Overwhelmed new school nurse

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I've been working as a school nurse for a little over three weeks at my local district. I am juggling four schools. My previous experience is limited--I was a substitute school nurse one day a week for six months at a larger well organized district. I feel like I have no idea what I'm doing. I am wondering if I made the biggest mistake of my life. One of the schools is a small private school and I literally stare at the wall while I am there because I have no students visiting the clinic and no idea what else I should be doing. I have been given limited resources, no protocols or policy/procedure. Subbing was very different--the clinics were very busy, lots of meds and diabetics, even a tube feed. All the charting was electronic which I excel at and I was primarily at the same school. I loved it.

Now I feel idle and that paperwork is the only thing I will ever be doing. And I don't know how to handle so many situations. I forgot to send a head injury form home with a student (because I really hadn't even been briefed on the subject) and got nicely talked to by my supervisor because the parent was upset.

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Specializes in School Nurse.

First - Welcome, you are with friends.

Second - there are so many things to do. State screenings done? Immunizations current & not delinquent. What alerts & conditions do you have - start contacting parents for what they want to happen when their little one is having an issue.

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Specializes in Pediatrics Retired.

Welcome to the farm! You mentioned a supervisor. Is that person a nurse or someone familiar with nursing?

And, are you the first school nurse here or replacing someone?

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I am replacing a nurse that had been here for ten years who left in the middle of the school year because she was frustrated at having to juggle four schools after being at one previously. She left things in great shape. All screenings done from what I can see (except for NTD) and immunization letters were sent end of January.

The supervisor seems very busy and hates it when I ask too many questions...She cuts me off all the time. She is the head of health services and seems to just be overextended.

It seems medical alert lists are up to date with EAPS in a binder. I did not like the wording of some of the EAPs, so I rewrote several already.

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Specializes in ICU/community health/school nursing.

Welcome!

It is not unusual to be dumped into the fray without knowing every policy and procedure. Are those on line for you? Or in a book? For the time being, when you have something - head injury, lice, etc. - look up the policy.

Hang in there. Four schools seems like a terrible gig.

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Specializes in Pediatrics Retired.

There is a lot of school juggling experience on here but I'd advise you to sepnd most of the time at the busiest school and titrate the time down for the others. Student health and safety is top priority and everything else comes next.

I'd also recommend emailing your questions to your supervisor. That way if she doesn't answer you, you're covered, and if she does answer you, you're covered.

Don't hesitate to ask on here...good luck!

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Specializes in School Nursing.

Is there a school nurse in a neighboring district/building who you might be able to bounce things off of? I like calling and asking seasoned nurses I work with before going to the supervisor when possible. (Our supervisor is not a nurse, so often this is more effective for me as well).

Also, Welcome! ONE OF US! ONE OF US! ?

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Welcome! What is your daily routine like? Do you go into all four schools each day? I agree with spending the most time in the largest school. Did the nurse you replaced also oversee four schools or is this something new? It sounds like you need to figure out a routine and some structure to balance your days. I cannot imagine juggling four schools, especially as a brand new nurse!

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Specializes in kids.

Contact (and join) your state association! and NASN too if you can swing it. Lot's of great resources there!

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Well unfortunately I am not allowed to structure my own days very well. My schedule is set. Monday and Wednesday I spend 1/2 day each at the two boring small schools. Tuesdays I am at the busy school all day. Thurdays I am at a medium school. And Friday I spend the morning at the busy school and the afternoon at the small school. I wish I had more control, but the smaller schools are private and have a contract with the bigger district, so I am committed to 2.5 days a week. there.

I think I might start to look for a new position as guilty as that makes me feel in the district I subbed in. Rumor has it there will be an opening for one school come fall. I just feel like I am flailing with no assistance or guidance.

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I totally feel your pain. This is my first year as a school nurse. Im at a High School with about 750 kids.

My background is ICU, Dialysis, Hospice all very structured areas of nursing.

Now I feel alone, most of my orientation has been hit or miss with a lot of research on my own. I have 7 diabetics! The non-compliance is horrible.

When does the confidence kick in?

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17 minutes ago, murrayn said:

I totally feel your pain. This is my first year as a school nurse. Im at a High School with about 750 kids.

My background is ICU, Dialysis, Hospice all very structured areas of nursing.

Now I feel alone, most of my orientation has been hit or miss with a lot of research on my own. I have 7 diabetics! The non-compliance is horrible.

When does the confidence kick in?

This is school nursing in a nutshell, unfortunately. When I was new four years ago, I too was just thrown in with zero orientation or guidance, and no nurse leader to call. So this forum became my nurse leader, my nurse's station, my second opinion, etc. It has been a godsend. I would say my first year I felt unsettled more often than not. The second year felt better but I still had LOTS of questions. Year three I felt like I could officially start giving advice to the newbies ;) . I still have questions all the time, but can also finally answer other people's questions as well. School nursing is indeed a very independent, self-directed type of position. Definitely not for everyone. But if you genuinely enjoy it more often than not, give it time.

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