Not sure what to do...

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I have been a school nurse for 2 years. I currently oversee close to 3000 students, by myself. I have close to 350 students with emergency care plans, 31 type 1's, probably 50 with active seizures and hundreds with asthma. I have a 8-3:30 shift, but tend to work an extra 2+ hours everyday, just to get caught up on paperwork, phone calls to parents and medically clear and prepare for the mounting field trips.

I see see an "average" of 50-75 students daily. Our counselor "academic advisors" tend to use/borrow me often for mental health issues. (I don't mind helping with these is time is available)

I currently feel torn, I love working with my kids. I know I make a difference, with my students, staff & our community. I have a "mostly" great relationship with staff...but I feel I am falling behind. I have told admin, but to no avail...not help is provided.

I have been recently been reprimanded/scolded for advocating for Para's that are being abused/assaulted by DD students. The admin stated I'm pitting the staff against the students. I believe it is my job to protect our students and staffs well-being, but according to "them" it's not my place.

I feel like I should walk away while I still have face. I have worked in other districts. They all have their own issues.

I NEED SOME ADVICE....

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Specializes in Pediatrics Retired.

One nurse for that many students is ridiculous and flies into the face of industry standards. You are being used for your credentials. Like hiring the new grad for the DON of a nursing home. You can't possibly be a student advocate for the student body needs and it's not healthy for you personally. Administration is aware of all this but as long as you'll eat it they'll keep feeding it to you. Time to throw down the gauntlet. Get you some help or adios!!

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Specializes in school nursing, ortho, trauma.

Well put. I whole heartedly agree. Perhaps start polishing the old resume and staking out greener pastures if they won't improve things.

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It is unreasonable and unsafe for just one person to have that many students. Honestly, if it were me I would be out of there and look for a better situation.

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Specializes in ICU/community health/school nursing.

NASN used to publish an "acceptable ratio" (I think it was one nurse to 850 kids). Then they moved away from a number and started talking about acuity (meaning, the number of nurses should be relative to acuity). Well, your acuity demands at least one other nurse! 50 visits a day....that happens rarely to me but when it does I go home exhausted. Good luck to you. What you're experiencing is out of the norm. Perhaps NASN can be helpful here?

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Specializes in School nursing.
NASN used to publish an "acceptable ratio" (I think it was one nurse to 850 kids). Then they moved away from a number and started talking about acuity (meaning, the number of nurses should be relative to acuity). Well, your acuity demands at least one other nurse! 50 visits a day....that happens rarely to me but when it does I go home exhausted. Good luck to you. What you're experiencing is out of the norm. Perhaps NASN can be helpful here?

Per NASN:

"Although evidence to support ratios was limited, some states and NASN recommended one school nurse to 750 students in the healthy student population; 1:225 for student populations requiring daily professional nursing services; 1:125 for student populations with complex healthcare needs; and 1:1 for individual students requiring daily, continuous professional nursing services (American Nurses Association [ANA]/NASN, 2011)."

I range from 25-50 per day and man, when I hit 50 I am wiped! I did work in a district with ~1650 students and average visit number was ~125. And because of that, we had two full time nurses. And we were both still exhausted at the end of day.

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I had the same problem last year and basically put it all on paper for them including the industry recommendations of nurse to students ratio. I told them everything you said, number of patients, meds, diabetics, chronic care kids, etc. I think its a huge liability issue if you present this to them and something happens. If they don't start listening, I would start looking too. You are right in that all districts have their issues, but yours is a serious one that is putting students health at risk as well as your sanity!

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I want to thank you all. I have come to realize, Sometimes when something is so monotonous and constantly in your your face you become either blind, or Nievely numb. I believe I started becoming that way....but not anymore. I actually spoke up for myself and contacted my fellow school nurses, as well as our union rep...found out THEY ALL HAVE MY BACK!!!

I appreciate all your feed back.

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Specializes in NCSN.
I want to thank you all. I have come to realize, Sometimes when something is so monotonous and constantly in your your face you become either blind, or Nievely numb. I believe I started becoming that way....but not anymore. I actually spoke up for myself and contacted my fellow school nurses, as well as our union rep...found out THEY ALL HAVE MY BACK!!!

I appreciate all your feed back.

Good for you! That is awesome news!

Sometimes I think we all get caught up in advocating for everyone around us we forget about ourselves. :)

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