New to work and School Nursing.

StudentRN56, BSN, RN · Dec 7, 2021

Well, I'm new to nursing and school nursing as well. I do not have a high school - I have 3 elementary schools and a middle school @ 2000 students total. I do think that middle school students and generally their parents are less demanding because they are used to their kids having their kids excluded due to vomiting, diarrhea, or fevers. I'm surprised how many elementary parents are surprised that we don't want their barfer at school.

I was assigned schools that were close to my house - 12-15 minute max drive, one is about less than 5 minutes from my house. I was not assigned schools where my kids go on purpose because you could find out confidential information about your kids' friends and let it slip. I was actually hired to take 1 school from each nurse in the school district where I work - so I'm pretty popular with my partnership/fellow school district nurses. They have been very supportive!

I work 8a-4p Mon-Friday with 30 minutes lunch, 2 15 minute breaks. I work at the school in the morning, usually through the kids' lunchtime - if they have diabetics, I will often help with them. Then I work from home on case management and covid calling. So much covid calling... I have 50-60 hours of comp time accumulated, so I'm trying to take that time. Benefits are great - free health insurance, PTO and sick time right away - though. All the holidays off. Honestly, it is a pretty great schedule.

I'm employed by the education service district which supports many school districts. Only RNs are in the schools as the "school nurse" for case management in our ESD, but we have school health assistants (SHA) and LPNs that handle daily tasks or work on covid response. In my schools, several of the health assistants are Medical Assistants - it isn't a requirement but it just seems like a good fit for people.

HTH!

salpn · Dec 7, 2021

I'm an LPN in a high school. Like the above, our "real" school nurse of record has to be an RN. LPNs and LVNs are used in other support roles. I work in the main office, lot of reviewing IEP/IDP/IHPs but some clinical stuff.

k1p1ssk, BSN, RN · Dec 7, 2021

18 hours ago, coldcasejustice said:

My question.. I am thinking about school nursing, but not sure what ages (K-12) are best suited for my introduction back into the world of working. I have anxiety returning to work after such a long gap & rusty skills. ?

Kids (and parents) who are less demanding are what I’m aiming for ? so- I am thinking HS, but I have no idea! Please share your thoughts, input, ideas. Schedules..

I'm not trying to be a naysayer, but to be completely honest - coming into school nursing right out of the gate thinking it is going to be a good way to "ease" into working again is not a great idea.

It sounds like you are looking for a role where you will be able to get reassurance and support, but as the school nurse, you are more often than not the ONLY medical professional in the school. You may have the opportunity to call a supervisor, but only if they aren't also incredibly busy...

And in general, this year is a terrible year for "less demanding" parents/kids. I don't think any age level is better than another on this front, it's just different battles; In the elementary level, I battle with teachers and parents over illness symptoms and exclusions; at the MS/HS level you're dealing with all that, plus a ton of mental health issues - really all of the overflow from the adjustment counselors/psychologists.

If I were you and really looking seriously at school nursing, I would ignore the age ranges (unless you know you are better at communicating with one age group over another) and look for a role that pairs me with another medical professional who has been in their job or at least the district/school for several years and knows the community well.

Good luck!

RuralMOSchoolRN, ADN, RN · Dec 7, 2021

I am a RN and have been in school nursing for 3 years now. Honestly, it depends on the school/population of kids. I work in a very rural area and out of 600 kids only have 1 type 1 diabetic, a handful of asthma kids, 3 kids on regular medications. My friend works at a large public HS in a bigger city and says she feels like a clinic or inpatient nurse--lots of diabetics, several with ostomies, seizure disorders, etc.

So far I haven't really had anything happen that is over my head--anything urgent (fractures, active seizure, lacerations that need sutures) get first aid and 911 is called. But I could see if the acuity level is much higher needing more nursing skills daily.

I love the hours, no summers, no holidays, my time off is OFF, etc. But there is a huge level of autonomy and I don't really talk with many adults during the day unless calling parents or briefing staff on covid issues, etc.

NutmeggeRN, BSN · Dec 9, 2021

A LOT has changed in health care in 6 years...OK 18 months! As you have not been working, this arena may be a bit overwhelming, depending on how much support you have from an RN. A lot will depend on the nurse practice act of your state.

ihavealltheice · Dec 9, 2021

So, I don't want to discourage you, but school nursing isn't as easy to jump into as people think. Even having a medical assisting background doesn't quite prepare you for what you'll face (usually completely by yourself). Many seasoned nurses come into school nursing thinking that is is going to be easy only to be discouraged and quit. If you're dead set on school nursing, definitely start in a school where you have another RN to work directly with. If not, I would highly advise to get a job in the clinical setting to really hone in on your assessment skills and then make the switch to school nursing. Plus, as it was mentioned before, school nursing now is NOT what school nursing was 2 years ago. It is VERY stressful right now.

As far as the age groups go: Throughout my career as a school nurse, I have covered every age from PreK to post graduate transitions. Transitions has been the only area that is not demanding as far as students/parents.

Each grade level has their own quirks. While you may have super needy and helicopter parents at the PreK and K level, you'll be dealing with a lot more mental issues, drug/alcohol, fights, serious injuries from sheer stupidity at the high school level. Plus, parents (and students) are still fairly needy at that level. So, its really what age group YOU best feel comfortable with.

KKEGS, MSN, RN · Dec 15, 2021

Here's my brutally honest 2-cents:

I have worked everything from Pre-K (my current position) to elementary, middle, alternative high school and post high school transition Special Education program and there are definite pros and cons to each grade level. None of it is easy and they all come with their share of challenging kids and parents. Elementary school health offices can be incredibly busy (30-40 kids a day is common and I had a day where I saw 80 in a school of around 600 kids. That's one kid every 3 minutes all. day. long.). Middle and high schools can be busy too (lots of mental health issues in these grades) but they are more self sufficient with things like putting on their own Band-aids and taking care of their own diabetes and asthma and things (Usually. You certainly get those kids who don't do what they are supposed to do, like my middle school Type I diabetic who would dose herself with insulin before lunch in my office and THEN NOT EAT because none of her friends were eating lunch. Awesome.)

I would see if you could maybe shadow or start off as a sub nurse first to see if it's something you'd like. It's not for everyone and a lot of people have a hard time transitioning from a hospital or clinic background into a school building. You are often the only medical professional in the building so you need to make sure your assessment skills and prioritization are top notch because there is no one to help you. Also a lot of new school nurses struggle with the fact that you are sort of at the bottom of the totem pole. You are a medical person in an educational world and educational priorities will win every single time over what you feel are priorities from a healthcare perspective.

If you can accept all of these things it can be an AWESOME job! There is no denying that the schedule is great and the job can be quite rewarding if you find the right position. I am on my 3rd school nurse position in 5 years and finally have found the perfect fit for me. Good luck to you!

coldcasejustice · Dec 21, 2021

Thank you so much everyone for your insight and guidance. I appreciate the time & effort in these replies and in such detailed information. Thank you for letting me know what to expect in each environment/ grade level and what skills I need to focus on. The workload sounds so busy & overwhelming, I’ll think about it awhile. You nurses are doing a great job, thank you so much!

Denysse Lopez, BSN · Feb 14, 2022

Hey! I'm a new grad that just got offered a School Nurse position in the bay area. I'm seeing that school nursing is not the way to go right out of nursing school. What would you all recommend for a new grad who wants to work in pediatrics? Thank you!

Istolethefizzyliftingdrink, RN · Feb 20, 2022

On 2/14/2022 at 12:17 AM, Denysse Lopez said:

Hey! I'm a new grad that just got offered a School Nurse position in the bay area. I'm seeing that school nursing is not the way to go right out of nursing school. What would you all recommend for a new grad who wants to work in pediatrics? Thank you!

I started as a new grad in the neonatal ICU. It actually worked out really well because neotates are very different from adults, so they had a very thorough, all encompassing orientation process, the hospital I worked for hired new grads for that department all the time for that reason. I was able to build my assessment skills, teamwork, critical thinking, etc while working with a population that I loved.

Denysse Lopez, BSN · Feb 20, 2022

29 minutes ago, Istolethefizzyliftingdrink said:

I started as a new grad in the neonatal ICU. It actually worked out really well because neotates are very different from adults, so they had a very thorough, all encompassing orientation process, the hospital I worked for hired new grads for that department all the time for that reason. I was able to build my assessment skills, teamwork, critical thinking, etc while working with a population that I loved.

Thank you for your reply!!