New School Nurse - how to prepare

SaltineQueen · Dec 20, 2018

What will your duties be as a float? I wonder if you'll have to deal with the paperwork junk or if you'll just be responsible for sick visits while you're there? What ages?

Farawyn · Dec 20, 2018

Hi Everyone,
I will be working as a school nurse after the new year! My time as a hospital float will be coming to an end in the next few weeks - not soon enough either - and I'm excited to have found a position in a division of nursing I've been wanting to give a go. While I've worked with kids and teens quite a bit, I haven't done pediatric nursing except those times I floated to the ER.
I'm sure it's been asked, but what did you do to ready yourself. I'm sure there's a learning curve and some baptism by fire involved, but any advice/help I can hear is great. I've been reading through some threads and must say that you've all made me feel like I am making the right decision.

Welcome. We wear pink on Wednesday.

ruby_jane, BSN, RN · Dec 20, 2018

Welcome! Most of the learning curve is NOT nursing per se - it's how your district "does things." Underlaid with how your principal/admin wants things done.

Get familiar with what the district requires in terms of vaccine compliance - you're hitting at the five-month mark and if you've got kids who are on catch-up, they'll likely be due in January.

Ask the principal what's most important - keeping the kid in school or accommodating parents (you'll have to find a nicer way of saying that....my sugar coat has all fallen off right now).

Remember that this is a lot of PR. And managing expectations. You're a float nurse so you have all kinds of value added to bring to the table.

LikeTheDeadSea, MSN, RN · Dec 20, 2018

Welcome!

One of us! One of us! One of us!

The beauty of a Health Office is that once you're settled, it truly is YOUR office. The person before you may have laid a foundation with the building, so getting over the "well so-and-so did it this way..." is tricky, but sooner than later people will understand how your prefer things and it'll be much smoother.

scuba nurse, BSN, MSN, RN · Dec 20, 2018

WINE! LOTS OF WINE!!!!

BrisketRN, BSN, RN · Dec 20, 2018

Do a little studying up on diabetes (and counting carbs), asthma, and allergies. Check out the NASN back-to-school checklist and the many links it can bring you to. See if the school has a clinic manual or if the district has a manual for clinic policies--if so start skimming through! Good luck!

jess11RN · Dec 20, 2018

Is there another school nurse in your district or local area school nurse that you could ask to "mentor" you during your first year?

Your biggest learning curve will be in regards to state regulations and what paperwork/mandates there are. So, that is where a local nurse can help.

Always remember that we are all here to answer any questions too!!! :)

NutmeggeRN, BSN · Dec 20, 2018

Join your state association!

halohg, RN · Dec 20, 2018

not sure what age group you are tending to, but know when a child says they have chest pains its way different than a hospital assessment and most times they do not even point to their chest. It is a lot of dectective work. I would prep by thinking ahead of what questions I am going to ask for the most frequent type of visits. Other than contusions and abraisions most often are stomach aches and headaches. It is a lot of dectective work as most cases are not intestional blockages and subdermal hematomas but really a rather benign happening and sometimes it's just Math. Also know if the student asked to go to the nurse or were they sent. Many visits are a staff member just wanting documentation or covering their a$$es. In the younger schools there is a lot of politics and teacher involvement so know that will need managing as well as very thick skin. We are here for you and good luck

RatherBHiking, BSN, RN · Dec 20, 2018

Welcome!! :)

I think it's nice if you send an email introducing yourself to your staff and setting some guidelines right away. Things like please send a pass (you can even make some up with name, teacher, reason for visit, etc if needed) for every student visit (trust me it helps a lot), you will be taking your lunch at XX time each day and who will cover (get this set up right away because otherwise you won't get a lunch and no one will care), you will be happy to check blood pressures at XX time each day or certain days (otherwise they just come in willy nilly with a room full of kids and expect to be helped immediately), you will only send kids home for actual vomiting, fever, or suspected infection (that way they know they can't use you to just get problem kids out of their class for vague issues like "not feeling well"-and the kids learn too they need actual real symptoms to be sent home. Of course there are always other circumstances that warrant going home but it sets a basic guideline.) Plus anything else you'd like them to know and sound friendly. Try to be nice and talk to as many teachers/staff as you can regularly. When you establish a relationship with them they will treat you nicer. Eat lunch with them, go to their class to talk to them during their planning period, ask if they have any questions about their students, etc. It goes a long way.

Try not to get mad at the teachers for doing stuff we think is common sense. They don't have a medical background and don't think the way we do. I've learned to just say, if an asthmatic can't quit coughing or complains of needing an inhaler EVEN THOUGH THEY LOOK FINE, send them to me. You would be surprised how much they freak out over silly things like a minor nosebleed and then the serious stuff they are like no big deal they look fine. I had one with an oxygen sat of 88% and yes she LOOKED fine because kids compensate well but if you looked closer you could see her breathing a little harder than normal but to the teacher she just looked out of breath from gym. Same with diabetics, please call me if they are acting sleepy. Yes it's nice they let some kids sleep in class but not this one. Things like that.

I agree reading up on kids with the asthma, allergies, epi pens, diabetes carb counting, as well as ear infections, rashes, pink eye, etc. I found it helpful to have pre made notes made up where I fill in the name and injury that basically say your child was injured at school, how/where, what was done, and that it seemed minor at the time but to follow up with dr if pain/swelling continue or gets worse (for LITTLE injuries). Anything on the head call the parent and any major bruise/cut call the parent. Look at your county protocol/orders for treatments required for kid visits. Learn your med policy and lice policy.

Remember, most of the time there is nothing critical. These are healthy children with minor illnesses and injuries that just need a little TLC to get them through the day or sent home to recover. Don't feel like you have to rush. The pace is slower. Your biggest issues will be with parents or sometimes teachers. The kids themselves are usually easy to work with. If you aren't sure if you should notify a parent of something or not then call. Better to be safe than sorry.

You're starting at a good time of year. All the care plans, emergency care plans, med books, etc have probably already been set up. You will be checking shots with the prek and kg registration coming up in early spring. Don't feel like you have to get everything done in one day. It will be waiting on you the next day and the next... You won't have to worry about the next shift coming on mad you didn't get something done! :)

Oh practice saying no for a while too. When I first started they wanted me to assist with all kinds of stuff that the old nurse did. I kept saying no, I need to figure out my job before I do extra stuff. They weren't mad and now I do pick up extra stuff but don't let them throw it all on you at once. If you are made to say yes because your principal flat out says you have to then ask for someone to help you. Explain you've never had school nurse training and you don't get the training for your job like teachers do or a mentor usually.

You will feel overwhelmed at first and that's normal esp because you won't get much training for the job. However, as long as you get the kids through the day alive you will have had a successful day.

I think you'll be just fine!! Best of luck and we will help you any way we can! :)

Merry Christmas!! :)

EnoughWithTheIce · Dec 20, 2018

Blue_Moon is right on point. Do not try to take on extra stuff until you feel more comfortable with your nursing responsibilities.

Do not let staff and parents try to bully you into doing things their way instead of the correct way. Parents send pills in baggies with no consent forms and ask you to give their 5 year old 6 adult advil, teachers push you into sending kids home with every minor sniffle. To me, this is the toughest part of school nursing. Someone is usually always upset with me and as long as I have the policy or my nurse practice act to back me up - I am ok with being that mean old nurse.