Now they need my help.

[TiarasNBand-Aids]

I am in my 2nd year of school nursing after 17 years in the ER. Made the jump knowing the pay is not great and it would be lonely at times, but with two young children the opportunity to spend evenings and holidays with my family was priceless. I am however thinking this may not be for me.

I work in a middle/school grades 6-12, approx 600 students and 70ish staff. It's a somewhat rural community, poverty, lack of resources and community support. I have had a few incidents that have left me rethinking my change in specialty. I'm really struggling with the recent one. I am hoping for guidance or a some truthful tough love.

This past Monday as I was sitting in my office I watched 3 police cruisers and an ambulance pull up in front of the school. My first thought was lock down drill. Super long story short, I was told everything was "fine" and basically shooed back to my office when I questioned fire doors being closed. It ended up a student was in crisis and was being taken out non voluntarily for eval. I only found this out today after I was "invited" to a meeting tomorrow morning. I was told, "we think there are medical issues going on and we can't ask those questions." I declined and told them they handled the situation without allowing me to be involved I am not going to jump in now to fix it for them. I know this now sounds crazy but what part of taking a child out of the building in an ambulance isn't something a nurse should be apart of if not at minimal aware of? I am used everyday for the teachers and counselors to drop off the kids who "just need a break" or for a nap or because they have another appointment and the kiddo is still in tears... but I'm not needed at times of crisis until they need answers and are unable to question the mom.. please tell me the truth am I just meant to stay in the ER or what I'm experiencing is crazy?

thank you for taking the time to read my rambling thoughts.

I am sorry, that would frustrate me beyond belief. I really think it is not school-nursing specific, but more school admin specific. I have almost the opposite in my school where they tell me everything and want me involved in every 504, IEP, etc. Occasionally I am left out, but it is almost always an oversight and not intentional. I am wondering if the issue is that your admin just doesn't understand the importance of keeping you in the loop. Who was there before you? Maybe she didn't "train" them properly

[cid1]

I am never involved in crisis situations. Our counselors and social worker handles all of that. There is no reason they can't ask medical questions to the parents at a re entry meeting. I also almost never have anything to do with those.

[NutmeggeRN, BSN]

I hate the separation of guidance and the health office. We used to be very united and now...not so much. If there was a medical issue that precipitated the need for an ambulance by all means you SHOULD be involved. If it was truly psych... meh.

[OldDude]

First...You're not meant to stay in the ER. Your kids are on loan from God and you get only one chance to watch them grow up.

Second...Life long school personnel are like cows. They walk the same path every day, day after day, on the same path the cows before them walked. It takes a lot of training and repetition to cause them to deviate onto another path. In the grand scheme of things, school nursing is relatively new to some schools. And it is still in its infancy to be included in the nuts and bolts of some school administration; not purposefully but it's, figuratively, just now showing up on the cowpath. Your challenge is to assist them in making this connection/inclusion when and where it involves your expertise and experience...they don't realize how fantastically lucky they are to have you there. So, just consider their history, (remember they've only lived inside the walls of an educational institution their entire lives), be enthusiastic, engaging, and they'll eventually get with the "plan."

Third...you'll see who the most important person on campus is when a kid starts seizing on the floor of the library. That would be YOU!!

All and all, forget about it. It's history; let it be a learning experience for all and march forward.

[tining, BSN, RN]

What OD said is spot on. I am left out of things and then their light bulb goes off and I am asked to help. Probably an oversight. Meet with admin and tell them you would like to be on their team for these things and soon you will be like MHDNURSE!

[WineRN]

Like those above me posted, I think this in an Admin issue.

I get to know everything, mostly because I'm very vocal about my role and I have a good relationship with my staff and counselors. My teachers often complain to me when I know more about what's going on with their students than they do because sometimes there is a gap between what's going on at the Admin level.

But that being said, I can see a similar thing happening here if it spiraled quickly and those involved were capable and able to handle the situation and alert EMS. They shouldn't have shooed you into you office, but maybe them inviting you to the meeting after was them looping you in

[KKEGS, MSN, RN]

I am also in my second year of school nursing. These true crisis situations have happened twice in my 2 years. Neither time was I really involved. The school psych and guidance counselor/social worker took care of it and, frankly, I was fine with it. Although I have obviously had some education in mental health it is not my forte. I feel like the psych and counselor are much more equipped to handle it. I was nearby in case they needed me but was not directly involved at all.

[SavyNurse, ADN, EMT-B]

I have been called after a crisis just to check over the student to make sure they did not get harmed during the event. But after talking to the SPED here I am actually going to get trained in Crisis Prevention next week with another teacher. That way if someone is not here with have others to step in. On the other hand trying to find out what student may have behavioral needs (which may effect how I end up treating them) has been like pulling teeth.

[OyWithThePoodles, RN]

If a child is involuntarily removed I am not involved. There's not really a reason for me to me. If a hold is used, they will get me afterwards to assess the child for injuries. That's all. None of the nurses are safe crisis management trained, we are there to assess and provide medical attention if needed.

[ruby_jane, BSN, RN]

So...they didn't think you could do ANYTHING??? I mean....even if I can't do "anything" I can do some things.

Hope the vent helped. Many people pointed this out already: it's not you, it's them.

[Cas1in72]

I hate the separation of guidance and the health office. We used to be very united and now...not so much. If there was a medical issue that precipitated the need for an ambulance by all means you SHOULD be involved. If it was truly psych... meh.

I have this issue in my building. I feel what you are saying. I have tried and tried to work with guidance, I am used to the hospital approach to things. All disciplines work together for a common goal. I am never thought of until there is an emergency. Heck, Im left off of staff emails, dont know about staff meetings, got left out of the safety/ crisis meeting ( active shooter training), dont get copies of IEPs that have direct medical interventions listed. I had a situation earlier in the year with a suicidal student, to say I am a little on edge about that topic would be an understatement. About a week after the incident, I had a student come to my office making statements that were alarming, I went to the counselors to speak to them... COME TO FIND OUT, this student was known to the guidance dept, counselors and principals to have made a suicide pact with another student and I was not made aware of anything!!! I think that was the straw that broke the camels back for me. I can only do what I can do, but to be left out of loop has got to be one of the most frustrating parts of this job.