I need your help ASAP please

[Nurse2Kids]

Calling all school nurses, here's my situation:

I have no school nurse experience other than what I've studied extensively over the last few weeks, and it's A LOT! I do have years of experience in the hospital setting with kids and adults.

I was offered a position in a larger school district with many other nurses in the district, at a middle school. The socioeconomic level in the area is low. This particular school is set in an area with higher drug/crime rates.

I've another interview at a very small school district that has never had a school nurse before, but it's a great district in a semi-rural area. This school is only just now creating a school nurse position, so it would have to be set up from the ground up. Is it even fair to the district to have a nurse with no school experience doing this position?

I know I would like the smaller school area, but my go-to people would be other nurses from other districts and you all. At the larger school I would always have someone to contact for any needs or questions, and would also have vacation relief, etc. The nurse that is retiring out of this district is allowing me to shadow her on my own time for the remainder of the year to get familiar with the ropes, and I hear she is very good.

Another factor to consider is the smaller school has the same school year schedule as my teens, so all vacations would be the exact same. At the larger school, they would be mostly the same, other than Spring and Winter breaks.

The pay b/t the two isn't enough to be a factor in this.

I would love to hear your opinions, and appreciate brutal honesty!

Oh, and if you feel I should not consider the rural area job at all, should I tell them during the interview, or just complete the interview and decide afterwards?

[WineRN]

I think this really depends on the kind of person you are.

For the city school: You will need to have strong assessment skills, a big and unbreakable heart and strong charting and communication skills. It will be great to have all of that support, but it sounds like you will really need it. With the area you are describing you will probably be the main health care provider they see and rely on. Also lower socioeconomic levels brings on families who CAN'T afford to leave work no matter how sick their little one is, who can't afford to go to the dentist even when the little one's mouth is more cavity than teeth and a host of other issues that are heartbreaks and put a lot of weight on your shoulders. Since the school has had a nurse, they will have set expectations for you which is great for a new school nurse.

For the small school: You will need to become an expert in your nurse practice act, be willing to stand up to authority and be a long term goal kind of person. I never realized how differently nurse's think until I took this job. Educators just don't see the world like we do, and I'm not saying that like it's a bad thing, it just is. They won't understand why you need illness guidelines, medication administration policies, etc. They will think things like lice are scarier than strep. BUT if you can push through the first year or two you can really set yourself up for an amazing job that YOU created.

I hope this helps a little :)

[NutmeggeRN, BSN]

What is your gut telling you? I'm a big believer in gut feelings.

...except when a 1st grader tells you their gut is gonna vomit. Then I only believe 10%.

Until they boot on your shoes...

[OldDude]

can you please elaborate? I need as much info as I can get.

Stuff that Amethya pointed out and there are no shoes to fill, no preconceptions, you'll be in on the ground floor of a small semi-rural school, parents will be more available, staff will appreciate having a school nurse, etc. I can't see a down-side compared to the other school you describe.

You'll have plenty of time to learn the rules and regulations. The most important thing is student health and safety; everything else falls behind that.

[bsyrn, ASN, RN]

When I first started, there was no nurse in my school. I came in to a desk and a catalog with NO school nurse experience. Many years later I am still here and thriving :) I would say go for the smaller school. It is nice to set up things the way you want them and not be compared to anyone else. Yes, it will be a lot of work and quite a lot of learning on your part but you stated you had an experienced nurse willing to help so just go for it. We are all here cheering you on too!

[Cattz, ADN]

23 years ago, I set up shop as the first nurse ever in a small, rural school. I would do it all over again in a heartbeat. It is challenging, but you can put your own "brand" on it. Since you are the first, there should be few pre-conceived notion about what you should or shouldn't do. Go for the rural school!

[Cattz, ADN]

And, Oh Yeah- one more thing. Most definitely, go with the schedule that you will have the most time with your kids!

[plainfieldguy]

I'd probably go for the smaller school, too! But certainly try to shadow another nurse if you can and make connections with the district or state school nurse liaison to make sure you are completing all of the required tasks that the state will come knocking on your door for.... like screenings, immunizations, etc. Ask around some of the schools where you live--you can probably find one or two who will let you 'volunteer' or shadow with them as we're winding down the year. Some states offer a training for new school nurses--if so, be sure to attend! You can probably google a 'back to school' checklist for nurses to give you an idea of some of the tasks ahead of you. Use the summer to read Selekman's book "School Nursing: A comprehensive text". Next year, ask the school if they have or can arrange to have a consult doctor--someone who can sign off on some basic standing orders. Lot's to learn... we're all still learning. It's a great job :)

[Workitinurfava, BSN, RN]

On the other side of things, the rough school can give you a ton of experience.

[MrNurse(x2), ADN]

I had no school experience, I had deep but narrow experience with adults. I set up my own office with the help of this super support system here. I suggest you take on the small school with no preconceived notions. You will find teachers more self sufficient and appreciative of your presence. They are also much better at letting you know which ones should be going home. Good luck with your choice.

[Amethya]

Exactly what everyone has said, since you are literally starting from scratch, you can set up your own method of madness. I had a bit of an issue on my first year because everyone was already used to the last MA, who did things in a certain way. That kinda worked against me because each new idea I had would be shot down because "The last nurse did this and that!" But after working my way against it, now everyone doesn't talk about her anymore and accept my ideas now.

So yes, take advantage of that small rural school and do your best!

[ICUtoSchoolNSG]

You will have support in the rural school, they won't physically be school nurses in the building but you'll have your state school nursing assoc, hopefully other local school nurses that you can reach out to, and this forum. You can set things up however you want them, and do it right. NY has an amazing School Nurse Orientation in August. See if your state offers one. I learned so much, made friends, and was assigned a resource person who I can email with questions. If I have a question, that i can't answer on the NY school health site then I have many school nurses to ask. The school nurse community is an amazing group! I have been welcomed and supported. Much more than I can say for hospital nursing. Welcome to the community!

I am the founding school nurse at my small, urban, low SES charter school and am in my third year since we opened. I have many years of pediatric and community experience, but this is my first rodeo as a school nurse. I have loved being the one to get this program up and running. It is really nice to be able to run the nurse's office in a way that works for YOU right off the bat. You have no shoes to fill, no teachers telling you that the previous nurse did X, Y and Z, etc. I also have the full support of an administration who understand and value my worth to the school. That goes a LONG way.