I need your help ASAP please

  1. 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?
  2. Visit Nurse2Kids profile page

    About Nurse2Kids

    Joined: Apr '18; Posts: 24; Likes: 21
    from TX , US

    33 Comments

  3. by   ruby_jane
    Welcome to the school nurse side. We have saltines and wear pink on Wednesdays. (Although I failed at that today).

    I am going to gamble and say you'll be best supported in the urban district. If the rural district is just getting the nursing position together, there will be a lot of stuff that school nurses need to do that may be left off the job description (unless they're using another district's description and are fully prepared to support those policies/procedures.)

    School nursing is a lot of history taking and focused assessments. You're probably good at that already. Medication management - probably you got that, right?

    There are physical screenings to do that are required by your state. Those have to be reported, and you have to be trained to do those. Vaccine record screening is an ongoing effort - will either position provide a computer system that will allow you to rapidly track this data? Or will you have to make a spreadsheet?

    My point: you've already got the nurse part fine. The SCHOOL NURSE (how to do things without the physical presence of any other medical person, what reports to file and when and how) - that stuff needs coaching. Or, in my case, I flailed around til I found it. But go with whatever will provide you the best shot at being successful. There's a lot to be said for being on the same schedule as your kids, though. Make a list of questions to ask both districts. Good luck!
  4. by   NutmeggeRN
    If you choose to go with the rural school, be sure to join your state nurses association and the NASN. There is a wealth of experience to found at both.
  5. by   OldDude
    Run as fast as you can and accept the smaller school...there are several Texas school nurses on here so you'll have access to that resource. Welcome to the farm!!
  6. by   Nurse2Kids
    Can you please elaborate OldDude? I need to be fully aware.
    Last edit by Nurse2Kids on Apr 18
  7. by   Nurse2Kids
    Quote from OldDude
    Run as fast as you can and accept the smaller school...there are several Texas school nurses on here so you'll have access to that resource. Welcome to the farm!!
    can you please elaborate? I need as much info as I can get.
  8. by   Amethya
    Quote from Nurse2Kids
    Can you please elaborate OldDude? I need to be fully aware.
    He says this because if it's a large school, with high drug and high poverty area, you will have so much issues with parents and students, I can't even imagine.

    I work at a school with about 514 kids, in a semi-high poverty area, but the students range from different economic areas and lifestyles, since they come from all different districts and areas in the city.

    The reason I can handle it is because I'm super laid back and easily approachable, so the children think of me as an older sibling, not an authority figure. So they tend to treat me with respect and we get along. The parents are coming around with me and I'm getting along with them because I know Spanish (majority of my students are Hispanic) and I been there for 2 years already. I know every child already and they trust me easily, so it works in my favor.

    I'm lucky I got a small school to learn from so when I actually become an RN, it would be easier in another district.

    That's my suggestion for you, to try to find a smaller school, in a better area, so you won't have that much of an issue with parents (it's still going to happen, it depends on the parents) and you can learn about your students more. You can again experience from there and when you find a better SN job, you can take it.
  9. by   LikeTheDeadSea
    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%.
  10. by   GdBSN
    Welcome!!! Starting at the smaller school can pose some challenges, but it can also be very rewarding. You can set up the office the way that you want to. Yes, there will be a learning curve, but you will experience that with any job you take. First and foremost, your job will be to provide emergency care to the students and services to the chronically ill. Which as a nurse, you already know how to do. Only after that has been taken care of, you can focus on the paperwork. In Texas you will have to have certifications in Vision/Hearing/Scoliosis/Acanthothis. Will you have a nurse director? Are there currently policy and procedures in place. You can always contact a neighboring district to review their current policy and procedures.
  11. by   Nurse2Kids
    no nursing director or other medical personnel at all. It's a very small school. Nothing in place at all yet, no policies, no documentation system, etc. It would all have to be set up, but I do have a very experienced nurse in close vicinity willing to oversee/help with all of that.
  12. by   imaneedmycoffeefirst89
    I would go to the "smaller" school, simply because you'd be starting from scratch.
    You would be organizing the clinic the way YOU would like.
    I came after several different nurses in October and a lot of the paperwork is missing, misplaced or outdated.
    I work in an elementary school with about 900 students and it's in a tough area as well, sometimes it's hard to deal with the parents and children because they are raised in a certain type of environment.
    As a new nurse I can tell you, this site has been more than helpful and you can definitely ask me anything and i will help you, we'll learn together. lol
  13. by   GdBSN
    Quote from Nurse2Kids
    no nursing director or other medical personnel at all. It's a very small school. Nothing in place at all yet, no policies, no documentation system, etc. It would all have to be set up, but I do have a very experienced nurse in close vicinity willing to oversee/help with all of that.
    It could be very challenging...but the end result would be very rewarding. How has the school district completed the state mandated screenings before? Have they tracked compliance on immunizations? How have they handled medication administration and treatments at school (these could all be good interview questions, BTW)
  14. by   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

close