunately I am not the HAs supervisor. It makes for a difficult dynamic. I’ve come in smiling and friendly. The HAs are employed by the school district and I’m contracted out from the county. It very strange. I’m kinda looked at as a visitor. I honestly don’t feel like it is a safe system. I think I need to quit. I feel like throwing up every morning. I feel terrible leaving right before school starts though.

["nursy", RN]

Are there other nurses in the county that you can talk to? Your supervisor? A job description? Somebody has to know something about the job....if you talk to your supervisor and let them know how overwhelmed you feel, they should be able to give you some guidance.

[TriciaJ, RN]

On 8/28/2019 at 7:09 AM, Nursemomo3816 said:

Thank you! Im in Oregon ?

? Thank you for giving me another reason for being glad not to have kids. To think that's the school system I would have had to send them to.

*Off-topic rant over. Carry on.

On 8/28/2019 at 9:35 AM, Nursemomo3816 said:

I’m supposed to train 6 uninterested busy secretaries to give emergency meds and insulin

Am I reading this correctly? That in Oregon you are allowed to administer INSULIN to a student if you are not a nurse? I know my state MA is super strict, but I find it scary that an unlicensed person can give a medication that can easily be given incorrectly. In my district where I work, 99% of the medication errors are with insulin and only nurses are giving it. Scary stuff.

It sounds like a very overwhelming and potentially dangerous situation they have you in- not the norm in most states. I am sorry that your first introduction to school nursing is this situation. It really can be (and usually is) a wonderful specialty.

[CanIcallmymom, BSN, RN]

1 hour ago, MHDNURSE said:

Am I reading this correctly? That in Oregon you are allowed to administer INSULIN to a student if you are not a nurse? I know my state MA is super strict, but I find it scary that an unlicensed person can give a medication that can easily be given incorrectly. In my district where I work, 99% of the medication errors are with insulin and only nurses are giving it. Scary stuff.

It sounds like a very overwhelming and potentially dangerous situation they have you in- not the norm in most states. I am sorry that your first introduction to school nursing is this situation. It really can be (and usually is) a wonderful specialty.

They can give it in TX too. I had to also train secretaries and backup, as I do not have a "nurse" sub.

[Nursemomo3816]

I am not comfortable with one secretary giving 6 kids insulin at lunch. I feel like it is easy to make a mistake with one kid let alone 6. I haven’t even looked at the kids with siezures, SARS or other issues. I gave my notice today.

12 hours ago, Nursemomo3816 said:

I am not comfortable with one secretary giving 6 kids insulin at lunch. I feel like it is easy to make a mistake with one kid let alone 6. I haven’t even looked at the kids with siezures, SARS or other issues. I gave my notice today.

Good for you! What did they say? Did you tell them why? They won't be able to keep a nurse (at least not one who cares about keeping her RN license) if they don't make some changes.

17 hours ago, CanIcallmymom said:

They can give it in TX too. I had to also train secretaries and backup, as I do not have a "nurse" sub.

That is so scary to me. Maybe Massachusetts has just brainwashed me into thinking only a RN is competent enough to draw up and inject insulin and glucagon in an emergency (in schools anyway). I realize in the real world, parents, babysitters, etc. might give both of the things, but in a school, it is all on the nurse and anything that goes wrong falls back on the nurse.