New School Nurse: VENT

MinnieMomRN · May 19, 2012

1. My orientation was a two day course on school nursing that was state mandated, and two days in the school. One with the nurse I was replacing, and the other with the nurse with whom I job share. None of the preceding were paid days, and they were all coordinated because I did the coordination. Otherwise it would have been nothing. BUT, I am pretty self-directed, and I did a lot of reading on my own. It can be overwhelming at times, but it's never boring!

2. The office staff is usually pretty nice. For me it's the 7th grade teacher.... she's an ornery, unpleasant sour-puss who treats me like a fluff-head who's only job is to hand out ice packs and to annoy her about following the school's Epi-pen policy. *sigh* BUT, the majority of teachers ARE good to work with.

3. Fitting in... Hmmm... not so much. You see, they look at every situation from an educator's perspective, while I look at it from a medical perspective. In the hospital, a Doc might get annoyed with you, but they usually understood where you were coming from. In the school, we try to get the staff to see the importance behind what we do. Sometimes they get it, sometimes they don't. BUT, the people who understand are here on AN. We support each other, help each other, and listen to each other vent. This board is a life-saver after a difficult day.

We do what we do for the benefit of the kids, and that makes it all worth while. When you see some of the interventions you initiated have a positive outcome for your kids or for their families, you know your nursing care matters. That is an awesome feeling. I love my kids, and my job. I can whine and moan with the best of 'em, but I gotta say that my worst day as a school nurse is better than my best day in the hospital. Hang in there!

(((Hugs)))

~Minnie

NutmeggeRN, BSN · May 19, 2012

This is a job that is very much on the job training, but if you are self directed and professional,you will figure that out. As far as the office.....there is one who really lives to irritate me, I know it!!! She has this need to be involved in everything it has taken some work but I think I have finally gotten her to realize that yes I DO need to know about scheduled surgery/emergent surgery/communicable diseases/wheelchair/crutches/hospitalizations....need I go on?

Her claim is they do not want to talk to me: the real issue is they do not want to tell the same story over and over again, especailly after they have been grilled by her!!!!! ARGHH!!!!!!!!!!

:banghead:

The soon to be princiapal knows how :he is and has made it excruciatingly clear to her that I am to get the call, she is either to transfer it or let me know that I need to call someone back......amazing the info I found out this past year....

Hold your ground. The phrase I use often "In my porofessional opinion....."

Good Luck!

Britrn04, BSN, MSN, RN · May 21, 2012

1. My orientation was a two day course on school nursing that was state mandated, and two days in the school. One with the nurse I was replacing, and the other with the nurse with whom I job share. None of the preceding were paid days, and they were all coordinated because I did the coordination. Otherwise it would have been nothing. BUT, I am pretty self-directed, and I did a lot of reading on my own. It can be overwhelming at times, but it's never boring!
2. The office staff is usually pretty nice. For me it's the 7th grade teacher.... she's an ornery, unpleasant sour-puss who treats me like a fluff-head who's only job is to hand out ice packs and to annoy her about following the school's Epi-pen policy. *sigh* BUT, the majority of teachers ARE good to work with.
3. Fitting in... Hmmm... not so much. You see, they look at every situation from an educator's perspective, while I look at it from a medical perspective. In the hospital, a Doc might get annoyed with you, but they usually understood where you were coming from. In the school, we try to get the staff to see the importance behind what we do. Sometimes they get it, sometimes they don't. BUT, the people who understand are here on AN. We support each other, help each other, and listen to each other vent. This board is a life-saver after a difficult day.
We do what we do for the benefit of the kids, and that makes it all worth while. When you see some of the interventions you initiated have a positive outcome for your kids or for their families, you know your nursing care matters. That is an awesome feeling. I love my kids, and my job. I can whine and moan with the best of 'em, but I gotta say that my worst day as a school nurse is better than my best day in the hospital. Hang in there!
(((Hugs)))
~Minnie

Thanks Minnie, It is so hard and overwhelming in the beginning. I have done a lot of reading and preparing for this new role, but I guess I just did not anticipate the "educators perspective". I can really identify with that. I am part-time at a school that has an office person that has been there FOREVER and is the "nurse" on days I am not there. Trying to do my job is a challenge at best! I will soldier on.....2 more weeks to go. I really have a lot of thinking to do this summer. Maybe this school is not for me versus the role.

Britrn04, BSN, MSN, RN · May 21, 2012

This is a job that is very much on the job training, but if you are self directed and professional,you will figure that out. As far as the office.....there is one who really lives to irritate me, I know it!!! She has this need to be involved in everything it has taken some work but I think I have finally gotten her to realize that yes I DO need to know about scheduled surgery/emergent surgery/communicable diseases/wheelchair/crutches/hospitalizations....need I go on?
Her claim is they do not want to talk to me: the real issue is they do not want to tell the same story over and over again, especailly after they have been grilled by her!!!!! ARGHH!!!!!!!!!!
The soon to be princiapal knows how :he is and has made it excruciatingly clear to her that I am to get the call, she is either to transfer it or let me know that I need to call someone back......amazing the info I found out this past year....
Hold your ground. The phrase I use often "In my porofessional opinion....."
Good Luck!

OH I can see your frustration........part of the problem is I look younger than I am (a bonus in many situations, but maybe not this one) and I think they feel I just graduated from college and strolled into this place as green as can be. I really need to be more self-assertive and stand my ground! It is so hard to do in unknown territory though ugghhhhh!

Flare, ASN, BSN · May 21, 2012

1. I had o take a full course of classes to become a school nurse certified for my state, but as far an on the job training or precepting - nada.

2. My office staff is great, respectful and helpful. You may just be working with some real doozies. I find that the kill 'em wiith kindness route can sometimes break the ice, If that fails, try bringing in brownies - office staff people can't resist brownies and you come off as trying to be part of their team.

3. See #2. Kill em with kindness and participate. If they are having a lunch pot luck, bring something. If there is a staff-student basketball game, participate. If there is an activity you can help with, then help out. Remember, you are seen as a lone wolf in district - some people find that hard to approach. Make yourself approachable and let them see that you are an interesting and involved person and they will be sure to let you "into the fold". But remember - just because you are nice and approachable doesn't mean you are a pushover. It takes a light touch, but in time you will find an assertive tone where your coworkers understand that you are firm but fair and that you mean business.

100kids, BSN, RN · May 21, 2012

1-there was no training for me before starting here. Just thrown in and figure it out. Heck there wasn't even any paperwork on how things are done around here. I have asked a lot of questions on AN, used my state's health services site, made friends with the school nurses at other local school districts and called on them and read, read, read. I still have a long way to go as far as I'm concerned. I wish my state had a set of classes you could take before starting but they don't so I'm looking for things online.

2-office staff is very nice here, they are very thankful to have me but that doesn't mean they understand what I do. Sometimes I think they expect me to know everything already. They have no clue the differences between nursing and school nursing.

3-Fitting in is tough. I'm not a teacher but I'm not really support staff either, kind of in between. I always have a smile on, I make sure to visit the teacher's lounge so I know who's birthday it is, etc. Be friendly that's most important.

good luck! It was a crazy start for me but I still love it!

Nurse ABC · May 21, 2012

I have to vent; all my RN friends are in the hospital environment and just don't get it :-(

I have been an RN for almost 10 years and recently started working in an Elementary school in February. The office staff are just plain mean, disrespectful and oftentimes inappropriate. Like I am this huge inconvenience whenever I ask them for records or
assistance etc..
I have been placed in this school and really left to my own devices...it is like on the job self training with a liaison that checks in here and there. Here are my questions, 1. In general, were you given some strong orientation and training for your position? I mean, I know how to be a nurse, but a school nurse not so much. The paperwork, records, immunizations etc takes understanding and instruction. 2 How are your office staff? How do you deal with bad, toxic attitudes? I mean I have taken more heat from Drs and not been this upset! 3. As a new school nurse, how do you fit in? What was your experience as a new school nurse back when you were green?
I would love to hear your tips and advice...I am seriously considering not going back next year!!!

When I was first hired as a school nurse over 15 yrs ago the only training I received was how to do one kid's tube feeding since he was being integrated into my school and given a binder of copies of the forms they used. I did it full-time for 5 yrs then quit for 10 yrs and went back to substituting for the past 5 yrs where I got 1 day classroom orientation and 2 days to work with a school nurse as my orientation. Having substituted I've been to 22 schools and it's been interesting to see how things are done at each school. So no-you don't get an orientation like a hospital but I've always been able to call someone for help whenever I needed to. The office staff at every school is different. Some are extremely nice to the nurse and go out of their way to make sure she has everything she needs and the staff respects her and other schools totally opposite. There is always 1-2 people in every building that are very difficult to work with. Sometimes that's the principal and sometimes it's a teacher or aide. Usually the secretary is nice to you because she's so happy you're there and she doesn't have to deal with all your stuff but most are very busy and can get a little irritated if you have to ask them for a lot of help. The best way to deal with difficult people is to be extremely nice and don't get argumentative or defensive because that just fuels their fire. You can't change them-you just have to deal with them and sometimes if you're nice to them long enough they will occasionally listen and be open to you but you have to pick a good day! As for fitting in, again, it depends on the school. I've worked several long-term positions and some schools make me feel part of the team and others not at all. More don't than do unfortunately. Like someone said it helps to get out there and volunteer and talk to everyone. Make rounds on the teachers and get to know them and ask if they have any problems or suggestions and offer to help with activities. They are most concerned with educational stuff and sometimes our medical stuff gets in their way. It's a whole different mind-set. Even at the schools where they accept me and make me feel part of their team I still feel a little isolated because I'm the only medical person in the building. I find I get the most respect from the special ed teachers and the secretaries. Unfortunately it sounds like you're in a school where there is not much respect going on. I feel for you. I was in a school like that before I quit to stay home and it was one of the reasons I wanted to quit so bad. I went back there to sub and it has changed a lot since then. I then long-termed subbed at a school that's like the one you're in and one huge problem was until the principals were made aware nothing changed. Also, I noticed most of the teachers didn't even realize she was gone or why which said to me they didn't know her very well at all and it was near the end of the year. I got to know a lot of the teachers better than she did in the 3 months I was there and I didn't have the problems with them she did so it's really good to develop a relationship. All that being said, I have never felt as comfortable in a school professionally as I have in a hospital. Good luck with your decision!

Britrn04, BSN, MSN, RN · May 22, 2012

Thank you all for the input and kind words....it has boosted by confidence. I can truly identify with many comments here. I do not want to quit and run from one school to another. I understand there are many personalities and all schools are going to have challenges. I agree it truly is a different mind-set and that is all part of the learning curve! I am sure I will be back here for more strong advice!!

luv-of-kids · May 29, 2012

Since you just started in feb, a lot of it may just be because your new. I'm not technically a school nurse, but I do private duty and went to school last year with a patient. His class was a life skills class so there was one teacher and 3 assistants. The assistants were very nice, helpful and grateful I was there (my little boy was a handful!!!! Lol), but the teacher not so much. We bumped heads a lot over my patients medical needs. I didn't say much at first until I talked to my patients mom and she told me that she trusted me to say what I needed to say to his teacher and I was to handle his medical care. From then on, I politely but firmly would tell her I would take care of his medical and when I was finished she could "teach" him. I think she felt intimidated by another professional in her classroom. Another time, I walked into the teachers lounge to get a coke from machine and some of the teachers were on their lunch and no kidding, all conversation stopped and all heads turned to stare at me!! I told the assistants and they just started laughing and said "they do that to us too". As time went on and I got to know some of the staff, it was much better. You know how us nurses have our "nurse group"? Teachers have their "teacher group" too and your kinda in their territory so to speak. Sorry I rambled, hope a little of that helps. Good luck!!

mom's outlet · May 29, 2012

To BritRN04 - Hang In There! School nursing is the hardest job I've ever had, but the students are the reward. They will grow to love you because you help them when they need it the most. It takes a few years to build those relationships, and you'll even find some nice teachers and office staff, eventually. To your questions -

1 - I had minimal training. I had subbed in my school district for 5 years, so that helped and I knew the other nurses. One nurse taught me the computer documentation system in one day, and then I read the rules on our State Health Services website - about Individual Health Plans and Immunization rules, mostly. If your school offers to send you to any classes on your documentation system, GO! I learned so much and met a lot of great school nurses. By learning more about the system, I learned how to run reports to show what the school nurses does - the high volume of visits, meds given, injuries at school, etc. It saved my job this year during the budget cuts. Like the others said, be visible when you can - go to staff meetings, participate in school events anytime you can. I organize CPR classes for my staff and they like having that available.

2 - Office staff - kind of a pain! I have some very nice ones who are helpful, but they also want to tell me all of their health problems which can become very cumbersome. My first responsibility is to the the students, not adults who have cars and can make their own appointments with a doctor. They gossip about each other alot, so I try to stay out of that - so thankful that I'm mostly trapped in my office! My group is generally supportive, but I also do my best to handle all medical needs and not dump on them. I take a 20 minute lunch and have one secretary who covers during that short time. I eat right by the office so she can grab me if she needs me. It's a frustrating facet of school nursing - the teachers get 45 minutes - 1 hour for lunch plus a conference period, and I'm lucky if I can eat like an animal for a few minutes. Teachers don't seem to have any idea what we do - I see 40 - 50 kids/day, calling lots of parents, and still have all those shot records and screenings to do. But if an adult walks by and no one is in the office, they say "OH, it's quiet in here today!". After 4 years, I accept that they really have no idea what I do, and they may never. I'm never bored, and never lonely, but the job is lonely in the respect that no one on campus understands you. I've heard administrators say dumb things like "we don't need school nurses", but then will ask you to "run over and check out this kid asap" even though "anyone" can do it.

3 - about fitting in - kinda covered it above. We're not teachers, so they generally don't know what to do with us. I'm friendly as much as possible, but I still don't have a lunch group - partly because my lunch is so short. My best relationships are with the counselors and administrators. They do seem to appreciate my contributions - after 4 years, they can see that I keep excellent records and they don't get any complaints about the nurse's office.

Again, the students are the best part - as you get to know them and their stories, you will love them and they will appreciate you. The school nurse helps families during their most vulnerable times. I have many students who leave the hospital one day and return to school the next day. They are so grateful when I understand their diagnosis and they don't have to explain it to me. The second runner-up is the summer and holidays off! You can't beat the time off. I hope you can stay with it a little longer but it's certainly understandable if you decide to go another direction - that's the blessing of being a Registered Nurse!

lilcece363 · May 31, 2012

1. In general, were you given some strong orientation and training for your position? Yes. We had a two week orientation to go through.

2 How are your office staff? How do you deal with bad, toxic attitudes? My office staff accepted me right away. However, I do have a medical records clerk who has been doing thing her way for 8 years (it's the first time they have had a full time nurse in the school) and she doesn't like that I have to change things to make them LEGAL lol. She gets annoyed that I have so much documentation to send in (bc she has to send it). I have had to tell her to back off and let ME be THE MEDICAL PROFESSIONAL in the building before.

3. As a new school nurse, how do you fit in? What was your experience as a new school nurse back when you were green? I just made myself known. This is only my second year so I am pretty new myself :)