New School Nurse

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I recently accepted a position as a fill in school nurse with the potential to go full-time at the beginning of next school year. I come from a surgical telemetry unit and obviously these two specialties are quite different. Could anyone out there give me some advice on which material to brush up on to better prepare myself for this specialty?

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Start with diabetic care and equipment, Epi-pen administration, asthmatic care, inhalers, nebulizers and spacers. Seizure care plans and how to administer diastat. It’s great that you will have this time before the start of the new school year for the rest of the day to day happenings. Be ware of the politics in your building, and how to deal with parents. And we are always here.

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Skill wise you will be fine. But def look into type 1 diabetic care totally different than type 2. Get familiar with asthma and inhalers equipment etc, epi pens, diastat, and nasal versed emergency meds. Action plans. Your school guidelines when to send a child home. Make sure you have an exclusion chart handy. Know your forms like med dispense. Know the requirements for vision and hearing screening. You will also need to know your states immunization Requirement and your schools exclusion date. And resources to give Family For a child to get vaccines who don’t have a doctor or health insurance. Make a thorough sub folder the sub will appreciate that and may even enjoy and be comfortable subbing at your building. Also learn what part you play in 504 and Ieps. Medicaid billing. ETR forms. Biggest thing is learning how to communicate with parents and even staff. Don’t be afraid to stand your ground. Staff and parents will question your assessment. A lot of time staff and parents think all we do is see sick kids with stomach aches and headaches that are trying to skip class. They do not realize how much more we do and that is only a small percentage of our daily job. It will get aggravating hearing that but just try to ignore it. Don’t be like me when I was a sub and send everyone home who said they vomited in the bathroom or classroom. Call the teacher to see if they vomited in the classroom. Most of the time they didn’t. Also if a student is sick it’s unlikely they made it to the bathroom to get sick. If it’s a student I see often I’ll send them back to class if it is a a student I’ve never seen I call home because it’s certainly possible. Diarrhea is also a tough call call home if your unsure and the student isn’t a frequent flyer. Rashes I hate!!! You will learn to hate lice and it’s lower on your priority list but first on teachers and admins! But anyways You may sometimes feel alone, but you are not you got us and hopefully other nurses in your district or nearby who know what you are going through ? I love this group! Don’t be a stranger!

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That’s great advice! A lot of info, but definitely gives me some direction and a starting point. Thank you! Hopefully I can get the hang of it!

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I just switched to school nursing from ED last year. Will you sub just with particular age groups, or is a unified district with all ages/levels?

On the surface it's much simpler than hospital - healthy young people, lots of ice packs and Tylenol. But, then you dig into other layers of things you never thought about....

*Training laypeople with VASTLY different levels of medical literacy and common sense about everything from VNS magnets to EpiPens (as an ED nurse I had never seen an epipen even though I had given Epi IM and IV many times!)...

*The sexually active 15 year old who replies, when you ask about protection, "don't worry miss, we only do anal" (!)

*Someone has to decide if this pale, shaky kid with a headache is just anxious and tired, or if he has something more serious and needs a higher level of care - and it's YOU, by yourself, without a lab or imaging

*Um wait, what? Wrap an ankle? But the techs do tha - aw, man!!

So I think above advice about study topics is good, but the most important thing is a spirit of adventure, appreciation of the kids, and confidence in your skills. Your hospital experience will serve you well- you know sick vs not-sick. The learning curve is all about policies and personalities, which you really just figure out when you arrive. I hope you love it (I do!)

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Along with the above skills mentioned, brush up on your side-eye look and use of therapeutic silence. Oh and on Wednesdays we wear pink! Welcome!

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Specializes in School Nursing.

Welcome!

ONE OF US! ONE OF US!

I was going to link the textbook above. I just bought a second one so I could have it at home and my office.

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Specializes in Med-surg, school nursing..

Welcome! This forum is the school nurse hangout, lots of friendly people and great information.

That said, if you are starting out as a sub, don't focus on the screenings and immunizations, you shouldn't really be dealing with any of those and it will just stress you out. (BUT, speaking as a sub to full time school nurse who never got trained in how to do ANY paperwork, these are important to know and if you ever have downtime, as your nurse co-workers to walk you through it all.)

Brush up on policies and procedures for things like lice, head injuries, limb injuries, signs of strep or ear infection if you have an otoscope, ASTHMA!! Kids can decompensate fast so you need to recognize the signs of a kiddo in distress. Allergies, seizures.

At first you will want to send every kid home, but pretty soon you'll get better at sifting out the frequent fliers.

Best of luck!

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Specializes in Peds, MS, DIDD, Corrections, HH, LTC, School Nurse.
1 hour ago, BeckyESRN said:

Along with the above skills mentioned, brush up on your side-eye look and use of therapeutic silence. Oh and on Wednesdays we wear pink! Welcome!

I've seen the "pink on Wednesday", what exactly is that?

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Laflaca, I will be subbing for all levels, elementary through high school. Thanks for the advice! ? I’m excited to get started, and I really hope I love it!

11 hours ago, laflaca said:

Will you sub just with particular age groups, or is a unified district with all ages/levels?

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1 hour ago, MHDNURSE said:

If you can swing it, buy this book:

https://www.amazon.com/School-Nursing-Janice-Selekman-DNSc/dp/0803669011/ref=sr_1_3?crid=3EX8YS37XOFXA&keywords=selekman+school+nursing+textbook&qid=1555074271&s=gateway&sprefix=selekam%2Caps%2C136&sr=8-3

By far the best resource out there (after this forum of course ;))

I will definitely check it out! Thanks!

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