Love working with children, should I choose school nurse?

[sourapril]

This is actually for my little sister, who has one more year in nursing school. She loves working with children and wants to be a pediatric nurse at a hospital. But since it's so hard to get a job nowadays for new grads, I was wondering if she should also seek out the school nurse path. Do school nurses get paid about the same rate? Would her classmates look down on her. You know how someone who work at ICU look down on med-surg? Any advices?

[DCtraumarn]

School nursing is a lot of "social work" nursing. I have two close friends who are NP's and they job shared at two schools. Their experiences were quite different from hospital/inpatient peds. They had to deal with issues relating to kids on meds, kids not getting fed or needing dental work, issues with helping families with no resources cope with illness or disabilities. They were salaried but school districts don't pay as well as other facilities, but you do get generous time off and they both worked at the hospital as prn RN's. My only experience with peds is Burn since all Burns came to our Burn unit regardless of age. This allowed us to maintain our Level One Trauma/Burn Adults&Peds certification.

[sourapril]

She eventually wants to be a NP. Would school nursing give her enough experience? Also, do they generally get paid less?

[DCtraumarn]

Yes - she could become a pediatric NP (this is one of the NP tracks) with prescriptive authority. School Districts are under tremendous budget contraints and salaries are lower than private sector, but she could supplement her income with other work.

In the BSN program there is actual an option for school nursing - I think it requires some additional course work. She should also see if she can do a clinical at a local school district. That was one of our community clinical sites as both undergrad and at grad level.

[mustlovepoodles, RN]

As a new grad she really needs to hone her critical thinking skills *before* she tries going into solo practice,which is what school nursing is. Not that she couldn't do it, but it will be a REAL steep learning curve. You have to be very comfortable with your assessment skills, have a very firm grasp of child development, be able to manage difficult parents & staff, and you must function completely independently in a non-medical environment. In case of an emergency, it's just you and your bandaids. Can she do that as a new grad? I dont' know. I've been a nurse for 34 years, 25yrs in peds. There is NO WAY I could have done this job effectively as a new grad. I simply didn't have enough life experience, let along nursing experience. I use every bit of my previous hospital experience and nursing education in my job.

My suggestion for your sister is to get as much critical hospital experience as possible, especially if she wants to be an NP. School nursing is great, but she will lose skills pretty quickly. Perhaps she can do an internship in pediatrics. It's a hard specialty to get into, at least is some parts of the country. But she needs to get her foot in the door.

[sourapril]

My suggestion for your sister is to get as much critical hospital experience as possible, especially if she wants to be an NP. School nursing is great, but she will lose skills pretty quickly. Perhaps she can do an internship in pediatrics. It's a hard specialty to get into, at least is some parts of the country. But she needs to get her foot in the door.

Thanks for all your wonderful suggestions but I am a little confused about what you said. It sounds like school nursing is something a new grad should avoid because it requires so much independent judgment. But what you mean by "she will lose skills pretty quickly?" Does she not get to practice all the skills she learns from school as a school nurse? If she does school nursing for a few years, is it hard to get back to be a hospital nurse? Would no one wants to hire her? Sometimes I hear people saying that if you do LTC for too long, that's all you can do for the rest of your career. Sorry, I am just not familiar with the specialty.

[delilas]

School nursing is far harder to get into than hospital nursing, as far as I've seen. That being said, the two school nurses I know (one took 9 years to get a school nurse job, the other 4 years) are very happy in their jobs. And it is true what Poodles said about losing your skills - School Nurses are often very limited in what they can do because the school is carrying the liability, not a medical institution. For example, one of my friends can't even place a bandaid on her student - she has to hand it to them.

You aren't going to be running IVs and cathing patients and doing wound care and full assessment as a School Nurse - your primary responsibilities, depending on the school you work in, is eye and ear exams, lice exams, taking temperatures, and taking care of minor pains and sprains. Anything moderately serious sends a child home. It's rare to perform high or even moderate level nursing at a school, and those skills you don't use are very easy to lose.

If there is a children's hospital nearby, there will be a long range of different positions. If she's going for RN, she may rotate through it. Tell her to put on her game face and work it - two girls in my RN class got hired on as a result of their clinicals. If she's great with working with children, there are more than enough very sick kids that could use a caring nurse.

[mustlovepoodles, RN]

Thanks for all your wonderful suggestions but I am a little confused about what you said. It sounds like school nursing is something a new grad should avoid because it requires so much independent judgment. But what you mean by "she will lose skills pretty quickly?" Does she not get to practice all the skills she learns from school as a school nurse? If she does school nursing for a few years, is it hard to get back to be a hospital nurse? Would no one wants to hire her? Sometimes I hear people saying that if you do LTC for too long, that's all you can do for the rest of your career. Sorry, I am just not familiar with the specialty.

Delilas summed it up pretty well. Working as a school nurse is very different from working in acute care. As a school nurse my job is primarily to keep children healthy and safe and IN SCHOOL. I have to recognize emergencies when I see them, but 95% of my nursing is simple assessment, giving ADHD drugs, managing minor injuries and illnesses. I know for a fact that I have lost skills. I have not started an IV on a child in about 15 years. I have almost no knowlege of chemotherapy protocals. There is a lot of technology in use in acute care settings that werent even invented when I last worked in a hospital. I daresay that if I tried to go back to acute care i would HAVE to take a refresher course. No question. On the other hand, I am in a place in my own life where I don't want or need to work in acute care. My nursing is largely cerebral. I rely on past experiences and education to bring appropriate care to my young students and their families. I know that what I do is very important to the families whom I serve and that's why Im a school nurse.(*it's definitely not the money! I could probably make as much working as a nanny)