right out of nursing school to school nurse

elkpark · Jun 4, 2009

I've been in clinical practice, and in and out of nursing education, over a couple decades now, and I think it's a really bad idea for new grads to start out in clinical situations where they're working alone, without other, more experienced, RNs around to ask questions of, check things out with, and observe. Wouldn't you be working basically alone as a school nurse? (Not many schools have more than one nurse per campus, do they?) If the answer to that is "yes," I would definitely advise against it.

Once you graduate and start working, you'll be amazed at how much you don't know and still need to learn. Please don't set yourself up to fail by starting out in a setting where you'll be more or less isolated from your best sources of advice, guidance, and mentoring, other nurses.

Also, if you start out in a role like school nurse and stay there a while, you'll have a v. hard time later getting an acute clinical position if you decide you want (or need!) one. Once you have some solid, acute clinical experience and expertise, you can always "branch out" into any other area you want, but the reverse isn't necessarily true. Starting out and spending time in a number of non-hospital type nursing roles can close a lot of doors for you later on. I would encourage you to seek out an acute, bedside, hospital-based position and stick with that for at least a year or so, and then move on to whatever you really want to pursue. If you're esp. interested in school nursing, it would make sense to get some solid experience in pediatrics (inpatient, I mean). You can never go wrong starting out with that kind of experience, even if it's not something you particularly want to do -- think of it as "paying dues," or completing your nursing education -- and it will set you up for success in a wide range of roles a little later on.

Welcome to allnurses, and best wishes for your career! :balloons:

Purple_Scrubs, BSN, RN · Jun 4, 2009

I worked in the hospital 4 months before starting as a school nurse, and I could not be happier! I think if you want to go that route, you have to be willing to do some homework. I shelled out about $100 for some school nursing texts from NASN and STUDIED them the first few months I was on the job. You really need to know asthma, diabeties and severe allergies inside and out. You need to have very very good assessment skills, and confidence. You should be comfortable doing g-button feeds or meds, straight caths, etc. You will not have another nurse close by if you are having trouble cathing a kid, and you don't want to have to call the parent and tell them you can't get it done!

It helps if you have another nurse who is never more than a phone call away, like I do. The lead nurse for my district is an angel, and I was on the phone to her basically daily for my first few months! If you do not have someone like this, find a school nurse mentor. Also, take a first aid course (learn how to splint possible fractures, etc) and read your procedures manual on day one. Find lots of continuing ed opportunies in pediatrics or specific to school nursing. I am even considering signing up for some ride alongs with EMS.

It can definitely be done right out of school, but all the conditions must be right and the person has to be right for it. Read every thread on this school nurse forum and you will see that we deal with our share of mess too, but usually from parents and teachers. When things go badly in school nursing, they go bad quickly and sometimes very very badly. You have to always be on your toes and ready with your skills, because they will be put to the test. Good luck!

kkk222 · Jun 4, 2009

Thanks so much for your advice.

NurseLoveJoy88, ASN, RN · Jun 5, 2009

I'll be finished nursing school in 6 weeks and I personally don't think school nursing would be the right fit for a new grad. I've worked in school health for over two years so I already have experience in school health. It all depends on your schoo's population as well. At the school I was working for there were not alot of kids with medical leave. The nurse was in charge of writing careplans and signing off on med orders. However if you plan on working at the school as a full time nurse you may find yourself not utilizing all of your med-surg nursing skills. Just follow your heart. I know some new grads that started out in school nursing and couldn't be happier it just depends on what you are in to. Me personally I like for my work to be more fast past and sometimes working in school health was very slow past. Good luck to what ever you decide.

Artistyc1 · Jun 5, 2009

In the district I work for, none of the 16 nurses had fewer than 20 years of nursing experience before coming into the district. With all the liability and decisions that need to be made, I would live in fear of every decision I made, if I had just graduated. There are too many variables, and you are often the only medically educated person in the building. There is so much to learn AFTER the basic education a new graduate has gotten, and much of that has to come from other nurses. Learning from a book may not have the same impact as actually witnessing the realities of medical emergencies. This is only my honest opinion, take it for what it is worth.

Having been a hospital nurse for over 25 years, in various capacities from staff nurse to house supervisor, I decided it was time for a drastic change. I genuinely loved my L & D job, but after 16 years of that, I was getting burned out. As I hope to retire someday, LOL, it was time to seek employment that offered better retirement benefits than I would be getting from my hospital job. I really am enjoying this job, and plant to stay till retirement, (if they will have me, and if budget cuts don't affect my department too much!)

kkk222 · Jun 5, 2009

okay thank you very much,,, i had a feeling it wasn't a good idea. I really really want to be a L & D nurse. But I was thinking about school nursing too and wanted to see if anyone ever came right out of school and went into that field.

Flare, ASN, BSN · Jun 15, 2009

You don';t get a whole lot of on the job training in a school. You either know the skills or you don't. Like Purple scrubs said, you don't want to have to call a parent because you are unsure of a straight cath. It's best to get a little acute care time under your belt and really develop your assessment skills. Sometimes those little ones come in with one thing and it takes a little investigative work to figure out what to do. Also - as others mentioned - you are the sole health care provider in the building. There are schools that have some than one nurse, but for the majority, the school nurse is riding solo. That being said, you really need to have confidence in what you are doing and seeing. There is no precepting nurse showing you the ropes for 6 weeks. It would behoove you to cosider becoming an EMT on top of being a nurse. I learned a lot in the emt course that i apply quite regularly in the school.

Purple_Scrubs, BSN, RN · Jun 15, 2009

Interesting that you suggest that, as I am considering doing just that! I realize that I am a bit behind the 8 ball without a ton of hospital experience, so I am constantly seeking opportunities to enhance my practice. I have been tossing that around as one way to do so, but I was unsure it would really come in handy. I just might go for it now!

NurseLoveJoy88, ASN, RN · Jun 16, 2009

You don';t get a whole lot of on the job training in a school. You either know the skills or you don't. Like Purple scrubs said, you don't want to have to call a parent because you are unsure of a straight cath. It's best to get a little acute care time under your belt and really develop your assessment skills. Sometimes those little ones come in with one thing and it takes a little investigative work to figure out what to do. Also - as others mentioned - you are the sole health care provider in the building. There are schools that have some than one nurse, but for the majority, the school nurse is riding solo. That being said, you really need to have confidence in what you are doing and seeing. There is no precepting nurse showing you the ropes for 6 weeks. It would behoove you to cosider becoming an EMT on top of being a nurse. I learned a lot in the emt course that i apply quite regularly in the school.

Just to piggyback on this. She is totally correct. Because I was a CNA working in the HR, when ever I was in doubt about a child I was able to call my RN supervisor at all times to clarify. As a school nurse you won't have that much training and there will not be a nurse you can call on. I'm sure you can call your supervisor, however she would expect you to be able to assess and intervene as a prudent nurse would... therefore you should try to build up your assesment skills.

I'll be a new grad next month and I wouldn't want to do school nursing or home health right away because there is so much automony in that.