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We are going to try to restructure our school nurse program next year so I need some advice. Right now there are 2 nurses divided between 3 campuses and the county is roughly 3500+ students. I have a base school and she has a base school which are the two bigger schools in the county. Years prior we had 1 school nurse that was based out of the district office and she traveled to each school on a need basis (insulin, catheters, trach care, ect.). That seemed to work great honestly. The school nurse was there to monitor and manage the care plans, IHP meetings, trainings and do some skills but it made the teachers more involved in the little things like bandaids and medication admin. I think we should go back to that kind of setup. We know they will more than likely not hire another nurse to be at the smaller school and no we do not have assistants or LPNs or anything like that and wont be getting that. The way it stands right now they expect the two of us to be responsible for every and any medical need that happens plus do all the other things we are responsible for. I am driving 25 min to a school every other day for the last hour of the day just so admin can say Im there and put on bandaids and give ice packs. I can only go at that time because of other needs at my base school. They save any and every medical thing for me and at 2:00 Im dealing with things that should have been addressed at 8AM. That is getting frustrating. This is our smallest school with 300 students. How does your school nurse structure work if you are the only nurse or have a lot of students and campuses to see?

I just think if the schools couldnt say they had a "full time nurse on campus" that would cut down on some of the drama. Truthfully we are not full time on one campus because we have to travel to the smaller school daily. And yes I believe every student deserves a school nurse but with our lack of funding that is not going to happen.

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Specializes in Pediatrics Retired.

What age group is at the small campus?

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What age group is at the small campus?

Its prek-12

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Specializes in Pediatrics Retired.

So...since you're confident there won't be anyone hired to tend to the small school, I'm thinking you might want to compile an Injury/Illness report in the form of a staff "decision tree." It would have to be a simple form with checkboxes associated with stomach ache, headache, sore throat, cut, bruise, bump, pain, etc., simple interventions, a threshold instructing to "report immediately" to Mother Hen, RN, or call 911. At the end of the day you would be aware of the more important stuff and the rest would simply be a review for you to QC. If they wouldn't assign a staff member to deal with the complaints the forms could be distributed to all the teachers/staff members to utilize.

You could also take advantage of technology and have a video feed set up from the small campus to your office or cell phone. That would be very helpful for decision making. And, that stuff isn't so expensive anymore. People do it for their home security all the time, "I see someone at my front door." - as they look at their cell phone.

Let us know how it works out. Good Luck!

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So...since you're confident there won't be anyone hired to tend to the small school, I'm thinking you might want to compile an Injury/Illness report in the form of a staff "decision tree." It would have to be a simple form with checkboxes associated with stomach ache, headache, sore throat, cut, bruise, bump, pain, etc., simple interventions, a threshold instructing to "report immediately" to Mother Hen, RN, or call 911. At the end of the day you would be aware of the more important stuff and the rest would simply be a review for you to QC. If they wouldn't assign a staff member to deal with the complaints the forms could be distributed to all the teachers/staff members to utilize.

You could also take advantage of technology and have a video feed set up from the small campus to your office or cell phone. That would be very helpful for decision making. And, that stuff isn't so expensive anymore. People do it for their home security all the time, "I see someone at my front door." - as they look at their cell phone.

Let us know how it works out. Good Luck!

Thank you. Right now its more of a power struggle thing with the small school and not a medical need. We were just going to be on call for nurse services and the admin there said it wasnt fair the bigger schools had nurses and not them. They closed two of our smaller school 2 years ago and this school is afraid it will be next so they fight tooth and nail over equality. I think the video idea is great but they want us there physically. They call us all the time to come for things that could be managed by them or over the phone. When I say "well just call and let mom know whats going on" they will say "No only the RNs can make the phone calls" Um who came up with that rule. Thats not the rule anywhere else and yall dont even have a nurse half the time. Its so stupid!

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Specializes in Pediatrics Retired.

"Hey, no fair!" I hear that every day at school.:crying2: If they want a nurse they can hire one - otherwise deal with reality. I would think the campus would like to show it could be self sufficient under the current circumstances to deter the chance of future closing; but who says logic and objectivity has to come into play when it comes to school administration.

This "fix" is above your pay grade. If they ask what you think about it, tell em, but other wise decide what you will accept or not accept, sit back, smile and wave.

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"Hey, no fair!" I hear that every day at school.:crying2: If they want a nurse they can hire one - otherwise deal with reality. I would think the campus would like to show it could be self sufficient under the current circumstances to deter the chance of future closing; but who says logic and objectivity has to come into play when it comes to school administration.

This "fix" is above your pay grade. If they ask what you think about it, tell em, but other wise decide what you will accept or not accept, sit back, smile and wave.

You are so right. I guess it just disturbs me that they think so little of what I do that it is "nothing" to pull me away from my schools and my students to drive 25 miles to a school and sit there for show or put on a bandaid. That really bothers me and I will be telling them at the next board meeting. But you let a child have a seizure at my base school and I guarantee they will be changing their minds on us leaving for no reason. The "RNs only make the calls" is wrong for example I get a call at 2:00pm for diabetic blood sugar dropping rapidly and they want me to come right away. I explained that if it is a true emergency they should call parents and possibly 911. They said no you will have to make the call. I said well im not there and in an emergency situation the principle can make the call then. The students BG was 76 I mean it really wasnt an emergency but they had given carbs and it wasnt coming up. Call the mother! I am 30 min away! But they said I have to come. This story ends with me driving like a mad woman there expecting for find a child lying on the floor but no he was back in class happy as a clam.

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Specializes in Pediatrics Retired.

With that attitude...one more reason to close the campus.

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30 minutes is too far in a true emergency. They need to suck it up and handle it!!!!

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