Concerns about Transition to School Nurse

[zurie]

I have an interview today for school nurse at a 6-8th grade campus. My first two years of nursing have been on an adult tele/step-down unit at a trauma hospital. I actually enjoy my job most days but I've always been drawn to community nursing and education, and I'm longing for the M-F I had in my previous career. My concerns are centered around my lack of pediatric experience, which is zero outside of nursing school clinicals.

Are there any school nurses here who transitioned from adult acute care? How did you manage?

[pedi_nurse]

(is it sick that I REALLY miss starting IVs and drawing blood?). ?

NOPE. I miss this stuff a lot as well. I love it when I get to do some decent wound care... helps fill the void a bit.

[Ems2n21]

In my experience I have found most school nurses lack good beginner to moderate emergency skills or knowledge in childhood illness & emergencies. Most have what I would assume beginner level but not all. I fell between moderate and expert when I started as a part time school nurse. My background was fire/rescue/EMS/ER nurse/camp nurse so I lacked pediatrician office nurse & knowledge of all immunization timing. Obviously ER gave me knowledge of the biggies to expect for the child coming to the ER with a fever or a booboo. You would benefit a ride along with a medic/EMT and definitely sitting with an experienced triage nurse. Simple things like a 5yo saying the have a bellyache require an assessment/decision that can have life altering consequences if we are wrong like in torsions and appendicitis. I once had an eye complaint during allergy season that ended up being an ulcer. Strong assessment skills are great but most important is EVERY ENCOUNTER REQUIRES AN ASSESSMENT! Don't blow off any kid for any reason. 99 times one will come & only need mommy TLC kinda care but that 100th time you will need to add the experience/training/expertise of being an RN. Don't miss that chance. Lastly, sit with a School Nurse who has all the credentials and papers that say school nurse (because it is a speciality) and find one that has the skills that you are weaker like the pediatric emergency/illness/assessment. Make sure you know who your medical direction is coming from & what it says! Personally I wrote my own and had a doctor sign it. Document each encounter & what the plan is & know the rationale for the plan. I am a great asset to the school nurse but I am NOT the whole school nurse. I have no desire to sit with parents or doctors to make a child's care plan or go through all the charts making sure whatever state requirements are met or sending the information to the state for their records. But that is part of being a good nurse. Know your resources & utilize them. Have an emergency plan for every likely emergency. Taylor your budget to fulfill the needs of the students. Find free stuff like Tylenol and maxi pads give out free boxes of their product (or used to). If you have a school that sends out half a dozen kids per week via ambulance, hire /contract an EMT from the local responsible responding EMS company. I would do this before hiring your own EMT by the school or district at least until you are completely comfortable with care and understand the local EMS protocols. God bless.