Going from school nursing into hospital nursing??

[WDW1971]

I graduated with a BSN in 1995 and went straight into a position as a school nurse in Dallas. School nursing was something that I had wanted to do since I had started nursing school.

Over a period of 7 years I worked for 3 different school districts, and I loved my 2nd job which was in a terrific high school. My husband and I moved in 1999, and my most recent full-time job was in a 4th-6th grade school. After 3 years of working there full-time, I grew quite bored with the common needs of elementary school age children (mostly "boo-boo" care). I resigned from full-time work 3 years ago. For the last 3 years I have been occasionally substituting and volunteering for the nurses in the school district where I used to work. The problem with substituting for school districts is that it only pays around $80 a day - less than half of what I was making full-time. I still have a place for school nursing in my heart, and if I could find a job-share situation or a full-time high school position I might decide to re-enter that profession. But I was so bored sitting in an elementary school clinic for 3 years, even on busy days.

After 10 years I am still trying to decide if nursing was even the right career choice for me. In some ways I feel like such a failure because since graduating from nursing school, I have never really learned to do the things that people tend to think all nurses can do. I am mostly talking about some of the hands-on skills that I never needed to use in the school setting, and never really learned to do in BSN school. I think I might actually enjoy the faster pace of hospital work, and also the flexibility of scheduling. But because I never developed some of the basic hands-on nursing skills, I am petrified of going back into the hospitals 10 years after graduating from a nursing school that was VERY theory-based. No offense to LVNs, but I kind of feel like I need to go to LVN school first .

I am just curious to hear from other nurses. Has anyone ever been in this situation, or seen another nurse go from years of non-hospital work into the hospital setting? Especially someone who never really had much hands-on hospital experience to begin with?

[suzanne4, RN]

You can either go thru a refresher course or make sure that they give you a very thorough orientation.

[RosesrReder, BSN, MSN, RN]

Sound like you want a change in your career to get out of the monotomy. I think that maybe you could take a refresher course as mentioned above and then give it a try in a hospital to see if you want to do it, also you can try a LTC facility. Best of luck to you :)

[Jolie, BSN]

I have a different perspective on your situation. While I am sure that your "hands-on" clinical skills are rusty, I don't agree that you need a (lengthy, expensive) refresher course. They are intended for nurses who have been out of practice for a time, which you have not.

Your practice in the school setting is just as valid as another nurse's hospital, clinic, LTC, or homecare experience. You assessed your clients, utilized the nursing process, evaluated the outcomes, interacted with parents and other professionals, participated in client and community education, and worked independently, without the luxury of having colleagues on hand for support. You have most definitely been actively engaged in nursing care.

Any new employer has the responsibility of ensuring that you obtain the necessary clinical skills and practice experience necessary for your new setting. That can be accomplished by participating in a thorough orientation, attending relevant conferences, etc.

When you interview, emphasize the strengths you have gained by working in a unique setting, and inquire as to what educational opportunities will be offered to you. Good luck!

[bergren]

I agree with Jolie

I have alternated between school nursing and acute peds nursing after each relocation over the years. I am always apprehensive at first returning to the hospital, but each time I aclimate much faster than I'd have anticipated.

Your experiences and skills gained in assessment are quite valuable. You are overvaluing the skills gained the first few months on the job that BSN students are often so concerned about. In polling graduates, they are very confident of these psychomotor skills 6 months after graduation and are amused at how much they obsessed about them while in the program.

Take a refresher if it puts your mind at ease, but I also do not think you need it if you are hired by an institution that can adapt an orientation to your learning needs. Most excellent acute settings have extensive orientations and I think you should give yourself the opportunity to explore this other side of nursing. What is the worst that could happen? If you hate it, quit!

[WDW1971]

Thanks for the advice and encouragement, everyone :). I guess it's the fact that it's been 10 years since I graduated combined with the fact that I never did any hospital work after school that has me concerned. But you are right in that I developed valuable skills as a school nurse that I tend to forget about (e.g. assessment skills, communication skills, computer skills). Now I just need a place willing to work with me on the hands-on stuff. But it is still scary.

I called a local college here in Fort Worth about a refresher course they offer, but they are not offering it again until the spring. So it's time to start calling around to some facilities and hitting some job fairs.

Krista

[CrunchRN, ADN, RN]

Krista - TCC starts 8/2/05 - I have the info. PM me if you want me to fax it to you. I went straight to clinic work after graduating and never started an IV or drew blood. Have done lot's of assessment, injections, teaching, and on and on. I feel exactly as you do and had hoped to take the course, but my job is too busy right now. I have all the paperwork and phone #'s so let me know if you want them.Kim.

[nursenatalie, ADN, RN]

I definately recommend a refresher course. It might be different depending on what area of acute care you go to. We had a nurse come to our surgical floor after being a school nurse and even after 6 weeks of orientation she could not manage 3 patients. While I think it is great for you to try another area of nursing, I think you need to take some of the responsibility in preparing yourself for that change and dont expect to get it all from orientation.

[shammy]

I actually took that refresher course.... It was good but it is to get you thinking like a nurse again. Nursing process... assessment, planning, implementation, evaluation. There was some hands on but that is really stuff that is quick to pick up if you know that theory behind what you are doing. And there was a small clinical portion.

There is also M&M in Arlington that has a refresher course (didn't take it but am familiar with it) and it is the same sort of theory base.

Another option to get the hands on.... would be to go to any of the hospitals (Baylor, or Harris have formal programs for medsurg, but Plaza worked something similiar out for me) to gain confidence with skills. If the hospital you want to work at doesn't have a formal program make a plan with the NM on the unit.

Just wanted to share my 2cents.

[WDW1971]

Kim - Thank you. But are you talking about the continuing education nurse refresher course RNSG 1006? I called TCC yesterday to ask about it because it wasn't listed on the schedule. I had to leave a message, but someone from the nursing school (I think) called me back and left me a message. She told me that it isn't being offered this fall, that they are going to revamp it, and that it will be offered in the spring. She said to call her back in about a month and a half if I am still interested in the class.

One thing I don't want to end up doing is sitting in a classroom learning about the nursing process . Nothing against the nursing process, but it is definitely not what I need refreshing on.

[CrunchRN, ADN, RN]

Wow it sure is - I talked with them a month ago and they were raring to go 8/2/05. The other poster is right - if it is mostly theory that would be a waste. You just need med review and hands on. Try the hospitals. Let us know how it goes. GO FOR IT!

[CrunchRN, ADN, RN]

1 more thing - JPH has a 3 day IV certification class for $200.00 - I have a message for them to let me know when it is. That would probably help a lot. I am thinking of taking it. It will probably be mostly LPN's, but hey, I need to learn too!