MollyJ

Re: dogs in the building well, maybe I'm old but I've seen this. Problems: Drug sniffing dogs get nose fatigue just like you and I would if we went on a perfume sniffing mission. They are only good for so many minutes of work. Like maybe an hour. Not claiming expertise on the exact time. Disruptive to the school day and may not be worth it.

You are very young and when I see young people admitted to nursing school, I wonder at the wisdom. But you're there. Here's the news: You are going to have to take at least some of what she said "to heart". You are going to have to subsume being a typical 17 year old to some degree. The patients are not there for your edification, enjoyment or amusement. They are there for care. You are going to have to learn to censor yourself in a way that most 17 year olds don't have to. If you can, go _back_ to that instructor and tell her you want to talk to her again--not on the floor but in private and in her office. If you cannot do it with her, do it with a faculty member you are comfortable with. Get a very concrete list of what you need to work on. Consider finding a mentor, a nurse who will talk through situations with you. See, if you do that, you will be exhibiting a mature desire to work on doing what it takes to become a nurse. we have very minimal contact with student nurses in my school setting and I often meet students that I think could benefit from mentoring but I've never seen it done systematically. Still, try to create that for yourself. wouldn't think you are alone on this....

I think you are reacting to the parent-child dynamic here. The pain of a mom who could not "make it better" (even before this time) for her child. You might try writing out your thoughts. _Pretend_ you are going to submit it for the writing contest that allnurses sponsors. Here is a mantra that I sometimes invoke. My DH introduced me to this one and he says it is Buddhist in origin. Imperfection is part of the perfection of things. Many situations cannot be made "all right" and they can become the stuff of what makes us softer, more compassionate, more understanding of how love is always expressed imperfectly.

Perhaps we can form a support group. I'm using ours under duress. No one would ever think that ours was put together in consultation with nurses but many nurses obviously think the computer is the future and they embrace it uncritically. That last part is the part I don't understand.

In the state I live in we use a drug recognition protocol that is based on field sobriety tests. I think the results are iffy at best. I also believe that in our community parents can request from the sheriff's office a drug screening kit for urine that they read themselves. I will tell you that I am not necessarily for schools having the right to test kids. You know when we do tests in a clinical setting we do it to facilitate decision making, clinical decision making. I don't think schools are the best people to test kids. The "zero tolerance" policy means the kid may get expelled and that might not be the best thing for him. It also may simply generate too much resistance on the part of the students and the parent. I do not like our drug recognition protocol but it forces a discussion between child, parent and principal. That can create some movement in the situation especially if it can be connected to things the parent worries about with their child and things the child sees in his life that are signs that his/her usage is problematic. But it may not and you cannot make it so. I would say that I would _try_ to improve my relationship with the student. Let's face it, who among us would want to be a teen diabetic? And if someone here was one, then pipe up. The age of this student matters a great deal. I am guessing that we are talking about a High School age child. I would work to just get him to test more often and help him do problem solving but acknowledge he is in the driver's seat. It is not easier but it is more effective to confront a kiddo about drug concerns if you have a relationship with him. I think at least sometimes marijuana is a (mal-adaptive) stress coping mechanism. As you build relationship you can talk with your kid about diabetes and stress and stress management. Also another question is, "do you have an SRO in your building?" If you do, you, the principal and the psychologist should know what the protocol is for confronting a student that you think may be acutely intoxicated.

Jules, I would like your comment "twice" if I could.

I think possibly what matters is what your goals are for getting the BSN and what you want it to do for you. The place I got my BSN from was a State University and I feel I can "take my degree anywhere" and it definitely added to my nursing practice. It is these last two features that I feel are essential. You want a credible degree--and for me that meant a bricks and mortar institution--and it should add to my nursing practice. Now I am not arguing that everyone should look for a bricks and mortar institution but I think a nursing faculty who are working cohesively to provide a body of knowledge that they think a BSN prepared nurse should have is important to me. My two cents worth.

AbbyNurse, The test is done using a standardized kit and while you "could" cobble the kit together, I would say that surely in your community there is a kit you can borrow. The manual with the kit is invaluable. If you are a student, I would hope that the school might have one or could help you find one. It's a common enough tool in pediatric offices and maybe if you know a peds office they could help you. I administered them all of the time when I worked in public health and maybe the local public health agency could help. The test items are normed with being presented in a certain way and to be a credible presenter you will want to be able to do that.

You know, I think I would also consider calling my state rep or senator and telling them I cannot get the BRN to call me back. The more I think about it, the more outrageous I think it is that it is so hard for you to get them to talk to you.

I use "all bleeding eventually stops" but more often with teachers than kids. I'm in an elementary building. But how about those nose bleeds? You would think they needed T & C 2 units RBC's....

NanaPoo, I had a kindergartener whose mom is a teacher in the building. And the kindergarten teacher was telling her that at the beginning of the school year, some kindergartener was crying after being dropped off at school. The teacher's daughter looked up from her work and said, "You do realize you're going to see your mom after school, don't you?"

Subbing is a good way to get to know the building(s) and to try on the job. It also is a way for staff to decide if they like you. However, nothing beats the long term relationship with kids, staff and families. It may be what I like about school nursing the most. Shining in an interview is difficult. It can be "just chemistry". However, know that while the first aid stuff is often the most connected image of school nursing, it is not, IMHO the most important. Be willing to talk about your experiences in the care of children and families, your aptitudes and abilities in working with special needs kids including psych mental health issues, your comfort with doing or learning about technologies that might come to school, and your experiences with family nursing. Finally the weirdest thing about school nursing is that health care is not the "main event" there. Education is. Nurses and nursing are not very...important. Perhaps others can speak to this, too. You are an adjunct to the main business of education. So that's different. But I like it.

Jules, the APRN's and PA's I refer to mostly work (but not exclusively) for community mental health center's. Their supervising MD is retired and lives 3 hours away by car. They do not for the most part have access to the bushel of child psychiatrists that exist in the state that are in private practice. My community, a decent sized community of about 40,000 people has long struggled to recruit child psychiatrists because for the most part the hospital is not willing to admit child psychiatry patients. And I am not trying to paint the hospital as a meanie--their are some real formidable reasons for their decision. The features that feed in to the undersupport of the APRN's and PA's are systemic and not single cause. Reimbursement is a big part of it.

BostonFNP, I am not talking about kids who are well managed and doing well on the prescribed regimen. I am talking about outliers, tough cases. But these are individuals whose less than optimal _situation_ exacts a price on the child, the family, the school and the community. If they were your kid, I assure you, you would be seeking expert resources. But see, when we perpetuate the idea that all care can be equivalently provided by APRN's and PA's, then we lose access to that deeper level of expertise that is sometimes needed. I am not trying to argue that APRN's and PA's created this situation, please do not misunderstand me. But they have been exploited I would say. And if you are, as your name indicates, living in Boston that deeper level of expertise exists within a 30 minutes drive radius. That is not true my area. And many of the children in question are covered by Medicaid, CHIP. It would be hard to understate how poor the quality of child psych services are in my state and I am not trying to diss any practitioners that might be from my state. The system perpetuates a fantasy that these children can be solved with brief hospitalization and then tossed back to their local MHC's with no coordination or support to the MHC. I know that over-referral has been a topic here. I am talking about a different problem. The problem of APRN's and PA's not having sufficient support or resources for them or their patients. This model suits insurers but arguably in my state it is reimbursement issues that have limited access to experts. This is a systems problem but one that affects children and families in my community.

BostonFNP, I am not trying to get into a fight here. Surely, everyone has a patient they say about, "They needed someone; I decided it was someone smarter than me." This just looks more like APRN's and PA's left holding the bag than anything else to me. And surely you understand that 4 years of medical school plus a residency in psych and specialization in child psych might count for something, even though I know that you DO help a lot of people and I am glad for that as are they.