school nurse, biggest challenge/reward

mustlovepoodles, RN · May 13, 2011

My biggest challenge is educating parents. My school serves an underprivileged population, and that's putting a pretty word on it. Our families are quite impoverished and their lives have all the trappings of poverty--poor nutrition, poor access to medical & dental care,prostitution, gangs, guns & drugs, and child abuse. It is not uncommon for the parents to be very young and poorly educated, some as young as 17! Our kids do not come from a culture of education, usually. Most of them have only rarely left the county they live in. They don't own books or craft materials. They don't go to museums or concerts. They don't have music lessons or scouting expeditions. They can't play outside because of the violence and drug dealers. So all that adds up to children who are set up to fail in life.

On the other hand, my greatest reward is the flip side of that coin. When I make a difference, i make a BIG difference. For many of my kids, i am their only healthcare provider so i take that job seriously. I try hard to educate parents on making good healthcare decisions. Even simple things like, how to care for a vomiting child, a child with a fever, or pinkeye. Parents often look to me for guidance because they simply don't. know what to do.

A school nurse has to have excellent assessment skills. She has to be a careful diplomat. She is part mom, part psychologist, part public health official, part teacher. She has to be able to function independently in a non-healthcare setting where almost nobody knows what she does and may not even respect her profession. She has to be able to fix 90% of the children's woes with little more than ice packs and bandaids. She has to be able to make critical decisions in the face of emergencies. She has to know when to call for back up. Because anything that can happen at home can and will happen at school. :nurse:

Purple_Scrubs, BSN, RN · May 13, 2011

Ditto everything that MustLovePoodles said! My school is very similar to that description, and everything said applies. One of my biggest frustrations is getting ahold of parents when I need them to come pick up a student, because phone numbers are constantly changing or being disconnected. I also have students from a local homeless shelter that attend my school, and it is very hard to get ahold of their parents because they are not allowed to hang out at the shelter during the day...they are either working or looking for work or taking classes.

My greatest reward comes from becoming a trusted member of the community. I am in my 4th year now, so the parents have come to know me and trust me. I love being "the" nurse, and I have developed strong ties to my students, families, and the staff here. There is no greater reward than that.

As far as basic knowledge, assessments skills are key. I was a fairly new grad when I got into this, and while that is not ideal in most circumstances, I was able to make it work because I am and was confident in my assessment skills, and I had a great mentor who was there anytime I picked up the phone (and that was almost daily for the first few weeks!) I also read anything I could get my hands on relating to school nursing or pedi in general. You also have to be confident in yout basic nursing skills, because you never know when a student with a g-button will enroll, or a student will suddenly require daily catheterizations (that happened to me in year two and it freaked me out...I hadn't cath'ed anyone in years...but those skills come back to you pretty quick once you have mastered them). Other than that, join NASN, read everything you can get your hands on, and come post here and read about everyone's experiences :)

mustlovepoodles, RN · May 13, 2011

OMG, the calling of the parents--spare me! Last week I called every person on this kid's emergency call list and NONE of them were working numbers. :mad:

Thankfully, it wasn't a dire emergency, ya know?

mookyjoe, BSN, MSN, APRN, NP · Dec 1, 2011

I feel the pain. I got a kid at the health dept spilling leukocytes on dipstick so I explained the only clinic with same day appts was across town, but they said it was fine because their insurance would cover it. Then the other RN comes to my office and asks why I refer for a silly thing like leukocytes when nitristies means UTI. I said, "I found something abnormal, that required further evaluation and a follow-up by someone more qualified." She stated the parents were really upset with me for sending them across town and nothing was wrong. That was the point as I explained to them. I found something but doing the right thing was the "Stupid" thing. SOrry, but nobody got my license except me!!!!