New, solo, multi-campus school nurse with no training!

[DCtoRN, ASN]

I believe I’m lucky to have landed a new job as district school nurse, covering an elementary, junior high and high school with 1200-1500 students. The pay and benefits are good, I know and like many of the staff and administrators, and they’ve shown excitement to have me joining their team.

I was hired in early June and at my interview, I was lead to believe that I could come in for the last week or two to orient to their current practices and resources. Then I was told that I would start at the beginning of the 2021-22 school year, after the previous health staff (a single health room aid) has moved on to a different position. I offered to come in unpaid to observe and was ignored by my POC in the HR department.

Yesterday, the superintendent e-mailed me at my personal account to ask me to connect with the newly hired health room aid and give her direction on the set-up and practices for the school year. He also said that there is room in the budget for me to come in a few days early (before orientation and inservice week) to “set up inventory and organization” for the school year.

This district has been operating with a health room aid and occasional contract nurse involvement for thirteen years, so I feel that their expectations are probably more basic than my own personal ambitions, but my plan, beside doing a fair bit of self-driven education this Summer was to show up, observe current practices for a short time, reach out to the ESD, and a nurse at another district who has consulted for the district in the past and formulate a plan.

This is the scenario that I feared- total responsibility on day one with no orientation or training. I will express my concern in a constructive manner and I believe the district will work with me to make the handoff as safe and efficient as possible. 

I have been told that the Elementary School is where the greatest need is, helping the little ones manage the new routines and making sure medications, blood sugar checks, etc. are done appropriately. There has been no mention of my involvement with respect to COVID measures, but I’m sure I should be involved with that at every level, along with start of year IEPs and 504s. 

What action steps would you recommend? How much unpaid time should I devote to this? I attended the NASN virtual conference this Summer, I’ve pored over this Allnurses page as well as the NASN forums. I’ve read a bit of our state’s (Oregon) return to schools COVID guidance and e-mailed the state School Nurse consultant, who may be in the process of being replaced, so no reply. 

Sorry for the long post. Thank you for your replies.

Sincerely,

DC2RN

[Cattz, ADN]

Does your state by chance have an orientation for new School Nurses?

 

[DCtoRN, ASN]

16 hours ago, Cattz said:

Does your state by chance have an orientation for new School Nurses?

 

Thank you for reminding me of this. The last time I looked, registration wasn’t live yet and it is now. 2.5 hour orientation and 1 hour 504 plan training. I have Fast Facts for the School Nurse and the new-ish edition of NASN’s School Nursing textbook. My plan is to continue reading those books, these forums, NASN’s resources and state materials. I have also seen the resource page from (Wisconsin?) with lots of info.

I think it’s the specific application to my situation I’m stressing. But my superintendent got back to me, letting me know that I can come in early for “inventory and organization.” I will use that opportunity to familiarize myself with previous strategies, documenting, resources, etc….

[sleepwalker, MSN, NP]

WOW...a total of 3.5 hrs of orientation/training! That's just awesome!

fyi...I'm being sarcastic...it actually sucks!

Just now, sleepwalker said:

WOW...a total of 3.5 hrs of orientation/training! That's just awesome!

fyi...I'm being sarcastic...it actually sucks!

forgot that you get to come in, for free, on your own time, to work on organization....that's a bonus!

fyi...sarcasm continued..

[DCtoRN, ASN]

2 hours ago, sleepwalker said:

WOW...a total of 3.5 hrs of orientation/training! That's just awesome!

fyi...I'm being sarcastic...it actually sucks!

forgot that you get to come in, for free, on your own time, to work on organization....that's a bonus!

fyi...sarcasm continued..

Yeah, it’s better than nothing, I suppose. The state also has a school nurse manual with tons of links. There is no shortage of general and specific information out there on school nursing- but I’ll have to utilize this group and find a mentor nearby to help me navigate my onboarding. 

[Jedrnurse, BSN, RN]

One nurse covering an elementary, middle and high school?

Making sure that finger sticks and medications are being done properly? I read this as saying that diabetic care (among other things) will be delegated. Is this the case?

With the school nurse role as I know it and it's laundry list of duties, the situation you've described would be impossible to manage properly.

Maybe as you stated, the role is limited in scope?

 

Not to mention all the extra "goodies" that COVID will put on your plate.

[sleepwalker, MSN, NP]

seriously...this sounds like a recipe for disaster!

Who is your lead/contact? What duties are being delegated? Who's responsible for all the screenings, getting contact information sheets in order, med administration and reconciliation,  attending IEP's and completing 504's, responding to injuries/emergencies (staff and students), COVID duties,  etc.?

The amount of work being foisted onto you with no help, no prep, and a new aide is ridiculous and overwhelming!

[DCtoRN, ASN]

21 minutes ago, Jedrnurse said:

One nurse covering an elementary, middle and high school?

Making sure that finger sticks and medications are being done properly? I read this as saying that diabetic care (among other things) will be delegated. Is this the case?

With the school nurse role as I know it and it's laundry list of duties, the situation you've described would be impossible to manage properly.

Maybe as you stated, the role is limited in scope?

 

Not to mention all the extra "goodies" that COVID will put on your plate.

My sense is that ratios like this are par for the course in my state. We rely on LOTS of teaching and delegation.

One good new piece of info I got is that my “new” health room aide has been closely involved in the health aspects of the district for 5 years, including last year and is now being made “official.” She should be a great source of information on how they have operated for all these years with no on-campus nurse and it will be up to me to ensure things are being done properly. This was good news to me.

My communications with the Superintendent have shown that he is understanding of the situation that I’m in and he’s ready to support me as within his ability. I will be setting a date soon to go on the campuses and take inventory of supplies, policies and procedures.

I just got back from a vacation and will now be focusing on networking within my state and with you all in earnest.

[DCtoRN, ASN]

29 minutes ago, sleepwalker said:

seriously...this sounds like a recipe for disaster!

Who is your lead/contact? What duties are being delegated? Who's responsible for all the screenings, getting contact information sheets in order, med administration and reconciliation,  attending IEP's and completing 504's, responding to injuries/emergencies (staff and students), COVID duties,  etc.?

The amount of work being foisted onto you with no help, no prep, and a new aide is ridiculous and overwhelming!

I learned that the “new” aide has been in a supporting role to the previous aide and is just being promoted (no idea what her previous job title was.)

I will be working with a good team- superintendent, principals, school office staff. I certainly have my work cut out for me, but just knowing that I have at least one person who has been in the trenches there on my side is a game changer. 
I will work with the state school nurse consultant, our ESD, you all, and others to assess and make course corrections and enhancements to our school health program.