new at school nursing. please help

[june2009]

Hi everyone!

I just wanted to share a little about my background. I've been in nursing for a good number of years but recently obtained a position as a nurse in a school for autistic children. I'm not a certified school nurse so I don't do hearing or vision screenings, but I do assist the district CSN with obtaining immunization records and other records she needs to make her charts complete. she comes in once a month. What I do is more like medication audits, staff education, parent education, and eventually I'll be administering medications. right now, the teachers in the school administer medications (they are medication trained). We're a private school so we can operate this way. I actually go back and fourth between two different autism schools and only have one day per week at each one. My days are pretty full. We do have som medically fragile kids and I would like to get to know them and all the children as best I can. The charts they have are full of IEPs and education type information but very little medical information. I'd like to call each of our parents and foster parents to try to get a more detailed medical history on each of the children and was wondering if you guys thought that was a good idea, or if that was overstepping my bounds. You see, they are very small schools, and I'm the first RN they have ever employed. Next year I will be working 5 days per week between the two schools. I was also wondering what other suggestions you might have for a nurse in my situation. Any pointers would be so helpful! Thank you!:heartbeat

[bergren]

Welcome to school nursing!@@!

If there is a school nurse orientation in your state, I would recommend attending. They are frequently offered by either the state school nurse consultant or the state school nurse organization. If no orientation, I would plan to attend the state's school nurse conference this year. Some are held in the spring and some in the fall. To find your state association, go to http://www.nasn.org and click Affiliates (Chapters)

I would recommend joining the NASN's Special Education Internet Discussion List: link on NASN home page: http://www.nasn.org Click discussion lists.

NASN also has a Special Needs Special Interest Group. http://www.nasn.org Click Special Interest Groups

School Nursing: A comprehensive text is a great resource also.

[bsyrn, ASN, RN]

hi and welcome to the world of school nursing. http://schoolhealthservicesny.com is a great website, there are many forms you can use and they are very up to date on their information. it is one of the best resources out there. as for asking for more detailed health information, you are not overstepping. in order to care for your students you should have a detailed medical record on each student. good luck

[Heidi the nurse, BSN, RN]

Is there at least a health history form in the file? We break out things into a cumulative file (their school information) and their health file (because not everyone needs to know that information). I would talk to the CSN about her ideas for this - it is important to have an idea if the child has asthma or allergies or something that you would need to be aware of. If the schools are not getting a general medical history on the kids then you might want to develop a form with her.

[Flare, ASN, BSN]

I agree with the idea of sending out a form - the parents that tend to be compliant will have it filled out right away, the lollygaggers will wait until you call them you request it. You can then call and follow up with any red flags PRN.

The reason I prefer the form over calling is that calling sometimes puts people on the spot. I worked as a SN in an autistic school for a few years - the parents typically have a lot on their plates - giving them a form to digest over a spontaneous phone call will help them organize their thoughts on their children's detailed medical histories.