I may hate my School Nursing job...ADVICE, PLEASE?

Specialties School

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I started a job as a School Nurse on October 1 in a local high school, 30 minute commute each way. The kids are sweet, the teachers (that I've met) are nice, and the job isn't bad at all. I knew I would enjoy the busy parts. However, when I took the position I worried about the slow pace.

The high school I am in is only 480 students and I have 5 scheduled students daily; 2 independent diabetics and 3 ADHD meds at lunch. I have two students with epilepsy and quite a few with food allergies. On an average day I see 7-8 additional students for the usual; sore throat, nausea, HA, emesis, etc... Some days more and other days, like today, nothing. Besides this my days have been filled with trying to find busy work; reorganizing, completing CME's, organizing some more, etc...

Even though I am enjoying this job, I'm not sure if it's going to make me feel fulfilled and/or challenged enough. The schedule is going to be amazing with holidays and summers off, I get that...but I can't help but think what I could be doing or providing to people.

History on my past employment: pediatric office for 4 years as an LPN, telemetry/renal/stroke unit in the hospital for 1 year after completing RN school, and most recently 2 1/2 years at a local community services board working primarily with the Pediatric Psychiatrist.

I loved my job there, coworkers, the children, and the doctor I worked with. However, I wanted to be at home more often with my 8 month old daughter. Therefore, I took this position and a $14K pay cut along with it. Yes, money isn't everything but it has weighed heavily on my mind.

Recently, I've found myself looking at the job postings for the local hospitals. I'm not sure why. Today, I found a listing for a night shift position at one of the hospitals on the pediatric unit and cross training in the mother/baby unit. I am contemplating applying for this job but am afraid I am prematurely wanting to jump ship before giving it more time here at the school. But then I also think, when you know..you know.

Sorry for this long post but I just need some guidance and advice on where to go from here. I feel lost and unsure what to do. I don't know how night shift would be with having a family, plus the hospital the position is at is also a 30 minute commute. However, I don't want to be somewhere just because of the amount of time off and not feel like I have a satisfying career.

Thanks for taking the time to read!

Specializes in CPN.

Oh! and make sure your diabetics actually KNOW how diabetes works, not just a result and response type of management. I'm at a middle school, so it's probably more relevant for me, but nearly ALL of my diabetics have had no idea how insulin works in the body, or what ketones are and why they are bad, etc. Also, in the current climate, I've started trying to educate them on where to find medical care and insulin.

I had to help a friend of mine recently with this issue. We were on vacation together and her pump broke. She hasn't been off a pump in about 15 years and didn't have any long acting insulin, nor did she have an endo she could call to get guidance/prescriptions from due to insurance issues. Fortunately, we figured out which insulin you can buy without a prescription and she was able to call another, older diabetic for advice on dosing. It was really tricky though.

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Specializes in School nursing.
Oh! and make sure your diabetics actually KNOW how diabetes works, not just a result and response type of management. I'm at a middle school, so it's probably more relevant for me, but nearly ALL of my diabetics have had no idea how insulin works in the body, or what ketones are and why they are bad, etc. Also, in the current climate, I've started trying to educate them on where to find medical care and insulin.

I had to help a friend of mine recently with this issue. We were on vacation together and her pump broke. She hasn't been off a pump in about 15 years and didn't have any long acting insulin, nor did she have an endo she could call to get guidance/prescriptions from due to insurance issues. Fortunately, we figured out which insulin you can buy without a prescription and she was able to call another, older diabetic for advice on dosing. It was really tricky though.

THIS. Also because of pumps, so many kids don't know their correction factor and how to do that math. They head to me for that, but then I follow up with what they would have done if this happened not at school and mom/dad wasn't on call, etc.

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Thank you for all of the advice. I just don't know where to even begin with half of it. I might add that I was pretty much thrown into the job...I had 3 hours of training from my nursing manager and that's it. The nurse that was here before me had been gone for 4 weeks and so I unfortunately didn't get to hear her side of how things usually ran in the clinic. I'll reach out to her and see if she can help guide me in the right direction.

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Specializes in Cardiology, School Nursing, General.
Thank you for all of the advice. I just don't know where to even begin with half of it. I might add that I was pretty much thrown into the job...I had 3 hours of training from my nursing manager and that's it. The nurse that was here before me had been gone for 4 weeks and so I unfortunately didn't get to hear her side of how things usually ran in the clinic. I'll reach out to her and see if she can help guide me in the right direction.

Trust me when I say this, I was the same way. First year was crazy, 2nd year was semi crazy, this year is chill.

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Specializes in CPN.
Thank you for all of the advice. I just don't know where to even begin with half of it. I might add that I was pretty much thrown into the job...I had 3 hours of training from my nursing manager and that's it. The nurse that was here before me had been gone for 4 weeks and so I unfortunately didn't get to hear her side of how things usually ran in the clinic. I'll reach out to her and see if she can help guide me in the right direction.

That is SO rough! I had very little orientation myself, but at least had a week before school started to get my clinic organized. If you have any questions about how to "start" a clinic, feel free to ask in a new thread! And if you add what state you are in, you might be able to get more state specific information.

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I don't know much about school nursing but id say stick with it for the school year? I think it's easy to get cold feet when you're doing something new. I think after the school year if it doesn't seem for you then they can always look for someone new during the summer and you should have time to make a switch.

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Specializes in Pediatrics Retired.
Thank you for all of the advice. I just don't know where to even begin with half of it. I might add that I was pretty much thrown into the job...I had 3 hours of training from my nursing manager and that's it...

You got 3 hours more than most of us...

All good advice above. You'll regret it if you leave now.

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So you're saying that most school nurses get zero training? I haven't seen one policy or procedure on how I'm even supposed to be doing anything. I understand they may not exist. But Lord only knows if I'm doing anything correctly.

I dont want to regret leaving either, but I'm bored out of my mind currently. I even reached out to my supervisor today for guidance and that was a bust. Was only given the advice to visit for an hour each week the elementary school or middle school, alternating between the two as I might need to cover their clinics at some point.

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Get in touch with your state school board and your state department of health. I'm in Illinois, and ISBE and IDPH have mailing lists for school nurses. Each year they each put out a webinar about policies, procedures, legalities, changes, etc. It was SO helpful for me when I was kind of thrown into this last year. If I have burning questions I can email the head nurses at ISBE and IDPH (who have DECADES of experience in school nursing). If you're in a school district, reach out to the other nurses. If there aren't other nurses then check the websites of other nearby schools. You can bounce some thoughts off of them. I'm at a private school so I actually ended up on a mailing list for school nurses at the private schools around me.

When in doubt, I follow Illinois laws and CDC policies. If I feel like I don't have somewhere to document something, then I make up my own documentation.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Check out the National Association of School Nurses website for guidance in this specialty

2018 Back-to-School Interactive Health Office

Back-to-School - National Association of School Nurses

You have the TASKS of nursing down. Now to learn the wider world of nursing, especiallly public health needs of students.

Every transition comes with its own setbacks and rewards. Remember how you had no time to use bathroom, irrate adults and parents breathing down your neck. Pace is slower right now but will pick up steam shortly with flu and cold season approaching. Start examining immunization records, surely will find work to be done there. Best wishes in this transition.

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Check out the National Association of School Nurses website for guidance in this specialty

2018 Back-to-School Interactive Health Office

Back-to-School - National Association of School Nurses

You have the TASKS of nursing down. Now to learn the wider world of nursing, especiallly public health needs of students.

Every transition comes with its own setbacks and rewards. Remember how you had no time to use bathroom, irrate adults and parents breathing down your neck. Pace is slower right now but will pick up steam shortly with flu and cold season approaching. Start exazmining immunization reords, surely will find work to be done there. Best wishes in this transition.

Thank you for this feedback! I actually have been on that website looking around and used the interactive office. I'll take another look!

My position before this was outpatient, Monday through Friday 8-5. I worked closely with the case managers and clinicians to make sure our patients were receiving the care they needed regarding their mental health. So the pace was good...nothing like inpatient.

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Recently, I've found myself looking at the job postings for the local hospitals. I'm not sure why.

Me, neither! ;)

Aw...I'm just kidding. But we could have a hearty round of disabusing you of any glamorous notions of acute care these days, if you'd like.

Here's a little bit of my own very humble opinion re: acute care vs. the role you are in right now. I feel like there is a potential for you to be better regarded and respected and treated like a professional in the school setting. I could be wrong, I've never known that side of things. But...acute care is currently having a bit of a hard time demonstrating much regard for the bedside nurse (I'll leave it at that).

This is not to knock acute care (I'm there and I have a hard time imagining myself anywhere else); I mean to say that you probably have a little more going for you right now than you might be able to see/imagine. It kind of sounds like, at least to some extent, you could make your current gig as awesome as you want to make it, using suggestions like those already mentioned in this thread. That's worth a lot. Having a schedule that works well with parenting is also worth a lot - - these are all days you don't get back once they're gone.

Why don't you give it a go for this year, and if, when summer rolls around, you're still not feeling it, look at other options.

Good luck~

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