New school nurse!

[Palmtreeparadise]

Hi to all the school nurses! I'm new to school nursing (elementary). Been a nurse 18 years. So far love the kiddos, but feel overwhelmed. Whole different environment. You are truly solo. I knew I would be, but nervous about the responsibility in an emergency. Question....do you feel more comfortable after time? I've never done ER/trauma. I have only worked a couple codes in the hospital. I have gone over and over in my head responding to different emergencies and have read over steps in different triage situations. Thoughts? 

[k1p1ssk, BSN, RN]

Until you face every scenario, you won't be fully prepared, so in a way, the feeling doesn't quite go away, but yes, it gets better! For me, the nerves were/are more about how others would respond/help, etc, rather than questions of what am I going to do. I have imposter syndrome and so I come away from every situation wondering what I could have done to prevent it from happening - most often, I come to the realization that we cannot wrap these kids in bubble wrap and accidents happen.

One thing to keep in mind is that you are just managing the situation until EMS arrives, then they take over. So as long as you feel confident in your skills and know when to use them, and feel confident in directing others, you will do great! 

We have a common phrase on this board - "You will never regret calling EMS, but you may regret not calling." 

And this of this space as your breakroom! We all try to support each other, so come often and read all of the threads that come up - you'll feel more at ease as you see that we all struggle with the same types of challenges!

 

[Palmtreeparadise]

Thank you for your response. Yes, this seems like a great support group. I have been reading alot of the threads. I also have imposter syndrome. You would think after 18 years I would get over it! I have a hard time realizing things just happen and could not be prevented (I did not miss anything). I do respond appropriately in emergencies, but everyone looking towards me makes me very nervous! So being solo and imposter syndrome should be a great combo 🤣. 

[beachynurse, ASN, BSN]

I've worked in a high school for 20 years now, and I remember starting out as a new school nurse. My first year was in an elementary before moving to high school, and I don't regret it. I will tell you that if you've never worked as a school nurse before, it will take a couple of years for you to feel totally comfortable in your role. It's so much harder getting yourself together when you are working alone, but once you have yourself set up, it's so easy to keep things rolling year after year and it becomes almost automatic. 

Emergency situations, well, they do happen, and we just need to keep the student safe until EMS arrives. Then they take over responsibility for the student. 

I didn't realize the responsibility of being a school nurse until about 3 years after I started. I had a student OD, and I was terrified. I kept calm on the outside, but inside, well that's another story. The only thing I could do was keep him breathing, but It's not like I can call out for help. After all. who is coming? No one with medical training except EMS once they arrive. The buck stops with us with emergency situations. It took 5 minutes for the paramedics to get there, it felt like hours..

[NutmeggeRN, BSN]

There is a wealth of knowledge on here.  I also suggest you join NASN and become active in your state association. There is a  great school nurse group on FB as well, and I encourage you to follow Robin Cogan, The Relentless School Nurse on social media. Welcome!

[BunnyBunnyBSNRN, ASN, BSN]

Your first year is your hardest.  When you walk in next year, you will feel so much more confident...until the first new to you situation arises.  School nursing can be isolating, so this is why a community like this is so important.  We always say, "this is our nurse's station" - this is where we come to laugh, cry, vent, and support each other through it all.  

Also, on Wednesdays we wear pink!

[jbassLPN, LPN]

This is my first year as well. It has been a little overwhelming, but things are falling into place and I am getting a routine now. Any time there has been an emergency, my admin has been a great support. While I help the student they are calling parents or EMS if needed. I would talk to your admin about any medical emergency policies or protocols to help you feel more confident if a situation were to arise. Are there other nurses in your school district that you can talk to about anything?

[londonflo]

beachynurse said:

I had a student OD, and I was terrified. I kept calm on the outside, but inside, well that's another story. The only thing I could do was keep him breathing, but It's not like I can call out for help. After all. who is coming? No one with medical training except EMS once they arrive.

I guess your school does not have teachers/office help certified in CPR? (your quote shows me that there was possibly a knowledge gap. 

 

Quote

I was terrified. I kept calm on the outside, but inside, well that's another story. The only thing I could do was keep him breathing, but It's not like I can call out for help. After all. who is coming? No one with medical training except EMS once they arrive.

You could not call out for help? CPR classes are offered across the continuum of our society.  Now you know the holes in your employees education.  It  would help on teacher development days to have a "What If' scenario. Of course this would take time to plan. (your labor and time) (getting mannequins'  from the AHA association) (being assertive in what needs to be done -- use your example).  I have taught in social centers (like BOYS club), hospitals, and community college. I get a lot of nursing role satisfaction to design and implement these types of programs (no $$$$ salary involved if you believe in it), 

 

I work for a college that offers nursing programs. I had to get the paperwork for ALL students in the nursing program before  the student can go to the hospital. . I heard so many excuses " my mother had 3 kids and doesn't remember what we all had" "my school burnt down along with the records", et nauseum. I had to send them to the public health department to get NEW vaccinations. ....Again (for a second and third time)  I had to go through their records. I recorded all my time spent in paperwork, chasing students for their paperwork, students who could not produce their vaccination records and most importantly getting that information. Since I was already lecturing and clinical  I said I needed a service like this (PS. I billed my college for the time with a detailed bill). 

Castle Branch

Finally, my school agreed to use an outside service for checking vaccinations and their dates. This service does a lot of record keeping for schools.  Your acceptance of this and your promotion of this will free up your time. Your attention to one OD (I hope the student survived) will show the administration what is important. And again I say, get a place on professional development day to review CPR, What are normal emergencies and what are not. The non-emergencies (like paper cuts, someone cited) wear you out and don't provide HEALTH CARE

Beachy, I know you have just said you are waiting out our time to retire. What better legacy could you leave your school than rescuing the student who OD'd and how empowered your successor/ faculty is if another one occurs. 

[londonflo]

k1p1ssk said:

One thing to keep in mind is that you are just managing the situation until EMS arrives, then they take over

You are ACTIVE in situation doing compressions and airway bleeding?  

For  example: I find a patient unresponsive, I manage the situation until EMS come! What is managing: loosen their hospital pajamas? Define management -- and that is what you call managing.