What to do... Help

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I've been reading posts on here for a while but finally decided to try and get some advice. I've been a school nurse since August and I am a new grad (from May). I currently work in a middle school with almost 1000 kids in a very large urban district. I feel like I made a horrible mistake taking this job, I feel very anxious everyday that I have made some nursing judgment decision that was wrong and that I will be liable for that decision. I was told in my interview that I would have a good amount of orientation and would not just be thrown to the wolves. However, my orientation consisted of 2 days of going through the policy and procedures manual and then 2 hours of another nurse coming to my school with me to give me an idea of what to do prior to the school year starting. I feel as though nothing in nursing school prepared me for this. It's a constant struggle between parents, teachers, and policy and I am frequently overwhelmed with doubt in my nursing decisions. I had students coming in for lice checks and I had never even seen lice before! I am expected to do head injury assessments and had never even done a neurological assessment outside of getting my validation checked off in the nursing school lab. My supervisor tells me that I am doing fine when she does her monthly visits and there are days when I feel as though I have a handle on things (such as when I only have to see 15 sick/injured kids rather than the usual 30), but there are times when I don't sleep for days and feel like I'm having palpitations due to the stress. I am confused why I was hired to do this position as they must have known I would struggle, however it seems the district cannot keep nurses as I have heard of 3 recent hires quitting soon after starting (1 after the first day!). This job has made me doubt my personal judgment in taking this position, as well as doubt whether I am even cut out to be a nurse altogether. I feel like I am a liability to myself and the district and it's beginning to affect my mental health. Any advice? I am very sad as I had hoped to love this job and had only met school nurses who absolutely loved their profession. Perhaps I am an anomaly. :no:

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Specializes in Pediatrics Retired.

Nursing school only prepares you to pass the test for your RN license. Once you go to work you start to learn how to be a nurse in the field you decide. Unfortunately, in school nursing, there isn't anyone to learn from since, usually, you are the lone nurse on your campus. Most people and most nurses don't understand how unique a position this is. Frankly, your district took advantage of your innocence and naivety in hiring you. I can understand why you are having those feelings. Fast forward to today. You have survived half the school year and no one has died or suffered a severe incident. When I worked in the ER we would always celebrate at the end of a shift that no one died today. So, whether you realize it, you have learned a lot this semester in a literal solo crash course in school nursing. My suggestion to you is to keep at it until the end of the school year. Don't hesitate to throw out your concerns or questions here with us and see how you feel at the end of this school year. If you weren't a caring and compassionate nurse you would not be worrying over it. Hang tough and please talk to us.

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Okay, first, breathe.

You are a nurse. You graduated and took and passed the NCLEX, yes?

Just breathe.

You are not dealing with "patients". This is not an ICU ward. You are dealing with mostly healthy students.

Half of your 30 visits (and really, that's good for a school your size. My school is 7-12, 750 kids and I'm 20-40 kids a day) are just kids exaggerating and trying to get out of class.

The chunk of kids that are truly sick are going to be your problem.

Plus there is psych stuff out the wazoo, right?

I think you should take your time. Unless someone is coming in with a missing eyeball or limb, you can walk and not run.

If ever in doubt, call someone.

Call 911 if you are on the fence and you are not sure if it's a true emergency.

Educate yourself. Go on your state website and see what is expected of you.

Contact the senior nurse in your district every day, even to just say hi.

Be in communication with your principal.

Any learning opportunities ? Take them. Your local government website no doubt has classes you can attend- I am taking a Narcan course next week.

Make sure your CPR is up to date.

OldDude has a great pic of lice he can send you as well as some samples.

Come here. Don't be afraid. We will help you.

That being said, no. I'm not crazy about new grads being nurses. As mentioned in the other thread, you are the medical person in the building. This includes teachers, many of whom are big babies.

Yet some of us here have started out as school nurses and have stayed there and shone.

I would hope they weigh in.

This may not be the job for you. Palpitations and unhappiness and wanting to quit nursing? No. If it's that bad, update your résumé, tell the school you will be moving on at the end of the year.

I hope you have support. If you don't, we are here, but you should seek help. This is a HUGE change in your life.

School nursing is often a lonely job. It's why we are such good friends here. We are truly coworkers.

Just breathe. You will find your way.

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Specializes in School nurse.

I concur with OldDude and Farawyn. I did not go straight into school nursing and I did sub for 2 school years first. I'll add that you should review your state statutes relative to expectations and requirements. I don't know what state your in but some have really nice school nurse guidelines. If your unsure about how to handle clinical events you might want to take a look at something like guidelines for the nurse in the school setting by Loyola Medicine (you can Google it). There's a boatload of triage and assessment tips in there. Oklahoma has information for new school nurses (Google school nurse procedures). Keep in mind your own state statutes when reading. Also, do you have a county or state school nurse organization you can join? NASN has great info and classes as well. Being a newly minted nurse is tough but like OldDude said, you've learned more than you think already. One of the first things I learned is to trust your instincts, when in doubt send them out, and if it quacks like a duck it's a usually a duck :-). Reflecting on your day through journaling might help ease some anxiety and boost confidence. You'll see what you did well and figure out what to do better. I still say a prayer before I get to work and give thanks when the bell rings and everyone is still breathing ;-)

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Thank you all for your kind words and advice. I guess I believed this job would involve more creating emergency plans and being involved with IEPs/504s and less craziness! But that's what I get for having expectations lol. I'm amazed daily by the number of kids with chest pain (and no other symptoms) in a middle school. I try not to freak (assuming it's heartburn, gas, etc. especially right after lunch), but I also am very cautious (probably too much so). The potential head injuries are also nuts! Frisbee injuries, football injuries, running headfirst into lockers, need I say more?? I had a kid smash his finger almost down to the bone in a drum during band practice. Teachers not informing about field trips (even though they've been told multiple times!), non-compliant diabetics, parents who don't bring in meds and then get angry when I don't have medication to give their kid. I do have good days, which today actually was, but the bad days are just awful. I do feel more comfortable now than originally, I just wish things were more "here's this, do this". Obviously if someone got stabbed in the head or shot or was unconscious then I would be calling 911, but it's those iffy wishy-washy could be serious but most likely the kid is faking/over-dramatic things that scare the heck out of me!

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Read us. We deal with this every day.

Welcome to School Nursing.

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Specializes in Pediatrics Retired.
Read us. We deal with this every day.

Welcome to School Nursing.

Far condensed it...in the proverbial nut shell.

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Specializes in School nurse.

Check out the Loyola guidelines for a "here's this do that" list. Everything else, noncompliance, parents, teachers, paperwork etc is the joy of school nursing (wink). Oh and a sense of humor, sarcasm, and saltines cure everything, even lice.

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I agree with all of the above! If it's not for you, now you know and you can move on!

proverbial nut shell.

This sounds like a band I would listen to. Or a really bad adult film.

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Specializes in IMC, school nursing.

Take comfort that your classmates feel exactly the same way and are having their hand held. I tell new nurses all the time that the first year will have you asking what did they teach me in nursing school? Nursing is a career, take it slow. The feelings you are experiencing are normal, don't sweat it.

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Specializes in IMC, school nursing.
Check out the Loyola guidelines for a "here's this do that" list.

Have this in a binder and refer to it often.

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Specializes in Home Health,Dialysis, MDS, School Nurse.
Check out the Loyola guidelines for a "here's this do that" list. Everything else, noncompliance, parents, teachers, paperwork etc is the joy of school nursing (wink). Oh and a sense of humor, sarcasm, and saltines cure everything, even lice.

Whats the Loyola guidelines?

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