Achevy

Have you thought about School Nursing? Depending on your state, the pay cut might not be too deep. I work 0715-1500. I'm off all the same holidays as my kids plus Spring break and christmas break, etc. I choose to also work during the Summer at a Summer camp, but you wouldn't have to! If you need to be the breadwinner, you could always pick up PRN at a hospital during the Summer too.

In case this is an issue for anybody else, I ended up finding what I needed in our NC School Health Program Manual: "Early planning for field trips enhances safety of the student during the activity. Guidance provided from the NCBON in its revised 2021 position statement, Assisting Clients with Self-Administration of Medication states, "The unlicensed assistive personnel may not perform pre-filling and labeling of medication holders or syringes.” Guidance from the NC Board of Pharmacy in 2007 instructs parents to obtain a second labeled, child-resistant prescription vial for each medication when possible. The NC Board of Pharmacy also directs that school nurses may "repackage a day's worth" of medication for a field trip."

great idea, I'll see if they can clarify a difference between regular medications and controlled, thanks!

yes it does, thank you! I definitely wasn't going to send all of it and our lead nurse said I couldn't take out one dose because that was dispensing. I did a little policy searching, and as nurses, we are in fact allowed to send one dose for a field trip legally. There's no special consideration for Schedule I or II medications in our policy, we just treat them as securely as we would treat all the other medications. In leiu of an extra labeled bottle from the pharmacy, we can make our own label as long as it has all the needed components of the order. Hope this thread helps anybody else new that might wonder how to do it!

How do you all handle controlled medications (mostly ADHD types) on field trips? Do you sign out the whole bottle and have your delegate hold a lock box all day? I was told I can't just sign out a dose into a different bag or bottle because then it's unlabeled and technically "dispensing." I asked my other nurses and it appears we're all doing it differently.... our field trip policy doesn't say anything about this specifically. Something we'll need to write a procedure for, for sure. I'm in NC and it's my first year in this role.

Thanks for the reply! It's my first year and being the only healthcare professional is strange sometimes. Am I risking my license by operating outside of the orders? or am I risking my license by not treating the student and something bad happened? Thanks so much for the advice

I worked as a sub school nurse for 2 years. The first year, my only responsibility was to see the kids as needed and to pass the scheduled medications. I kept a paper log for the school nurse that she looked over when she returned. The school nurse copied my paper log into the system. I assessed and called parents. The second year, they gave me computer access, but my only responsibilities were still to look after the kids as needed and pass the scheduled meds. When you get to your sub offices, someone will give you a quick run down of their forms and where to locate parent numbers. Then take a tour of the office on your own and find all the supplies you might need. One thing that I learned as the sub nurse was to not overstep and try not to do too much. It was someone else's office that I was essentially just babysitting, so while I wanted to do more, it was important to show some restraint and stay in my sub role. I also googled School Nurse Fist Aid and read some blogs and printed infographics about common problems a school nurse would see and what the recommended treatments are. The more time you spend in the offices the more comfortable you will feel ?

I've had some students with asthma this year that really make me question myself! Yesterday's incident is on my mind. My 6th grade student with asthma is recovering from a cold. She had dance practice after school and would likely need her inhaler during practice. Her mother told her to go to the nurse to take her inhaler at 1pm. So the student came walzing into the office at 1 to take her inhaler. She's congested and clearly recovering from a cold, but she's happy with no SOB or wheeze and pulse ox 98%. My orders are for wheezing and asthma symptoms. Would you have given her the inhaler knowing she would need it later and count the congestion as an asthma symptom? Are you very strict about following the orders to a T? The student would not have come into the office asking for it, if mom hadn't told her to come. I told the student to come at the end of the day when dance started, but she never did. I stay worried that she needed it for her dance practice and I wasn't there and didn't let her have it earlier. What would you have done?

I honestly don't know the specifics of the Bill, but the changes for the School Nurses are coming from the Student Services leaders in my county.

Hi! I'm sure more changes will come, but currently the biggest change is with our mass hearing/vision screenings. We used to be able to mass screen unless a parent sent the form telling us not to screen their student. Now with the Parental Bill of Rights, we had to rewrite the document and now parents have to return it giving us permission to screen. My screening for 3rd grade is Tuesday next week and I've only gotten 2 back. So that will be a big change so far.