School Nursing: I Can Make a Difference

[NutmeggeRN, BSN]

My story…it has been a long time in the making, 36 years as an RN, 25 as a HS nurse and I still love my job! I started out in Med-Surg after graduation and worked HARD in a hospital that affiliated with a big med school. After that, due to a family move, I landed in rural area of the country and went through a few jobs; long term care, clinic work and home care. It was in home care that I feel I honed my independent assessment skills that serve me well as a school nurse.

I was actually approached by a local teacher who gave me the heads up on a retirement and she encouraged me to apply for the job. So I did, and surprise, I got it! School nursing had never been on my career trajectory but never the less, here I am!!

Life in the public school system has its plusses and minuses. The plusses outweigh the minuses by far. The schedule is awesome and snow days are the best! School nurses are supported in our community, as education is valued. We are very lucky in that respect. It is not always like that in many districts around the country. The job itself is never really the same day to day. Yes, I see my share of FF’s (frequent flyers), but I also see the most vulnerable of kids, sometime in that group of FF’s or sometimes in the child you never see but a few times a year. And when they are there, they make a big impact.

Trauma informed care is critical to my role. When a kiddo is falling apart without an identifiable organic cause, it is often based on stress, anxiety, mental health issues or that fact that the poo hit the fan in the home last night. Parents fighting, someone overdosing, police involvement, food insecurity and so on. Often they are not living in their own home, or there is a variety of other people living with them. IO see it in three areas, head pain/migraines, shortness of breath and in the gut.

Working with kids, is like peeling back an onion. It takes time to get to the root cause and sometimes it stinks and there are often tears. I have worked with families whose children have clearly exceeded their parent’s intellect. The child essentially raises themselves. Some do really well, others not so much. Sometimes I want to bang my head against the wall in frustration. But then there are the kids who, later in life, you run into and they share that the time spent in my office wasn’t because they were sick but because it was a safe place.

Day to day, I see 25-30 kids for a variety of issues. Some get scheduled meds, but not as many as when I first started, thanks to extended release meds for ADD/ADHD. But I have seen a HUGE increase in PRN meds for anxiety, which is very sad. Kids today are suffering from stress and anxiety like I have never seen before. I also have kids who cannot think for themselves because their parents sweep in and do EVERYTHING for them.

I have a lot of Epi Pens for kids who have increasingly dangerous reactions to a variety of foods. Nuts and more dairy, gluten, fruits, latex etc. For every kid that has an Epi-Pen, I write an Individual Health Plan (IHP) and need parent and MD signatures on medication and emergency action plans, updated every single year. The same for those who have inhalers for asthma, glucagon for low blood sugar, and Solucortef for adrenal crisis. And the planning that goes on for field trips is intense.

I see the usual complaints that vary seasonally, hay fever in the fall, lots of viral stuff in the winter months and then pollen in the spring. Mixed in are runs of strep throat, norovirus, mono etc. We have an athletic trainer, but only after school so I manage a lot of the injuries during the day.

And there are the unusual occurrences… a kid coming back from open campus with a fishhook in imbedded in the head, or the kid who pokes their finger into an open knothole in a picnic table and gets stuck or somehow manages to get rubber cement in their hair in art class…the list is long and entertaining!

On the flip side, I have dealt with overdoses, acute alcohol intoxication, suicidal ideation, ruptured ovarian cysts, fractures etc., all necessitating the activation of EMS. I am fortunate to have developed a solid working relationship with our local fire department. I have worked with families who child is diagnosed with cancer. I hold their hands as their child goes thru chemo and radiation and eventually loses the battle, but in the very end, I feel wins the war. I have consoled siblings and friends after a suicide, comforted classmates after a motor vehicle fatality, visited with families in the aftermath of the death of a parent or child.

But every day, I am here for my kids, faculty and staff and community. I have a voice in the community and can affect change.

[Peg Devine]

Very accurate. thanks for writing

[Nancy O]

So well written!!! So spot on. School nursing is so misunderstood by just about everyone (nurse colleagues in other areas, administrators, teachers, the general public etc....). I retired just about 3 years ago, after 20 years from school nursing (& after 20 years of hospital work)and have read so many articles over the years, and this article captures the multiple facets of the work, and my hat goes off to this school nurse for her ability to capture it so well (and concisely!) and displaying the "heart" of a school nurse as well.

[NutmeggeRN, BSN]

46 minutes ago, Nancy O said:

So well written!!! So spot on. School nursing is so misunderstood by just about everyone (nurse colleagues in other areas, administrators, teachers, the general public etc....). I retired just about 3 years ago, after 20 years from school nursing (& after 20 years of hospital work)and have read so many articles over the years, and this article captures the multiple facets of the work, and my hat goes off to this school nurse for her ability to capture it so well (and concisely!) and displaying the "heart" of a school nurse as well.

Thx for the kind words...this is truly my passion! ❤️