I may hate my School Nursing job...ADVICE, PLEASE?

[RNPediatric18]

I started a job as a School Nurse on October 1 in a local high school, 30 minute commute each way. The kids are sweet, the teachers (that I've met) are nice, and the job isn't bad at all. I knew I would enjoy the busy parts. However, when I took the position I worried about the slow pace.

The high school I am in is only 480 students and I have 5 scheduled students daily; 2 independent diabetics and 3 ADHD meds at lunch. I have two students with epilepsy and quite a few with food allergies. On an average day I see 7-8 additional students for the usual; sore throat, nausea, HA, emesis, etc... Some days more and other days, like today, nothing. Besides this my days have been filled with trying to find busy work; reorganizing, completing CME's, organizing some more, etc...

Even though I am enjoying this job, I'm not sure if it's going to make me feel fulfilled and/or challenged enough. The schedule is going to be amazing with holidays and summers off, I get that...but I can't help but think what I could be doing or providing to people.

History on my past employment: pediatric office for 4 years as an LPN, telemetry/renal/stroke unit in the hospital for 1 year after completing RN school, and most recently 2 1/2 years at a local community services board working primarily with the Pediatric Psychiatrist.

I loved my job there, coworkers, the children, and the doctor I worked with. However, I wanted to be at home more often with my 8 month old daughter. Therefore, I took this position and a $14K pay cut along with it. Yes, money isn't everything but it has weighed heavily on my mind.

Recently, I've found myself looking at the job postings for the local hospitals. I'm not sure why. Today, I found a listing for a night shift position at one of the hospitals on the pediatric unit and cross training in the mother/baby unit. I am contemplating applying for this job but am afraid I am prematurely wanting to jump ship before giving it more time here at the school. But then I also think, when you know..you know.

Sorry for this long post but I just need some guidance and advice on where to go from here. I feel lost and unsure what to do. I don't know how night shift would be with having a family, plus the hospital the position is at is also a 30 minute commute. However, I don't want to be somewhere just because of the amount of time off and not feel like I have a satisfying career.

Thanks for taking the time to read!

[BunnyBunnyBSNRN, ASN, BSN]

School nursing isn't for everyone. If you are looking for someone to say what you should do, I'm not it - except to say, follow your heart. If school nursing isn't for you, then bow out gracefully - you never know, when your daughter starts school, you may want to return to it.

Good luck to you!

[OldDude]

Stay where you are until the little one, or ones, graduate from high school. Then go work nights, weekends, holidays, as much as you want.

[Farawyn]

Immunizations? Screenings? Allergy care plans? Teacher education? AED checks? Sports clearances? Blood drives? Meetings?

Or, just come to my office and do all that for me. I'm woefully behind.

[Eleven011]

You've only been at it a month. I would give it a little more time to see if more opportunities might present themselves. A high school should provide you with ample subjects you could do education on. Maybe you can be a school group leader/helper. Chaperone field trips. Put the word out you are looking for projects. If it's truly not for you, then at least you can say you gave it a fair shot.

[JenTheSchoolRN, BSN, RN]

Immunizations? Screenings? Allergy care plans? Teacher education? AED checks? Sports clearances? Blood drives? Meetings?

Or, just come to my office and do all that for me. I'm woefully behind.

Me too!

I only have 500 kids in 7-12, but I see 30-50 a day! It is a high need population with many, many emotional needs and despite many, many ways I've tried to reduce it, it doesn't happen when my MS teacher turnover is frequent and I start over with a new bunch.

But when I did work briefly in our other school with grades 5 and 6, my day was much slower, so I get your feelings. But now I'd relish some of the that time I had then to get a solid hour or two without interruption to catch up on paperwork, revise/continue to write the health manual, finish screenings...

As someone else up thread said, 1 month isn't a long time. I'd say you will want to give it the school year to experience a full school year cycle. Also, can you get involved in your school outside of your office? I teach health part of the year (mainly sex ed). I do the yearbook (and pick up a nice little extra stipend for it) and I'm lead chaperone on our senior trip to Paris and Barcelona this year. Seeing the kids outside my office actually helps me serve them better in my office.

[Flare, ASN, BSN]

The pace is certainly different than that of a hospital's acute care jive. There is no need to buzz around and "look for trouble" in a school as it will genereally come and find you. Now that being said, in a high school setting the kids are a bit more independent and might not jam up your office with the same things that the rest of us may (needlessly) see such as the irritated eye that needs 5 seconds of rinsing in a sink, vaseline for chapped lips (as most probably carry a chapstick), and the bumps that we see that NEED ICE but take more time to chart than the child actually bothered to apply the ice pack generally are just walked off by that age. It's a blessing in that you aren't getting interrupted but i get it - being slow is also a grag. Once the base paperwork is done, there is a limit to how many times you can go over the same stuff.

Since you are new to the district, maybe you can inquire if there are any tasks or initiatives that you can get yourself involved with. Tread lightly here. This may be misinterpreted and then BOOM, your tasked with doing attendance calls or lunch count. But perhaps there is a student safety council that could use your input or the athletic department and the health office may need to collaborate with sports physicals. Have you determined what state mandated paperwork needs to be submitted and begun preparing for that yet?

And if all else fails and you are still unhappy, then it may be wise to move on. A great schedule does not necessarily trump a paycut and unhappiness on the job, however I find that happiness is what you make of it.

[k1p1ssk, BSN, RN]

With your pedi-psych background in mind, can you connect with the school psychologist or adjustment counselor and see if they would be willing to pull you in on some more difficult cases? Maybe you can give a little extra time/attention to the kids they're the most worried about but may not have time for... i average around 15-20 visits per full day (not counting my regular med kids) in a school of 190, so my day is nicely spread out. See if you can get into the classrooms and introduce yourself. Talk to admin about having a mini health curriculum! Make health-educational displays for your office! The world is your school-nurse oyster with that kind of time :)

I am guessing because you are new, you might not even realize what you "should" be doing. There are screenings (entire school body), immunizations, etc., etc., etc. Can you teach? So many ways to be busy. I live for the quiet days.

[Amethya]

Work at a school of 533, K-8. I'm sure you can find what to do, especially screenings and immunizations. How much you bet that there's some that are non-compliant right now? Then you have the medications and after that, well I would recommend what others said, teaching a class, doing other paperwork, helping the counselors.

[pedi_nurse]

It definitely is a different pace and role! I agree with some of the others - give it a little more time. If you aren't feeling like you have enough to do, I'd suggest looking into your state laws and ensuring your school is compliant with them (when I worked at a small-ish district, this was an issue despite having a health services director). I'd also recommend looking for other avenues to provide care to your students, such as:

- give talks on various topics,

- follow up on your student's health history,

- see if you can contribute to mental health awareness or even see what you could do to screen your students,

- educate seniors on navigating the medical system (can be really tricky if they aren't on mom and dad's insurance),

- talk about dating violence,

- put together an emergency response team in your school,

- make sure you have UDCAs trained,

- promote wellness among staff,

- in Texas we don't require all teachers to be CPR certified so one of my goals is to promote CPR certification among ALL my teachers,

- host a community health fair

Point is, there is a TON of potential for community health promotion in this role and with your slower clinic, you actually might have the opportunity to do some of those things that many of us wish we could do. That being said, if the role isn't for you that's no big deal! I will add however, that while it didn't seem like a huge time increaser when my daughter was 2 and in day care, now that she is in actual school, it's the perfect role (aside from something part time - my dream! lol).

[Workitinurfava, BSN, RN]

You may either be bored to death or frazzled to death. Pick the lesser of the two evils. Stay at the school.