nurse reviewer vs. school nurse

[nursex23, BSN, RN]

Hi everyone,

I recently left an LTACH after my first year as a nurse. I couldn't get past working weekends and holidays (I know, I know, I chose this profession). I applied to a few schools, doctors’ offices, and one insurance company. One school called and hired immediately and I’ve been here for about a month. There’s really not much to complain about but I am finding it difficult to work with middle school kids as far as dealing with their attitudes. Now this insurance company is looking at me. They both pay about the same. The insurance company could potentially be work from home which I find very appealing but I’m nervous to leave this school nurse job and the insurance company is worse. I’m also nervous to pass up the opportunity with the insurance company. I also don’t want to burn the bridge at this school because I just started and I would be leaving in the middle of the school year. I’ve compiled a list of pros for each job.

Pros for both

*close to home

*pay about the same

*schedule: no weekends, no holidays

*no stress of bedside

Pros for school

*schedule: long breaks, Christmas break, Spring break, etc.

Cons for school

*students can be disrespectful and overwhelming

Pros for insurance company

*potentially work from home

Cons

*don’t know of any

Can anybody share their experience and insight about these jobs? My long-term goal is to go into academia. Would either job help or hinder this goal?

["nursy", RN]

If your intent is to go back to school for yourself, the school nurse position gives you lots of time off, which is good for studying and such.

What kind of insurance work? Physical exams? or reviewing charts? Makes a big difference in what type of work is called for. Most nurses I know love doing exams. Most complain that chart reviews are very hard, you have quotas and deadlines (this is what I have head, so you may want to check it out).

If by academia, you mean nursing instructor, hands on nursing is going to be very important.

[nursex23, BSN, RN]

Thanks for the response! From my understanding based on the job description, it would be conducting pre-authorizations for treatment. My connection to this company is actually a physical therapist, not a nurse so I'm not 100% sure what the work is like for the nurses. Although I don't mind the hands-on nursing work, I absolutely love the paperwork (weird, I know). I'm not sure about what exactly it would involve so I think I'm definitely going to try total to a nurse from this company to get more information.

I want to go back for my MSN so that I can teach. It sounds like school nursing would be better for that goal so I guess I'll have to keep that in mind. Thanks for your input!!

[Jedrnurse, BSN, RN]

What specifically do you want to teach? Depending on that, you might want to think about increasing your length/breadth of clinical experience.

[LeaRNy]

Hi! I worked for one of the large insurance companies for about six months. It wasn’t for me. I have small children and thought the work from home was a dream. I came from another non-bedside role and was used to having flexibility in my schedule. There was none of that with the insurance company. It was a set time frame, although you could flex your lunch. It was Monday-Friday. If you would be late “getting to work” aka logging on you would have to use vacation time. I came from a world where we had autonomy and flexibility- there was no micromanaging as my superior knew I would complete my job, it was a mutual understanding. The insurance company was very much micromanaged. It was constant push to complete tasks and assessments and there was a quota or they threatened your bonus structure. The other big con from the insurance company and why I ultimately left was because of my mental health and feelings of isolation. I went from talking and interacting with patients and co-workers and all of a sudden I don’t leave my house for days at a time and am holed up in my basement office staring at concrete blocks while making calls and educating patients (if they answer) on usually hypertension or diabetes. It wasn’t for me and wasn’t at all as glamorous as I dreamed. Best of luck to you in your decision making!

[shark_nurse14, BSN, RN]

A month of school nursing is very little time, especially when trying to get used to middle school attitudes! I would highly suggest reading posts on the school nursing speciality page to get a better idea of school nursing as a whole. You might notice the longer you stay, the more comfortable you get and the more you like it, especially since right now it seems like your only complaint is about students you likely don't yet have a relationship with. Also, school nursing requires a large portion of educating students and understanding educational settings, which will likely benefit you in your future endeavors in academia.

I would also consider not just pay, but other perks like retirement plans, possibility of reimbursement for continuing education, and things like that! I find that working in a public school setting, our teachers union has fought for a lot that the school nurses end up benefitting from. For instance, I'm able to be reimbursed for my MSN courses because the teachers union fought to have their masters courses paid for years ago.

Lots to consider, good luck!

[Nunya, BSN]

As well as reading school nursing posts here, there's a FB page called...School Nursing that I think could be helpful. You can vent, ask for advice, see what other MS nurses do about this problem. The big thing I've learned is you can't take what middle schoolers say personally, it's just the age!

[WestCoastSunRN, MSN, CNS]

I would not get involved with the insurance company for the following reasons:

You will benefit GREATLY from any clinical experience you can get, if you plan to go into academia. And this is a biggie - based on what you said about intentions to teach.

You just started at this job. Many school nurses LOVE their job. You have not had the opportunity to form an opinion either way.

Don't job hop. You can ALWAYS make a change. I'm pretty sure if you leave school nursing now, you will always wonder about how it might have been had you actually given it a chance.

Nursing is hard and there are downsides to EVERY specialty. If the biggest downsides to the school nursing gig are middle school attitudes, you might consider yourself fortunate.

Also, I want to say, LTACH is a tough place to work. There are many bedside/clinical specialties that don't suffer the same challenges LTACHs do. I hear that you didn't like the schedule, just sayin'.

[Amaezingrace, BSN, RN]

Hi nursex23, I came across this thread as I was looking up up the topic of nurse reviewer. I am thinking of applying for job that sounds like the same description as you’ve mentioned in regards to conducting pre-authorizations if treatment, amongst other duties. I was curious to see if you took the job? And if so, if you would provide some more detail in what your day to day work is like at home? Is their flexibility or is it a rigid schedule? Or if you had an interview, then maybe you could share what types of questions you were asked? I really appreciate any info you’d be willing to share. Thank you and I hope you are enjoying whichever career you ended up choosing!

[nursex23, BSN, RN]

Hi Amaezingrace, I did not go with the insurance job. I decided not to even apply. I haven't decided definitively how I'm liking the school job so I'm going to stick with it for now. Good luck!