Starting full time as school nurse- any pearls of wisdom?

Eleven011 · Aug 1, 2015

I'm new also, will be starting in a couple weeks. No words of wisdom, yet, but i am going to meet with the retiring nurse for some training next week - do you get some orientation?

lifelearningrn, BSN, RN · Aug 1, 2015

Two full days of orientation that I know of, and from what I understand, the district does lots of workshops throughout the year that I will take full advantage of.

kriskatvt · Aug 1, 2015

Hi guys! I'm new too - Just left home health after 8 years. Started a new school nurse job in May, and was on orientation for a few weeks before school let out for the summer. I start back on Monday. Very nervous and excited! Would love to hear some pointers/wisdom etc

peaceful2100, BSN, RN · Aug 4, 2015

Hello,

I'm starting my 2nd year as a school nurse. I was in your shoes a year ago! I work in a high school!

Elementary and High school does vary just a little bit but overall some personal things I learned:

1) Definitely take advantage of your orientation and workshops. My district have nurse workshop at the beginning of the year and when teachers have their full professional development day the nurses have our day the same day.

2) Find a nurse mentor if they do not pair you up with one. If you are the only nurse in your district then reach out to another district and see if the nurse is willing to be an available contact/resource for you.

3) If you have a children's hospital near you contact them and ask if they have any resources for school nurses. They might be able to send you some information and give you info on workshops they have that would be of interest to you. Like my local children's hospital as an annual school nurse conference that was just last weekend. They also have a diabetic workshop, and other workshops like that. Some of the workshops are friendly for our hours (Meaning night/weekend workshops).

4) Establish Rapport with the staff and let them know that you are there to be part of the team to help ensure the students are healthy so they can be productive during the school day.

5) Do not be afraid to take a lunch break. It's for your sanity/peace of mind. Of course we all know there will be those days that just might not happen. However, I always have quick snacks on me just in case I need to eat my desk really quick. After a while you will be able to assess when the high volume hours are. I discovered high volume hours are between 11am-1230pm. So, this year in my staff letter I will inform staff that when ever possible I will take my lunch between 1235-105 and do not send students down to my office. If it's an emergency front office/security can notify me via walkie talkie (We have walkie talkies in our school) not sure if all schools do.

peaceful2100, BSN, RN · Aug 4, 2015

Oh, and if you do not have a tough skin develop one ASAP especially for those who are working in a middle or high school. Those kids will definitely try many things under the sun to get out of class. You still of course have a responsibility to check things out but after your assessment/judgement quickly get them out of your office. Some love to linger as long as possible. You will soon recognize those frequent fliers you may have to call home about as well. Yes, you will get those. They come in for the craziest of stuff.

Also, high school kids are notorious for not going to bed at night thanks to our lovely technology/social media. So, they come in extremely tired the next day thinking they are going to use the cot in the nurse office to take a nap. They are often pretty good actors/actresses for "faking sick". My theory if they are not puking/fever you are not laying down. If they have a headache/cramps I may allow them a 20 minute rest here and there but if it starts to get frequent I will say No.

Got to put your foot down and set boundaries from the get go. Many nurses before me at the school I'm at did not last long because they was unable to set appropriate boundaries and was walked all over from what I have heard from other staff.

RatherBHiking, BSN, RN · Aug 4, 2015

All great advice! I'd also recommend joining the NASN (National Assoc of School Nurses) because they also have forums, free CEU's, a free pair of glasses for any student you choose, and lots of school nursing resources. It does cost but I make my payments in installments that doesn't make it as expensive.

I'd also recommend reading School Nursing A Comprehensive Text by Janice Selekman. I've been a school nurse for over 12 yrs and I just recently read it in preparation for the National School Nursing exam and I learned a lot of things I didn't already know or understand. I thought I really wish I'd read it years ago! It explains the difference in IEP's, 504 plans, disability laws etc. and a zillion other things common in school nursing. If you don't want to join NASN try to at least read that book. It's worth it. It's huge and not cheap but it's a great resource. Someone in your district may already have it so check first.

Remember you will have a big learning curve and may get overwhelmed at first. Just remember, you're in a school system with a healthy population for the most part. Things are not as rushed in a school system like a hospital. Whatever you don't get done one day (like care plans, immunizations entered in computer, Medicaid billing, etc) can usually wait till the next day. There's not someone coming onto the next shift upset you didn't finish. It's ok to ask questions. There will be more lice than you ever expect. There will be more parents that are not good parents than you ever expect. There will be more frequent flyers than you expect. The flip side is you will get many opportunities to know you made a difference.

Also, #4 above: do whatever you can to get to know the teachers well. Be nice even when you disagree. Be professional. They truly don't understand what we do. I've had many times over the years where a teacher is doing something I don't like or agree with (like letting any kid come down who asks any time even if seen you three times already that day or insisting you send a kid home who you don't feel is truly sick, etc). Sure, you can talk to the teacher and the principal if need be but I've found that even when the principal sides with you they still let the teacher do what they want because after all it's an educational setting. I'm not saying let them walk all over you but choose your battles carefully. I've found that if I have a good rapport with a teacher they are much more likely to listen to me and try to do what I ask.

Good luck! :)

Farawyn · Aug 10, 2015

Go to your State Ed website, there is a section for school nurses. NY has a great one.

CalNevaMimi, LPN, LVN · Aug 10, 2015

Awesome! I find this message board to be extremely helpful for information, encouragement, and especially humor. For the elementary kids, I found that these three words got me out of a lot of screaming kid drama: "We'll fix it." When appropriate, I had students assist in their own first aid. It gives them a sense of control. Also, get to know the head custodian, as that person really runs the school. You'll never be out of soap and paper towels.