NICU to School Nurse

AWineyNurse · Aug 13, 2021

Hello!

I made the switch, and switched back. Now, there are pros and cons to everything. I'll explain below.

I was neuro/trauma ICU for 7 years, CCU, med/surgery, pcu to make up 14 years of nursing. I desperately needed a lifestyle change, so I made the choice to do school nursing. The pros and cons are very individual, but I will list mine.

Pros: the schedule!! Absolutely nothing like it. Best. Schedule. Ever. I also loved the kids. They truly are cute (and I had middle schoolers!). The relationships you make with the kiddos is great. It was less stressful, no hospital politics, no nursing drama.

Cons: There's no nursing drama because you are the ONLY medical professional there so everyone relies on your expertise. When there is an emergency (anaphylaxis, asthma attack from an undiagnosed child, SVT, diabetic issues) you are the only one who can handle it. You will have routine tasks all day, such as scheduled meds, insulin, paperwork, that doesn't get put on hold while you're responding to an emergency. Having a great administration goes a long way! There are no hospital politics, but there are tons of public education politics. It didn't effect me, so I didn't consider this a deterrent from the job. Parents can suck. There will be 10% who think you walk on water, 10% who make your life hell and are determined to get you fired, and 80% falls in the middle. I found that no matter my background and experience, I was not viewed as a respected professional. I was the one who gave ice, peppermint, and bandaid. Of course that isn't true, but uts often how you are treated by (some) teachers, parents, students, and other healthcare professionals. I missed being respected. Also, it can get lonely. You don't have anyone in the building who understands your job and that comradery is missing. Also, the pay sucks.

Although the con section is longer, the pro section held enough weight to make everything on that cons list completely worth it. I wouldn't trade my Summer, holidays, snow days, or any days off for anything in the world (at that time). My lifestyle has changed and I am back in the ICU as a travel nurse, currently at Johns Hopkins. It is completely possible to get back on the horse after being out for a while. You will have to pay your dues again by getting refreshed on your skills, but I was pleasantly surprised that I didn't need much brushing up, and I imagine you won't either. You may not lose a thing, if you learned it once you can learn it even quicker the 2nd time.

I hope this helps and I wish you the very best of luck. My end of the day opinion, is you will never regret having that time outside of work to pursue what you love, spend time with family/friends, find yourself, take care of yourself. It's worth it all.

RatherBHiking, BSN, RN · Aug 16, 2021

Everything AWhinyNurse said is spot on. You're going to go from a highly specialized area where there's a lot of life and death scenarios, using your skills, and being a very important team player in the lives of your patients to well "the nurse". No one cares much about you until they need you for an "emergency" such as someone vomiting or to send a kid home that's driving them crazy. A low blood sugar, well, the teachers don't seem to care so much about that. I find it very annoying how teachers over react to so many things a nurse would be thinking that's not that big of a deal and under react to serious stuff. I've had teachers get mad at me for not literally running as fast as I could to the playground for a kid who couldn't walk because I was dealing with a blood sugar of 40 and then when I do make it out to the playground finally I'm like where's the student and am told "I think they're out there playing now." I don't know how many times I've heard "oh I didn't know my student was allergic to that" after I have repeatedly given them the info that they were. I had a child choking in the cafe and an aide gave her the Heimlich maneuver and NO ONE even told me until 2 hours later. I've had kids with an obvious broken bone that I'm trying to get stabilized to have a principal or teacher try and make the kid move their arm and proceeded to move it for them as I'm yelling STOP! I've had parents cuss me out because their child got lice AGAIN. I've had principals throw me under the bus for things that were out of my control and not my fault (usually the teacher didn't do something) but I get blamed. Then there's the endless immunization checking and documentation and dealing with parents who don't get their kids shots in a timely manner, or they are obviously neglecting them or putting them in dangerous situations like dealing drugs at home and CPS won't do anything because they can't prove it as if a normal five year old can explain how to accurately shoot up and says mommy or daddy does this a lot. During the year of covid last year all our teachers and support staff were recognized by the county but guess who wasn't even mentioned! Yep and then we were looked down upon because we asked for extra pay while contact tracing for hours after work and on weekends when teachers would automatically get paid for a 30 min in-service after work. You will also be expected to do lots of things that aren't really a nurse job. Like find clothes changes, find new shoes, help kids who soiled or wet their pants, fix glasses, fix braces, counsel kids about body odor, make sure they have food for the weekend and if not help with that...lots of things.

It's an adjustment to go from a hospital position to school nursing. I remember having a hard time because I was bored a lot. (I don't have much time to be bored these days.) The pace is much slower a lot of the time and you're usually dealing with one mostly healthy kid at at time. Sometimes you'll have a few in there at once but it's all minor stuff. You're dealing with a healthy population of stable students. You're job is to make sure they are able to successfully make it through the day or be sent home if sick. You'll see lots of frequent flyers who just want out of class, want attention, truly don't feel well all the time so you kind of have to investigate why. Parents and teachers get mad because you can't automatically diagnose if a bone is broken or someone is having a heart attack. I'm like all Dr's run tests for these things. Then when I do recommend Dr follow up for something I know needs treatment they are like well I don't want to go to the Dr. Isn't there something I can take for this. Yes a prescription. That gets annoying. I have a lot of aides who get mad I'm not sending a snotty kid home. That's all, just snot from allergies or a cold. I'm like I can't keep a kid home until they are no longer snotty. That could be weeks. I've had teachers get mad I wouldn't send one of their students home who wasn't sick and then go to the principal and be told well they know their student...yeah who is playing them!

The best parts of the job is obviously the schedule. No nights, weekends, call in's and you get summers off, a week at most holidays, and snow days sometimes. It adds up to almost a part time job (but unfortunately the pay reflects that). Also, I love when I get a hug because I made someone feel better or we were able to get someone out of a dangerous situation. The kids always make me smile or laugh every day and sometimes I get little drawings or colored pictures. You work on your own which can be good and bad. I like the autonomy with no one breathing down my neck checking off what I've done for the day and you don't have to work with Dr's throwing out orders or aides that aren't pulling their weight. It's just you. Which can be a disadvantage with not one other person in the building who gets you. The closest I've found is the special ED teachers. Also in an emergency it's you dealing with it until 911 arrives. You can't call a code team to come and help. Thankfully it doesn't happen often. Your office is your own space. I've been in some nurse's offices that are open and huge and some that are literally transformed closets but it's nice to have your own spot. Whatever you don't get done as far as paperwork you can do the next day. It will be waiting on you but not usually a huge rush. It's a lot like being a social worker/mom many days. Many families are super sweet. You may get to watch Christmas programs or any other programs that are during the day if you aren't busy. The holidays are always fun and kids are excited.

You'll be fine! It's much less stressful most of the time. There's usually ebbs and flows to the day. The end of the day when it's close to time to go home you won't see many kids at all. It may feel overwhelming at first all the new things you have to learn but remember as long as the kids all get home alive you've done a good job and the rest can wait. Kuddos for you for trying something new too! If you don't like it I'm sure it won't be hard for you to find something else fairly quickly.

MK86, BSN, RN · Aug 17, 2021

I made the exact same move a year ago (maybe not the best time with covid LOL). 10 years of NICU and I needed a break. I'm in a smaller private school (450 kids ages 3-14) so don't have any medically fragile kids (trachs, g-tubes, etc). Most of my day is giving meds, cleaning up scrapes and organizing medical files. Have a few diabetics, asthmatics and food allergies but it's nice to take care of essentially healthy kids for a change. At least once a week I have a kid come down with something that isn't medical but they don't know where else to send them (ex. slime in hair LOL)

There are definitely some things I'm still getting adjusted to a year later, being the only medical person is probably the biggest (and having pts that talk and weigh more than 10lbs ? ). No one to bounce ideas off and honestly half the people forget you're a person until there is an emergency. You definitely have to be OK with spending time by yourself. You're not a teacher but you're not admin either it's kind of a weird role when you're the only nurse in the school tbh. I found this forum very helpful in so many ways. Also did get an emergency first aid book as a refresher for myself which has been useful. Parents can be a lot at times but that's no different from NICU. I found myself excited to come back this school year so I know I made the right choice for now at least. I kept PRN hrs in the NICU and I appreciate and enjoy my occasional shifts there way more now than I did when I left full time. I'm sure I'll most likely go back to the NICU either full or part time at some point but I like my life/work balance right now. That's the beauty of nursing though - so many options.

Lady_Leijing, BSN · Sep 12, 2021

I'm curious about this myself. I'm also a NICU nurse who is looking for something different.

I'm wondering: what sort of prerequisites do I need to make the switch? Is there a class or certification needed? What kind of training (if any) can I expect?

RatherBHiking, BSN, RN · Sep 12, 2021

You’ll need a bachelor’s degree if you don’t have one. You’ll also need a school nurse certification but you can get hired without that and the district will give you like a year to get it and give a little money towards it at least in my district. I recommend to get your foot in the door to sub if you can. Training can be from almost none to maybe a couple weeks if you’re lucky but usually somewhere in the middle of that.