KKEGS

Hello all. I am in the process of applying for a Primary Care Pediatric Nurse Practitioner program and need 3 references. One must be from someone in a position to evaluate my job performance so I asked my current supervisor who isn't a nurse but does do formal evaluations of my work each year. I still need two more. The problem is that I work as a school nurse which means none of the other people I work with regularly are healthcare professionals. I haven't worked in a hospital in over 5 years. I have emailed my former patient care manager from my last hospital job as well as the former Nurse Educator who guided me through a 2 year new grad program but that was 7 years ago. In your opinion should I ask my current colleagues, who are mostly teachers, or focus on healthcare professionals even if it's been many years since I worked with them? I could also ask one of my fellow school nurses who I have worked with for 4+ years.

That happened with my own kid a few weeks ago! Woke up not feeling well on a Monday. Kept her home and got a BinaxNOW from her school nurse. Tested her Tuesday morning. Negative. Tested her Thursday morning. Faint positive. Did a PCR saliva test Thursday afternoon. Negative. Ugh. ? Kept her home the full 10 days anyway since we treat a positive as a positive here. No one else in our house ever tested positive so I don't even know what to think. We reported it to our Dept of Health as a positive.

I work exclusively in our PreK program and have a supervisor (our Early Childhood Coordinator) and another boss above that one (our Director of Community Education) but really I have an incredible amount of autonomy which I love. I hate being micro managed. It's one of the reasons I left my hospital job. I am on our district teacher's contract so I have to be formally observed doing my job 3-5 times a year. Usually they will come watch me provide diabetes care and I also teach health lessons in the classroom (Germs & Handwashing; Taking Care of Our Teeth; Sun Safety) so they'll come watch me do a lesson. Day to day though I am very much left alone. Which again I love. ?

One of our RNs drives around to all of the schools on the last day with one of our resource officers. She collects it all and it is turned over to the police for disposal with the county. We also inform families that if they don't come pick up the meds on the last day we will dispose of them.

Here's my brutally honest 2-cents: I have worked everything from Pre-K (my current position) to elementary, middle, alternative high school and post high school transition Special Education program and there are definite pros and cons to each grade level. None of it is easy and they all come with their share of challenging kids and parents. Elementary school health offices can be incredibly busy (30-40 kids a day is common and I had a day where I saw 80 in a school of around 600 kids. That's one kid every 3 minutes all. day. long.). Middle and high schools can be busy too (lots of mental health issues in these grades) but they are more self sufficient with things like putting on their own Band-aids and taking care of their own diabetes and asthma and things (Usually. You certainly get those kids who don't do what they are supposed to do, like my middle school Type I diabetic who would dose herself with insulin before lunch in my office and THEN NOT EAT because none of her friends were eating lunch. Awesome.) I would see if you could maybe shadow or start off as a sub nurse first to see if it's something you'd like. It's not for everyone and a lot of people have a hard time transitioning from a hospital or clinic background into a school building. You are often the only medical professional in the building so you need to make sure your assessment skills and prioritization are top notch because there is no one to help you. Also a lot of new school nurses struggle with the fact that you are sort of at the bottom of the totem pole. You are a medical person in an educational world and educational priorities will win every single time over what you feel are priorities from a healthcare perspective. If you can accept all of these things it can be an AWESOME job! There is no denying that the schedule is great and the job can be quite rewarding if you find the right position. I am on my 3rd school nurse position in 5 years and finally have found the perfect fit for me. Good luck to you!

We do not use anything like that. No aromatherapy, no infusers, nothing. I myself have asthma and have had some bad reactions to some essential oils so I don't want any of that in my health office. One of our other district nurses has also brought up the fact that if you use aromatherapy for one student and there are other people in the room you are essentially treating those people without their consent since the smell gets everywhere.

I work exclusively with preschoolers and we do our hearing and vision screenings during their Early Childhood screenings when we check for cognitive, speech, behavioral and emotional challenges. For the vision screening we use the LEA charts (house, circle, square and heart pictures) and have them point to the picture that matches if they are too shy to actually talk to me. For hearing it's really hit or miss. It's not uncommon for us to have to schedule a rescreen for them to try again. I try to look for any reaction to the tones (a sideways glance, turning their heads, etc) or I ask the child to give mom or dad (or whoever brought them to the screening) a high five when they hear the tone. Sometimes it works, sometimes it doesn't.

I have found myself daydreaming about leaving nursing entirely. This is my 5th year as a school nurse and I have to decide if I am going to renew my license next year or not. I already know that I don't want to go back to a hospital schedule and I don't think I would be happy in a clinic either. It makes me feel like there isn't a place for me in this profession anymore. ?

We follow the infectious disease manual from a local county public health department. They produce the fact sheets that we hand out to parents when there is a communicable disease in the classroom. According to the strep fact sheet, which was updated in October 2018, students can return to school after being on their antibiotic for 12 hours and fever free. It doesn't mention that they have to be fever free for 24 hours though but we still require them to be fever free for 24 hours without the use of medications to reduce fever.

We aren't contact tracing at all this year but we used some COVID money from our state last year to hire 2 LPNs to help do the contact tracing. That was all they did was deal with COVID stuff so if a nurse was informed that a student or staff tested positive it was passed on to the COVID Team which consisted of one of our RNs and the 2 LPNs we hired.

Yep. I just have to shake my head.

Wow. We are doing basically nothing this year. All of the decisions surrounding COVID protocols were handed over to the school board. I live in a rural, anti-mask, anti-vaccine area. ? Last year we were quarantining left and right. Masks were required. Distancing was enforced. We were offering tests for our staff e/o week. We were shutting down sporting events. We shut down the dance team. Our homecoming queen had to be crowned via Zoom because she had tested positive. We were very strict. This year? Masks are only strongly recommended but not required. If a school reaches a 5% threshold of student absences with COVID sx then masks are required. Within 2 weeks of school starting 6 of our 7 elementary schools were masking. We aren't testing students or staff at school at all. If there is a positive case in a classroom we are just notifying the other families that there was a case in a classroom. No contact tracing. We only require quarantines for household contacts of a positive. Needless to say we are having positive cases reported left and right. It's worse than last year. ?

I agree with disconnecting the call after I have warned them to stop swearing and/or yelling at me. I absolutely WILL NOT tolerate being spoken to that way.

What a great topic! I can't wait to hear what others have to say so I can get some good ideas too! Our best inservices have been: * a presentation from our local mental health nonprofit (that provides services to a lot of our students) coming in to talk to us about resources so we know what is available when we're asked * MH-TIPS (Mental Health Training Intervention for Health Providers in Schools) - free, online and offered through the University of Maryland - increases competence in mental health issues, resources and implementing support in the schools * a presentation from our school resource officer for identifying when a student is on a substance and what type of substance they may be on, what side effects we might see and what to do if there is an overdose at school * a presentation from the Epilepsy Foundation of Minnesota to increase our knowledge of different types of seizures, treatments and what to do if a student is having a seizure at school

I am back for my third year as the school nurse in my district's Early Childhood Program! This year I am also the Early Childhood Screening Coordinator after our former one retired. We have decided to completely change the way we do our screenings so I have been very busy trying to get that all organized and figured out in addition to having 2 preschoolers with type I DM and having our largest enrollment in the last 5 years! ? We are seeing so many preschoolers struggling with behaviors and being behind in basic skills. We are thinking it has been the isolation of the past year and a half (many of them didn't go to daycare or any kind of preschool program last year) when many of them missed out on some pretty critical developmental milestones. It's been really hard to see them struggle. ☹️ I have been back at work for 7 weeks now and I am exhausted. But I have a good team behind me and we'll figure it out. Right now we are seeing a surge in COVID cases amongst our staff so we're working our butts off trying to cover everything. I come home and switch into self-care mode (pjs on, hot bath and a book, a glass of sparkling water [and sometimes wine] just to have the energy to get up and do it all again. ?