New School Nurse

Posted
by Nicole21191 Nicole21191 (New) New Nurse

I'm going to be a school nurse this year at a school for students with behavior issues. All the students are sent to my school from their home district. It is a fairly new school and I think that the nurse before just worried about daily and PRN meds. The supervisor doesn't have a lot of information as to what I need to have as far as information from the students. I was told that their home districts take care of immunizations and physicals, but I feel uncomfortable just letting that be done by a nurse that doesn't know the students and might be as far as an hour away. I just want to make sure that I don't let any kids fall through the cracks. So what do I need to do to start the year? What forms do I need to send home? What do I need to make sure I get accomplished?

Sorry those are some big questions, but any advice would be welcome! I feel overwhelmed and unprepared. Thank you!

(also, I'm in NY if that effects any laws or practices)

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

so my school, while public gets a population of students sent from outside districts. We have a choice school program in the state, and we're a choice and some are sent here for a specific program. Nobody gets in the gates without me having a complete immunization record. A copy from the sending district will suffice nicely, as long as they are up-to-date. I also require a copy of a recent physical. Again, if the sending district wants to hold the original and send me a copy, i'm fine with that but I need something to establish a baseline. The problem with that is that the state gives a little wiggle room on that and you know what happens if you give someone an inch. I am constantly chasing enrollees down for their physicals. (Not just the OODs either, everyone).

3 minutes ago, Flare said:

so my school, while public gets a population of students sent from outside districts. We have a choice school program in the state, and we're a choice and some are sent here for a specific program. Nobody gets in the gates without me having a complete immunization record. A copy from the sending district will suffice nicely, as long as they are up-to-date. I also require a copy of a recent physical. Again, if the sending district wants to hold the original and send me a copy, i'm fine with that but I need something to establish a baseline. The problem with that is that the state gives a little wiggle room on that and you know what happens if you give someone an inch. I am constantly chasing enrollees down for their physicals. (Not just the OODs either, everyone).

Luckily I only have about 60-70 students, but this is what I was thinking too. If they're from a district where they've never even seen the nurse, I can't just accept that they're going to take care of it. I'll let me supervisor know I'm going to be getting copies of all physicals and immunization records. Thank you!

halohg, RN

Has 25 years experience.

So I’m in NY on the flip side of your scenario. I have the charts on the students who are “out of district”. When I speak to nurses from other facilities sometimes they will call me and confirm records or ask for a copy to be sent to them. Since the medical information I have is part of their educational record there is no issue with HIPPA or FERPA. Nothing needs to be done on day one.

6 hours ago, halohg said:

So I’m in NY on the flip side of your scenario. I have the charts on the students who are “out of district”. When I speak to nurses from other facilities sometimes they will call me and confirm records or ask for a copy to be sent to them. Since the medical information I have is part of their educational record there is no issue with HIPPA or FERPA. Nothing needs to be done on day one.

Thank you, this is helpful! Is there anything you wish “out of district” nurses would or wouldn’t do?

halohg, RN

Has 25 years experience.

47 minutes ago, Nicole21191 said:

Thank you, this is helpful! Is there anything you wish “out of district” nurses would or wouldn’t do?

Not that I can think of but know how grateful I am that this population of students have a caring nurse supporting them. Don’t hesitate to reach out we are on the same team just in different buildings.

Hello,

Career changer here. I have, in midlife, become a nurse. I have 1plus years in the adult psychiatric population. Its walkie-talkie nursing and most patient concerns are passed off until the NP or Doc can see them on first shift when making rounds. I do use clinical judgment for emergency calls to doc, but my population is mostly behavioral and benefits from therapeutic conversation... medical needs are slight, and because it is a controlled environment, there is a little emergency. We have a few diabetics and standing PRN order for the OTCs like Tylenol or Miralax etc.

It is not an autonomous job--- we nurses in psych work as a team.


I have interviewed for a position as a school nurse... my dream, my goal! It is for a SPED school that specializes in transient children, those taken out of district, all IEP, far behind academically, and with ... behavioral issues that border on attitude really. Pysch nursing will be an asset, this is a hands-on school that does restrain for SIB and AB.

I have limited clinical skills. In other words, I have never been that hospital nurse I know my skill set in being a therapeutic ear is spot on, I can de-escalate and I can redirect. I can handle a psych crisis.

But can I "nurse" in this environment? I am terrified that I do not have the skill set to determine the finite aspects of school nursing. Physical assessment, who goes home, who gets a phone call, who gets sent back to class!?? I'm okay with hygeine and sex ed... but without a doc to call or a standing order, how to make the determinations in assessing students seems overwhelming.

My fear is that a school environment, versus a hospital one (on call doc is a blessing! and I guess school nurses do not have this safety net! ) will set me up for failure... I'm excited and I want to do this, and I am confident..... but I also have to know my limits and determine if I have the needed background and skill set.

Supportive, but real advice, please.

bsyrn, ASN, RN

Specializes in Peds, School Nurse, clinical instructor. Has 22 years experience.

It sounds like the experience you have would be very useful in that particular job however you truly do need excellent assessment skills to be a school nurse. Some schools have 2 nurses but most have 1 so you really only have yourself to depend on. I would try to get some hands on nursing experience before you attempt school nursing. The students these days are much more complicated with both physical and mental issues. Good luck 🙂