basketball13

I really appreciate all your feeback! Like you all said, I think it was just too early when I saw her so she only had mild symptoms. I just wanted to make sure there was nothing else I could have done. I actually did have her hop up and down a few times, and she did that without any trouble. Anytime anything like this happens, I tend to overthink and doubt myself. Thank you all so much for the reassurance.

Hello everyone, I am looking for some feedback. I had a 3rd grader come into my office mid morning the other day. She said that she felt like she may throw up. She did not have a fever, had eaten breakfast earlier in the morning, and she said she had a normal BM that morning. She had no specific area of tenderness or guarding of her abdomen. A couple other kids have had the stomach virus, so I thought she probably had the stomach virus or maybe it was from eating too much candy (this was after Halloween). I told her if she vomited or felt worse to return to the office. I told her to try to eat lunch and see what happens (lunch was about an hour later). I left to go to another school at lunch time, and I actually left a couple hours early from the other school that day for my own medical appointment so I did not follow up with anyone that day about her. The next morning I found out she had returned to the office later in the afternoon (still no vomiting or fever). They let her rest in the office for a little bit, but did not send her home. Apparently, her parents took her to the ER later that night for appendicitis, and her appendix was remove the next afternoon. She is fine, but I hate that I didn't catch it. Is there anything you would have done differently? Anything else you think I should have done that would have helped me recognize appendicitis? Of course, anytime a child complains of a stomach ache/nausea I consider appendicitis, but in this case I just did not have much reason to believe it was appendicitis, at least not at that point of time. I just want to do better in the future and appreciate any feedback you may have!

No, they didn't do much other than put O2 on her. They listened to her lungs when they first got there and said that her lung sounds were clear- which they most definitely were not. They took her BP, and I already had my pulse ox on her finger. That was pretty much it. Her mom did take her to the doctor and she has an inhaler prescribed which is at school now thankfully.

Thank you all. I am glad I called 911. In the future if something like this happens again and I am far away, I will tell them to call 911. The way the secretary described her condition to me, I was not sure how serious it was. Plus, this school calls me all the time for minor things. One time they called me and said this little girl hurt her knee really bad and needed checked. I drove over to the school, and when I got there she wasn't in the office. They said she was sitting on the bleachers in the gym. I walked in the gym and she was doing jumping jacks and running. The secretary was like "she was crying a lot!" lol. Regardless, better safe than sorry!

Thank you all! I definitely wish we had portable O2 tanks lol. Do you all think I should have considered giving her epi (and call 911 of course)? I just want to know better for next time.

I did at least tell the secretary that if she seems to be getting worse before I got there, not to hesitate to call 911, but I wasn't sure if I should have went ahead and told her to call 911 or not. The bad thing is is that I have no cell service between the two schools. Of course, I did not think of this until I was on the road. I wish we could stock albuterol, but it's a state law we can only stock epi and narcan. Narcan was just added this year, but our schools don't stock that as of now. Just epi.

I am a relatively new school nurse. The other day I got a phone call from one of my elementary schools (while I was at one of the my other schools) that a student was short of breath and struggling to breathe. They stated that she had been running in gym class when it started. No PMH or allergies that we knew of. I asked a few questions and then drove over to that school as fast as I could (about 15 minutes). Her face was bright red, lung sounds were wheezing, very labored breathing, tachypneic, O2 in the low 80s. She'd been like this for about 20 minutes at this point. Principal said she hasdn't gotten any better. Attempted to call mom, but initially could not reach her, so I called 911. While I called 911, the secretary reached the mother and she was on her way as well. EMS got there and put 2L of O2 on her. Within a couple of minutes, the wheezing went away, her O2 went up to the mid 90s, and her breathing became less labored. Mom arrived after the student looked much better from the oxygen. Mom has asthma. We took the O2 off of her and she continued to do fine at this point. EMS talked to the mom and didn't feel that she needed to go to the ER, but encouraged her to follow up with her PCP and get tested for asthma (which I generally agreed with). Mom ended up taking the student home and said she was going to call her PCP. Of course, since this has happened I've been questioning whether calling 911 was the right thing to do or if I should have held off. The nearest hospital is 45 minutes away. I had absolutely nothing at school that I could give her (we can only stock epi and narcan). What would you have done?

After I graduated a few years back I worked and floated between a cardiac floor, medsurg, and 2 psych units for a about a year and then worked the psych unit for a couple years before starting school nursing a year ago. I think a psych nurse can absolutely be a school nurse, especially if it's your dream. Psych comes in handy in school nursing. If it's always been your dream, I think you'll be happy with the switch.

I am 24 years old. I worked in the hospital setting for a little over 2 years before starting school nursing. Initially I was in a float pool working between a cardiac stepdown, med surg, geriatric psych, and adult psych floors. Initially I was exactly how you described. Incredibly anxious before each shift and super stressed during my shift. It was pretty bad in the beginning. After 1 year I had definitely calmed down and became far more comfortable, albeit an anxious mess during my shift. Towards the end I fell in love with the psych floor. I found it to not be nearly has high stress as the medical floor (though perhaps some would disagree), but busy enough so that I was certainly not bored. Plenty of direct patient care. Also, I just generally find psych fascinating making it even more enjoyable. I had to move however, and became a school nurse during that time. To be completely honest, I feel the school setting is far less stressful than the hospital setting. I'm not bored though. There is certainly always something that needs to be done and crisis do happen. While I may be rather busy doing various things like paperwork and such, it is not a stress/adrenaline type busy like it is in the hospital. In the hospital high stress/emergency situations typically happened the entire shift with no break, where as in the school those life and death type situations aren't happening constantly.. Therefore, I feel school nursing in less stressful because of that. I do personally though miss having those adrenaline type rushes while working, and I do miss getting to do direct patient care constantly so at times consider school nursing to be boring for that reason (not because I'm not doing anything productive). Does that make sense? It is hard for me to explain. One thing that does stress me out about school nursing in particular is that the public knows you're the school nurse and you become almost like a public figure. That means people are watching you more (at least in my small rural area). Also, you're likely to have angry parents talk about you on facebook for whatever reason and your friends and even family may see it. While I dealt with angry family member from time to time in the hospital, at the end of the day I likely didn't see them again or hear from them again making it easier for me to move on. I hate when people don't like me or get mad at me so this is one of the hardest parts of school nursing for me. Also, I miss having other nurses around to help me and even to talk to during work. Teachers understand teacher problems and aren't interested in how the school nurse feels lol.

At my busiest and biggest elementary school (around 230), I see around 20-35 (for a full day that is, on my half days I see around 15). Some days are easier than others. Some days it is mainly very minor reasons (bandaid for a cut, ice pack for an imaginary bump, itch cream, simple temp check). I personally do not mind seeing kids for all of these minor things.. I see it as job security lol. I quickly take care of each child and send them on their way. However, there are some days when it is a little more complicated. Hygeine issues, lice issues, truly ill or injured but cannot reach anyone by phone, etc. Even if I see significantly less kids on those days, it is much tougher for me and frustrating on those days. I've never had to take work home though.

I myself have battled depression and generalized anxiety since I was a teenager. I wrote it off during my teenage years as hormones. I went to college and started nursing school. I was a nervous wreck for clinicals. I was so terrified of hurting someone or messing up and killing someone... and I was just in the beginning stages of clinicals doing bed baths and talking to patients and I was terrified of messing up! I did great on the school work side of things, but clinicals were harder on me. I never slept the night before clinical. I did okay, but still had doubts about going into this profession numerous times. I almost quit in my last semester convinced I was too anxious of a person to do this. ICU clinicals terrified me and I did not even witness anything horrific as you are describing. I stuck it out and graduated. (I even worked as a nursing aide to try to help me overcome it and I do think it helped but I was a nervous wreck in that capacity as well though I was told I did well). I immediately got a job in a hospital in a float pool rotating between 2 psych floors, cardiac stepdown, and a medsurg unit. I never slept well before work and had horrible anxiety which led to even worse depression. I was so scared of messing up and not doing a good job. I cried before I had to go to work nearly every day and on my way to work I'd wish I would wreck so that I did not have to go.... things got easier though! After about 6 months I realized I hated med surg which was where I was scheduled to work the most. I then only worked between the cardiac stepdown and the psych floors. After 8-12 months I finally didn't dread coming to work. I also finally saw a dr. and was prescribed lexapro which helped my depression and my generalized anxiety. I was finally comfortable in my job and while there were still some stressful situations, I did not hate my job. I eventually went to psych full time and loved it. In my opinion psych is generally less stressful than medical units, but some would disagree. I did though just recently start working as a school nurse and overall the stress is significantly less on the average day. There are tons of different options out there, and once you become comfortable you are significantly less stressed. Don't let it scare you away. You are not alone. Critical care was not for me and may not be for you. You'll figure it out.

I too am younger, 24. I get it all of the time from staff. Occasionally from parents. I don't mind it though. In fact, I can of like it. For some reason it puts me at ease lol. Growing up, when I would go to the dr. or dentist and I was greeted like that, it made me feel more comfortable. My family talks like that a lot too. When I initially started working as nurse in the hospital at age 22, I got pet names all of the time from patients, other nurses, doctors, etc. Again, it never bothered me. Other nurses would ask me my age a lot and be surprised at how young I was. A nasty surgeon though who hadn't met me, went to the nurses' station and said the nurse of the patient in room # needs to come with me to that room for rounds. I walked in and he says "What are you in high school? You can't be the nurse." In front of the patient... He was always mean to the nurses. My first year, I struggled some with the older nursing aids. It was hard for me to delegate and they often looked down at me age. Eventually, I overcame it. I also struggled with patient visitors at times due to my age.

I am the one who started the original thread regarding my first emergency scare and it was similar to this! I had a girl come in for a super small paper cut with just a scant amount of blood. I put a band aid on it and she said she didn't feel good. She said she had a headache. She fell backwards hit her head and started seizing for 5-10 seconds and then came back to. 911 was called. The EMS too looked at me like I was crazy when I said she had seizure like activity (no history of seizures). They didn't believe me either. Turns out he doesn't do well with blood and has at least passed out before (parents never mentioned that to us of course lol). Apparently this is vasovagal syncope and when they pass out they look like they are having a seizure, but it is not actually an epileptic seizure. Pretty interesting. I couldn't believe a tiny paper cut cause that to happen! It was definitely scary in the moment though.

So I had my first real emergency scare in the school nurse setting. A fifth grade student walked into my office with a very small paper cut (and minimal blood) requesting a band aid. I finished putting a band aid on her and she then said she did not feel good. I asked her what was wrong and she said she had a headache. I asked herif anything else was bothering her and she said no. Unfortunately, I did not realize what was happening, and I checked her temperature which was normal. As I was putting the thermometer away, she fainted and fell backwards hitting her head and started to have seizure like activity for about 10 seconds. No history of seizures and no past medical history that we knew of. Her pupils were very dilated. She stopped and came to and started crying because her head hurt of course. We had her lay there. She was dazed, but knew her name, who the principle was, and where she was. I yelled for someone to call 911 as soon as the seizure like activity happened. The paramedics came and took her vitals which were normal. Of course, they doubted there was a seizure. Mom came and said she has fainted before from seeing blood. And she did say afterwards that the blood made her feel queasy. She did take her to the ER though. I did some research and apparently this is called vasovagal syncope and can cause what looks like a seizure, but really is not a seizure? Just wondering if anyone else has seen this, especially in the school setting? What did you do? I have seen NUMEROUS seizures in the hospital setting on a psych unit. Both epileptic and pseudoseizures.

THankyou!!