New job, really need advice:)

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Hi,

I am a RN/BSN & just started a job at a private school that is 1st-12th grade (800 students). Part of my job is to teach 4 classes a day in high-school sciences. I am feeling totally overwhelmed with being a new school nurse & teaching 4 advanced sciences. When I spoke with the principal about my feelings, she said that basically I was making the nursing role more than it should be & I should just use the time I have to pass meds, check immunization records, & be on call for emergencies. I feel like there is alot that I should be doing besides that based on my state's school nurse practice, but I'm not sure what applies for private schools? We have 6 diabetics, dozens of kids with epi-pens & a myriad of other issues that I feel I'm not able to monitor since I'm in the classroom most of the day. Has anyone every been in a similar situation? Is there anywhere I can find rules for private school nurses? My main concern is my liability of something does go wrong while I'm in the classroom.

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Specializes in school nursing.

Sounds like they want a 2 for 1 special to save money! Nurse to 800 kids IS a full time job. 6 diabetics ALONE will take up a lot of your time. Do you have an aide trained to cover for you in the clinic while you are teaching? Or, are you going to be pulled from class to handle minor problems?

What did the nurse prior to you do? how did she schedule her day?

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So far, I've only had to leave class once in the week since school started. My classes are all around my "scheduled" meds, but prn OTC meds can be handled by my medication assistant (the secretary). Minor issues are supposed to be handled by the front office while I'm in class.

The nurse prior to me left because she felt her license was in danger with so much time away from the nurses' office. I didn't know about that before I took the job. She also had fewer classes than I do.

My major issue not knowing what is required of me by the law, since it's a private school. I'm being told to let everything except meds & emergencies go, but I think that leaves me open to lawsuits. So far, I haven't eaten lunch there bc I haven't been able to stop long enough too. I've lost 7 lbs in the first week from not eating & stress. I am a little bitter, because 5 classes is considered "full-time" instructional staff for the high-school (where I teach), & I have 4 classes plus the nursing role. Everyone else seems happy & relaxed & I feel like I'm one step away from a stroke!

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Specializes in School Nursing, Public Health, Home Care.

I know this doesn't answer your immediate question, but are you licensed to teach?

I think many of us do "guest speaker" gigs in classrooms, but an actual class?

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Specializes in school nursing.

Just my 2 cents. When I am in the middle of a "school nurse dilemma" I ask myself this question - How would i handle this situation if I still worked on the floor of a hospital. That being said. If i worked at the hospital and I was told to forget about doing everything except pass meds and emergencies and that I would be away from the floor for 4 hours / daily to do a completely different job.......I would run as fast and as far away as possible!!!!

A nurse is a nurse is a nurse. I really believe what your principal is asking of you is beyond his scope to decide. Many times in my career as a school nurse have I had to speak up and explain the Nurse Practice Act to non-medical personnel.

What state are you in?

RED FLAG - the nurse before you left because of fear of her license and she had fewer classes to teach????????????????????????????? Wow! Just my 2 cents again - run, run, run!!!!!!

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No, I'm not licensed to teach. In the private school I work at the accrediting body just says that you have to have at least 80% of your instructional staff be licensed teachers. I can teach the sciences I teach because of my bachelor's in that field.

I tried to talk to my principal again today & was told that they rules that the board of nursing provides for school nurses don't apply because of our private school status, but I know they do & am making sure that I follow all of them. This takes all of my time & I even work on it at home, when I should be with my children.

Yes, the previous nurse leaving because of licensing fears is certainly a red flag. Unfortunately, I didn't know this before I started & wouldn't have taken to job had I known. The teaching was presented as 1 class at first, then by the end of the interview process (4 interviews) it had grown to 4. I realize in a private school they try to get as much as they can from each employee & nursing isn't seen as a full-time job. I think they barely see it as a part-time job.

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Specializes in Maternal - Child Health.

Perhaps you can PM Martha Bergren for advice.

But as I understand it, BON mandates apply to all nurses in all settings. Your school isn't exempt because of its private status.

As for state legislation pertaining to school health, there may be some difference between public and private schools in this area.

Your principal is displaying a disregard for state law, BON oversight, the health and educational welfare of your students and your professional, moral and legal obligations to your students.

If something untoward were to happen, I have a feeling he'd throw you under the bus. I would get on that bus and get out of the way before he has a chance.

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Specializes in School Nursing.
If something untoward were to happen, I have a feeling he'd throw you under the bus.

Yeah he would. In a hot second.

Is there a state School Nurse Consultant you could ask for advice?

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Specializes in Med-Surg; Telemetry; School Nurse pk-8.

RUN!!!!

Seriously, your BON expects you to practice within your state's guidelines. A private school can not change how you practice to suit their needs. Check your state laws and contact your BON directly so you CYA. Also, many private schools receive their funding for a school nurse through grant money. This grant usually specifies the requirements the nurse must meet. For example, although I work for a private parochial school, the funding comes through the public school district. This means I must have the same qualifications and must work under the same standards as my counter-parts in the public schools. Not a bad thing!!

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Thanks to everyone for their advice! I have spoken with my principal & they are keeping the kids from coming to my office for the first hour of the day (unless it's an emergency) to allow me a little extra time to work on paperwork/immunizations/screenings. I am closely following the BON guidelines & documenting everything:) This job is not at all what I was hoping for & this will probably be the last year that I work here unless they were to take some of my classes from me. I have WAY too much to do to teach 4 hours a day on top of everything else!!!

I also made contact with a school nurse that is an expert in the private school nursing field & she has sent me a lot of great information. I'm so thankful for all of your advice & help!

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what state are you in? One of my dream jobs would be being a school nurse but also getting to teach a science or health class; however 4 is ridiculous! Regular teachers teach that many! Here you need a Master's to teach though, so I think I would need my Master's to become a school nurse-teacher (a new title here where an RN gets her teaching certification).

I feel like the school is trying to get another teacher without paying for one. I hope it gets easier for you

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So if the normal load is 5 classes and you are teaching 4, you are only a .2 school nurse. The recommended ratio is 1 FTE RN:750 , so the school nurse job is already a full time role with 800 students. So your prorated ratio is 1:4000

Definitely contact your state school nurse consultant. http://www.nassnc.org/?q=node/26

You especially need to find out if you are even allowed to delegate meds in your state to an unlicesened person.

You of course are right that the BON regulations and the Nurse Practice Act certainly apply no matter what the setting.

NASN has a special interest group and listserv just for private school nurses:

http://www.nasn.org/Home/EngageandConnect

You would also want to check your state association for private school colleagues:

http://www.nasn.org/AboutNASN/NASNAffiliatesChapters

Why are you feeling obligated to stay all year at risk your health and your license?

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