Overworked

Flare, ASN, BSN · Nov 13, 2013

i don't think you're whining to ask to have a bit more help or at the very least - have some lunch time coverage and perhaps 5 minutes in the day to empty your bladder. But at the same time, I wonder how many of the referrals to your office are really unnecessary (ie chapped lips, mild headache/ cold symptoms that ultimately you are going to check and RTC or mild stomach aches that can be treated with bathroom visits before health office visits.) If you truly have 40-50 visits that are true substance then my heart goes out to you and you definitely need to have a better plan of attack - whether it's promoting better preventative care or more communication with parents to establish better health care and better follow up.

But if it's like any typical nurse's office and it's 20% legitimate stuff, 15% questionable, 10% routine meds and the rest malingerers - then your admins need to get their heads our of their booties and do something to help you. Because even if you decide to leave - it won't take long for the next person to grow weary of it.

100kids, BSN, RN · Nov 14, 2013

I don't think you're whining at all. I agree with Flare take a look at what percentage of the visits per day are really unnecessary and work on cutting those down. Talk to teachers, admins, administration if needed and explain what the problem is and how you all need to work together to decrease the # of kids coming to see you. It is in their best interest for things to work better. Also I know you said you are not taking lunch. I used to do this but I changed that practice this year because I was getting burned out with zero time during the day that I was not accountable to the little people. I know take a scheduled 1/2 hr for lunch EVERYDAY! The teachers know my office is closed form 12:30-1:00 so students should be sent to the office for emergencies only. All other children will be sent back to class. If the teachers know you are not available at those times they will learn not to send the kids. The front office knows how to reach me in an emergency but I am unavailable for band-aids, boo boos, headaches, nausea, etc. during that time. It has made a tremendous difference to me but if it wasn't scheduled everyday I wouldn't do it.

Good Luck!

RNlove17 · Nov 14, 2013

I'm so sorry that you are dealing with this and not getting any support. I am the sole nurse for approx 1500 students and staff at a high school. I however have a VERY capable health aide. I would die without her. We see anywhere from 35-60 depending on the day. They need to give you an aide!! I agree that you need to just close your office for lunch. I assume that your state has laws regarding breaks, so the school cannot fault you or have a real case against you for taking the break. Just shut your door and start establishing the boundaries. Obviously the real answer would be to have 2 people in the office to cover lunches so maybe they'll start to get the hint!

kidsndogs · Nov 20, 2013

Thank you for the comments. I agree that there needs to be more preventive care, teaching, health promotion. I have no time to do anything like this. I also don't seem to get support for this when I bring it up to the administration. They don't appear to have any idea of what is really going on. I find that my office is the first line of health care for many of these kids. Parents send their kids to school to have me look at them before they take a day off work, or spend money on a copay because no one can afford unnecessary medical expenses or to miss work. I feel like I can't be proactive because I am constantly putting out fires. I am not charting the kids who have chapped lips, or need a band aid ( I do pass out band-aids by the handfuls to teachers). I am charting the ones that need to be assessed or that I provided an intervention for. I try to check everyone who has hit their head, or fell and hurt a limb. I can not have a student limp in to my office and just tell them to walk it off. I also do a lot of individual teaching with my students when they come in. I discuss nutrition, exercise, injury prevention, pregnancy prevention, I care for my pregnant students, I take care of rashes... Then there are the daily burns from the kids in shop class, or the infected spider bites from home. I take temperatures, encourage more water drinking for headaches...I talk to parents frequently. I'm a good nurse, and I believe the kids like to see me because I treat them like they are important and they will learn in my office. I have talked to the principals about the need for help or for breaks. They say, why don't you just shut the door. So, it never fails, every time I shut the door I the office is calling me on my cell. Today I sat down to eat and I about a possible concussion. Last time it was a kid with a reattached finger and the bandage came off and blood everywhere. It is always something. I'm not even including the kids that I give daily meds to or the diabetics in the number of kids I am seeing. What I am charting is above that. I am leaving this job.

Flare, ASN, BSN · Nov 20, 2013

But that's just the thing - you are not the community clinic. Parents should not be using you as a no cost pre doctor's visit. These are the very things that are driving a good nurse out of a job. It is clear your mind is made up, but I would suggest that if you are granted some sort of exit interview or final evaluation, that you mention that a part of the reason that you are leaving is the fact that the parents are utilizing you as the community clinic and if the school administration does not figure a way to put an end to it, they will end up losing another good nurse out of a job. It's not nonsense visits that over crowd the serious visits and end up burning out school nurses when they don't get to eat and use the bathroom.

NutmeggeRN, BSN · Nov 20, 2013

Thank you for the comments. I agree that there needs to be more preventive care, teaching, health promotion. I have no time to do anything like this. I also don't seem to get support for this when I bring it up to the administration. They don't appear to have any idea of what is really going on. I find that my office is the first line of health care for many of these kids. Parents send their kids to school to have me look at them before they take a day off work, or spend money on a copay because no one can afford unnecessary medical expenses or to miss work. I feel like I can't be proactive because I am constantly putting out fires. I am not charting the kids who have chapped lips, or need a band aid ( I do pass out band-aids by the handfuls to teachers). I am charting the ones that need to be assessed or that I provided an intervention for. I try to check everyone who has hit their head, or fell and hurt a limb. I can not have a student limp in to my office and just tell them to walk it off. I also do a lot of individual teaching with my students when they come in. I discuss nutrition, exercise, injury prevention, pregnancy prevention, I care for my pregnant students, I take care of rashes... Then there are the daily burns from the kids in shop class, or the infected spider bites from home. I take temperatures, encourage more water drinking for headaches...I talk to parents frequently. I'm a good nurse, and I believe the kids like to see me because I treat them like they are important and they will learn in my office. I have talked to the principals about the need for help or for breaks. They say, why don't you just shut the door. So, it never fails, every time I shut the door I the office is calling me on my cell. Today I sat down to eat and I about a possible concussion. Last time it was a kid with a reattached finger and the bandage came off and blood everywhere. It is always something. I'm not even including the kids that I give daily meds to or the diabetics in the number of kids I am seeing. What I am charting is above that. I am leaving this job.

Im sorry to hear you are so frustrated....you certainly have the caring and compassion to do a really hard job! Good Luck, maybe when you list your reasons for leaving, they will take a better look at your situation?

RNlove17 · Nov 20, 2013

I was alone yesterday - and it was hell! And then I had administration questioning some of my nursing judgement. Ugh! I cannot imagine having to do that everyday, and I really feel for you