High School - School RN advice

[JG1977]

Hello and a big thank you to you fellow school RNs out there. I had asked for help/encouragement while interviewing for a school RN job and I did end up getting it! I took your words to heart and it was much appreciated. I worked both my clinic job and the high school job for a while, but I can't physically do both and then take care of my family. Therefore, I am only at the high school now.

Here is my question - What would be your best little nugget of advice? I mainly have specialty adult experience, so this is all brand new to me. I see a TON of kiddos daily and at least one emergency a day (large school). I am also a bit rusty when it comes to the type 1 diabetics. Any solid helpful advice would be much appreciated.

Thank you in advance!

[OldDude]

I'm not a high school nurse but if I was ever forced to be one I'd treat them, physically, all like adults with no past medical problems; generally. Then I'd understand they are emotionally immature and hormone charged along with the general rebellious attitude. Assume they are telling you half the truth most of the time.

Then I'd put in my application to be a deckhand on a crab fishing boat on the Bering Sea or a semen extractor at a turkey farm or some other job I'd rather do than be a high school nurse. Thank you for what you do!

[JG1977]

HA!!! Thank you for the laugh. I actually like working with the teens (minus the 'half truths' and the dramatic entrances). For the most part the kiddos are actually pretty respectful and the set up is much more than I had expected. There's just a lot of them!!!

[River Song, RN]

Then I'd put in my application to be a deckhand on a crab fishing boat on the Bering Sea or a semen extractor at a turkey farm or some other job I'd rather do than be a high school nurse. Thank you for what you do!

I am laughing out loud because semen extractor actually IS a job. A good friend who is now a highly respected genetic scientist told me about having to "collect semen" at the pig farm when she was a grad student. I assumed it was more a transporting gig .... nope the lowest grad student on the totem pole MANUALLY collected the sperm. What a way do earn your free tuition and stipend í ½í¸±

[JenTheSchoolRN, BSN, RN]

I work with grades 7-12 and I love the HS kids. You can reason with them. My rule of thumb in my office with them is honesty. I'm honest and expect the same. I'm a pretty "tell it like it is" person and I found both MS and HS kids respond well to it. Of course, my urban population of students also loves sarcasm and responds well to it as well, so read the room on your students.

One thing I will say about type 1 diabetes in HS: they can be very self-sufficient or they can be very non-compliant. The non-compliant ones I've seen typically are stressed out about school work and other factors and their diabetes falls lower in the ranking of their life. This can be frustrating, for the school nurse, for the parents, for the students. If you need a refresher, look into PD by you. I'm not sure what state you are in, but if you happen to be in urban area like I am, one of our diabetes centers offers a great day PD on Saturdays especially for school nurses. Also, ask the kids - the ones that are very self-sufficient have taught me so many things. I had more than one student attend diabetes camp and I ask them to teach me what new things they learned.

[SaltineQueen]

I don't have HS kiddos (not even in my home yet) so I'm not much help there. But I would be like JentheschoolRN about honesty. Heck, I've had that with some of my little kiddos when I can tell or find out they're BS-ing me.

As far as diabetes goes... Maybe connect with the diabetes educator at the local hospital & see if s/he would sit down with you for a chat. Or check your state Dept of Ed website to see if there's a student health section. In my state, we have loads of educational material for school nurses. There's also NASN.

[JG1977]

This is great info, thanks!!!

I am laughing out loud because semen extractor actually IS a job. A good friend who is now a highly respected genetic scientist told me about having to "collect semen" at the pig farm when she was a grad student. I assumed it was more a transporting gig .... nope the lowest grad student on the totem pole MANUALLY collected the sperm. What a way do earn your free tuition and stipend ������

There used to be a TV show called "Dirty Jobs" and one of the episodes was them showing them collecting semen from horses to artificially inseminate mares. The guy looked so embarrassed and uncomfortable. I have to admit, I was a little uncomfortable watching too, I mean I know they were just horses but still...

What specific questions about Type 1 Diabetes do you have? I am assuming you have the student's Diabetes Medical Management Plan, updated orders from his MD for his glucagon, etc.?

[Farawyn]

What Jen said. Be straight with me, and I'll be straight with you. Working with the HS kids comes naturally to me. I like them, and they like me. I do baby occasionally. Sometimes a 10 minute break, no cell phone, on the heating pad can make all the difference in a kid's day, it really can.

My advice is to follow your gut.

[ruby_jane, BSN, RN]

This is the best age! You can reason with them and they don't throw up on your shoes. They will Google their symptoms and come in with a diagnosis -- No, sweet pea, you don't have a kidney stone, you're just a little dehydrated!

You will need to become an excellent historian. Because I see a lot of weird stuff and I find out if I've stopped asking questions too soon I'll call a parent and the parent will reveal the bit of info that the student did not see fit to mention. Much like adults!

"Has this happened before?" "Is there anything else you can tell me?" "Is there anything else you can think of that might be causing this?" These questions will be your friends.

Also don't underestimate how stressed out they are. Two-thirds of my kids are tightly wound and on a college track. Every little thing that gets in the way looks like a mountain rather than a pebble.

Don't let yourself be keeper of the clothing for dress code issues. This year I told the administration that the clothes I have are only for kids with nosebleeds, stained pants, etc. Not the kids who wear jammies to school.

Finally, set up rules and be consistent. My biggest is - if you're breathing and not bleeding out, you need a pass to be in the clinic. Because they figured out that if they duck in at the last minute during passing period they'd maybe avoid a tardy.

[GdBSN, RN]

Welcome, HS kids can be the greatest to work with, but yes they can be great fakers as well. I will see a student in the hall laughing and joking with their friends, and the second they hit my door, they look like they are "dying." I like this age group because you can somewhat talk to them like adults, educate them on how to take care of themselves, and some even get it.

If you are a member of NASN (which I recommend, because of the info and CNEs for school nurses), there is a course on diabetes management in schools. Always read the school packet sent by the doctor, know your insulin dosages and how to calculate the CF. Never hesitate to call the doctor for clarification or to address concerns of trending BS levels. Most of my students with diabetes are self-carry, and they will come to the clinic when they are not feeling well. I always try to educate on healthy food choices and self care.

Good luck, and never hesitate to ask questions on this board. We are all here to support each other.