Preparing school nurse office from the ground up...need ideas!

  1. Well, after much appreciated input from this supportive community, I accepted the position at a smaller rural school. Money wasn't a factor initially, but it did end up playing into my decision.

    So here are the details so far. There are two campuses (k-4 & 5-8). I will be setting up an office on each campus (NO SINKS OR TOILETS in the office, but will be strongly pushing for sinks at least).
    If you can take a minute to think of everything I will need to have on hand, even documentation systems (I'm starting from zero), how you manage records best, how you store meds in a small offices, and any other tips or ideas you can give. If you post and think of something later, please come back to post more. I truly appreciate any support, help, ideas, and tips from the awesome school nurses here.
    I did find a school nurse conference near my area that I do plan to attend, and hoping to meet some resources/contacts there as well. I tend to be an over-doer, but I want to make sure it's as perfect as it can be. I need to show the school that the position is worth their investment, so they'll continue to keep it in place.

    Oh, about how long do you think it would take to set up from zero to go? Is 10 days enough? That's what the superintendent mentioned, but we are to talk more later. I'm thinking at least a month, but I'm also thinking about preparing records, policies, etc.
    I'm working full time now, but may leave my job earlier than intended in order to best prepare for this.
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    About Nurse2Kids

    Joined: Apr '18; Posts: 25; Likes: 21
    from TX , US

    21 Comments

  3. by   MrNurse(x2)
    SNAP can be leased for $325/ year, very comprehensive and self evident. Are you private or public? Budget? Immediately go to epi-pens for schools and get them sent to your schools. You will need ice packs, bandages, a go bag and defibrillator for each school if budget allows. A cot for students to lie down. I would approach admin and tell them that start up budget will be considerably larger. Nice things to have are a fridge/ freezer, sink, microwave to heat up hot packs. Thermometer, recommend tympanic for quick, accurate readings (my preference, read the threads and you will see lots of opinions). Do you have district protocols? How much latitude do you have for autonomy? You can PM me, I can give specifics for getting things set up. Policy is going to be guided by your nurse practice act.
    Last edit by MrNurse(x2) on Apr 23
  4. by   MHDNURSE
    Budget will determine a LOT. Did they tell you what your budget is to get the office set up? Is your school already using EMRs? We use Power School for everything so I have to use that. If they already use one, that is one less thing to have to budget for. Medical supplies will eat up a lot too. Figure out of you are allowed to administer OTC meds at school. Laws vary state by state and district by district.

    Buy the book "School Nursing: A Comprehensive Text" by Selekman. There is a lot of good information in there, including how to set up an office. You can make do with the space that you have. I set mine up from the ground up and have no sink, no bathroom, my floor is carpeted...I had to make do with the space they gave me, but I make it work. And I have moved three times in three years and am moving again in August- still no sink or bathroom. You will figure it out. Pinterest has good stuff from school nurses too to give you some ideas.
  5. by   Nurse2Kids
    Quote from MrNurse(x2)
    SNAP can be leased for $325/ year, very comprehensive and self evident. Are you private or public? Budget? Immediately go to epi-pens for schools and get them sent to your schools. You will need ice packs, bandages, a go bag and defibrillator for each school if budget allows. A cot for students to lie down. I would approach admin and tell them that start up budget will be considerably larger. Nice things to have are a fridge/ freezer, sink, microwave to heat up hot packs. Thermometer, recommend tympanic for quick, accurate readings (my preference, read the threads and you will see lots of opinions). Do you have district protocols? How much latitude do you have for autonomy? You can PM me, I can give specifics for getting things set up. Policy is going to be guided by your nurse practice act.
    Thank you so much for these tips! I'm meeting soon to discuss budget and necessities. I'm not familiar with any district protocols, but I'm sure there must have been something, although I imagine it's minimal. I'll know more after our first meeting. Public school. No school doctor, only RN. These threads have been extremely helpful! I've looked into the Epi pens....great idea!
  6. by   OldDude
    Congratulations!!! Good choice

    There are a few school nurse supply companies. I use MacGill. Go online and request a catalog. You can use the table of contents of the catalog as a "check list" of things that would benefit you to have on hand. Some of it is fluff but the catalogs cover pretty much all the "stuff" that goes into stocking a school clinic.

    Otherwise, the program Mr describes above sounds good to try if I were you.

    Look at online school policies of surrounding school districts; food allergy, medication at school, fever criteria, head lice, etc.

    What a grand opportunity for you!! Have a grand journey!! You know where we are.
  7. by   ruby_jane
    Quote from Nurse2Kids

    Oh, about how long do you think it would take to set up from zero to go? Is 10 days enough? That's what the superintendent mentioned, but we are to talk more later. I'm thinking at least a month, but I'm also thinking about preparing records, policies, etc.
    I'm working full time now, but may leave my job earlier than intended in order to best prepare for this.
    If you are completely having to assemble the clinic your self - put the beds together, unpack all the supplies, hang the med cabinets like I had to- 10 days is not enough. Because you'll also need to leave at least a week (and maybe more) to screen all your records for vaccine compliance. I had a month before I started. I was paid at the summer school rate, but it was well worth it. Go in asking for a month at your regular salary and see what they throw back at you.
  8. by   Nurse2Kids
    Quote from OldDude
    Congratulations!!! Good choice

    There are a few school nurse supply companies. I use MacGill. Go online and request a catalog. You can use the table of contents of the catalog as a "check list" of things that would benefit you to have on hand. Some of it is fluff but the catalogs cover pretty much all the "stuff" that goes into stocking a school clinic.

    Otherwise, the program Mr describes above sounds good to try if I were you.

    Look at online school policies of surrounding school districts; food allergy, medication at school, fever criteria, head lice, etc.

    What a grand opportunity for you!! Have a grand journey!! You know where we are.
    Great ideas! thank you!
  9. by   NurseVal93
    A Sink is absolutely essential, and I would push for a bathroom.. you don't want sick kids to have to walk all the way across campus to go. You will need a fridge for medications, and cabinets that lock for meds that do not need to be refrigerated. Also you will need a bunch of chairs and recovery couches (cots/beds), with privacy curtains, I have 4 chairs and 3 beds.
    I use AERIES here at my school, and I love it very much. Its not only for me, but for the front office, counselors, attendance office, admin, teachers.. etc. So if they were looking for a more comprehensive system that they could get everyone on, that would be helpful, I think. Its super easy to navigate and all their info is there. I also have a wall of file cabinets for their paper health folders.
    Impelement policies on fevers, and communicable diseases. Also very important, make sure that when kids enroll that they have their parents sign a health problems/history form, as well as a consent form in case the child needs to go to the hospital.
    Create letters home, such as: requesting medication orders for students with health issues; head injury caution forms with s/s of concussion on it for monitoring at home, etc.
    I just dumped a bunch of stuff from the top of my head.. if I think of more I will come back.. Sorry if it seems disorganized and odd in wording! Good luck!
  10. by   grammy1
    Check with your local health department, they may have some useful information. In our state, the health department actually oversees and inspects the school clinics, so they may have a plan already set up. We just started using CareDox for documentation. Not my favorite, but not bad. The big plus is that it's free for the district, they only pay for the add-ons that you might want.
  11. by   LikeTheDeadSea
    I agree with a Health Department consult - ours require a sink with warm enough water and we get checked every year to prove it is working properly.
    I would definitely "aim high" when asking for things, because you'll likely get shot-down on some items in the budget back-and-forth, so if you can inflate it a bit, when they come back at you it'll still be reasonable.

    I'd call neighboring districts with a similar student census and see if they'll tell you what they order yearly. I have almost a thousand students at elementary level, so my advice may not be appropriate.
  12. by   Cattz
    Does your state have a State School Nurse Consultant? If so, make contact with that person. When I first started, I was glued to this resource- Manual for School Health Programs that is put out by Missouri. Here is the link Guidelines & Publications | School Health | Health & Senior Services . If your state doesn't have such a thing, at least it can be a guide for you.
    Here is the link to a page that has a lot of different resources that would be great as a guide for you- Guidelines & Publications | School Health | Health & Senior Services
    As far as immunizations- I was so overwhelmed to try to figure out if every student was in compliance- I had a person from the state to come in and do an audit of the immunization records. I just had to know exactly where I was starting from with the immunizations.

    I also went to a training for new school nurses/office staff, also done by the state. I highly recommend that if you have such an opportunity. It made it much easier, as all of us there were very new to School Nursing. To show how things can come full circle- I have been asked to be on the staff of this same training this summer!
  13. by   Nurse2Kids
    Quote from MHDNURSE
    Budget will determine a LOT. Did they tell you what your budget is to get the office set up? Is your school already using EMRs? We use Power School for everything so I have to use that. If they already use one, that is one less thing to have to budget for. Medical supplies will eat up a lot too. Figure out of you are allowed to administer OTC meds at school. Laws vary state by state and district by district.

    Buy the book "School Nursing: A Comprehensive Text" by Selekman. There is a lot of good information in there, including how to set up an office. You can make do with the space that you have. I set mine up from the ground up and have no sink, no bathroom, my floor is carpeted...I had to make do with the space they gave me, but I make it work. And I have moved three times in three years and am moving again in August- still no sink or bathroom. You will figure it out. Pinterest has good stuff from school nurses too to give you some ideas.
    We will be discussing budget soon, and I don't think they have an EMR in place yet. I believe that's what I'll be setting up. I can't administer meds without a doctor's order....not even a cough drop. I will by that book today! Thank you so much for the tips!
  14. by   Cattz
    Another thing to think of. Will you have "stock" medicine with standing orders- ibuprofen, tylenol, cough drops, etc? or will you only have what meds. parents have provided. I have been in schools with it both ways. I honestly prefer to have only what parents have sent and no "stock meds." This cuts down on a lot of generally unneeded student visits.

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