What School Nurses REALLY Do?

Many people think the responsibilities of a school nurse are limited to handing out Bandaids and ice packs all day long. While that's certainly a small part of the job, school nurses actually do a lot more than most people realize. From emergency preparedness (and response!), to keeping track of immunization records, managing concussions, fractures, sprains, and strains, caths, tube feedings, blood sugar checks, or just a little TLC during the day, school nurses do it all. Specialties School Nurse Life

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In response to this comment from a previous thread:

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"Can you tell us what you actually do in detail? That would actually be a more interesting read."

Give out Bandaids and ice packs, that's it.

Just kidding! Although that's what the majority of the general public thinks we do. What school nurses do varies from school to school, depending on student populations, state laws or district policies, etc. I'll get the list started with just a few things I personally do at work and my fellow school nurses can chime in!

Things School Nurses Do

1. I personally cover only 1 school and see 30-40 kids a day, and I know I'm one of the lucky few with such great numbers! It's not unusual for school nurses to see 60, 70, even more on a daily basis---from multiple schools or even the entire district. I assess, monitor, treat students for quite a variety of things: wounds minor and severe, sore throats, headaches, stomachaches, N/V, SOB r/t asthma, menstrual cramps, head injuries that may or may not turn out to be concussions, sprains, strains, nosebleeds, chest pain, many more. You name it, a school nurse has probably seen it.

2. Ensure students with chronic conditions (most commonly asthma, severe allergy, seizure, diabetes---but many school nurses also see students with more specialized needs such as those with cystic fibrosis, spina bifida, etc.) have plans in place that ensure the safety AND success of the student while at school. For example, a diabetic student would have emergency meds/supplies/a plan for hypo- or hyperglycemia. That's in addition to their day to day maintenance plan (e.g., checking in with the nurse before lunch for a blood glucose check and any necessary treatment.)

3. Administer daily and PRN medications, making sure all necessary forms are on file, calling parents when meds expire or run out, monitoring for any adverse effects, etc.

4. Educate students on self-care, healthy lifestyle choices, puberty, or more specific info related to their particular condition or situation.

5. Educate and train staff on common chronic conditions present in our school, s/s to look for, step-by-step response to emergency situations (anaphylaxis, hypoglycemia, etc.) Many school nurses also do CPR training for staff.

6. Working with administration to develop policies/protocols related to school health that ensure all students are safe and have equal opportunities to thrive and succeed.

7. Managing the occasional "special cases"---post-op student for example might need to learn how to use crutches/wheelchair to get around school, pain management plan, special accommodations in class (sitting near the door, needing a way to prop a limb up, etc.)

8. Document thoroughly on EVERY SINGLE STUDENT I see. That alone takes up a chunk of my time.

9. Annual vision, hearing, height, weight, acanthosis nigricans, scoliosis screenings for certain grades as mandated by state law.

10. Being the "safe place" for students with anxiety, other mood/behavioral disorders, and all students really. I'm fortunate to have counselors AND social workers but many schools don't so the school nurse plays that role.

11. Connecting students/families in need with community health resources.

12. Navigating the tricky world of teachers and education. You're the ONLY "medical person" in the entire building, nobody understands your job (but thinks they could do it since you just sit around handing out ice packs and Bandaids all day), if you're lucky another nurse is nearby or a phone call away but sometimes not, you are SOLELY responsible for your students' health needs and outcomes during school hours. It's tough being a nurse in a "teachers' world."

Anyway, I could go on but I know the other school nurses have plenty to add. TGIF!

Specializes in kids.

Nailed it!!

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I always describe my job as the medical professional in the building and the mom of everyone in it. It is no way an easy job, I am exhausted most evenings and my school is teeny tiny compared to most schools. BUT I am involved in almost every aspect of this school and I wouldn't have it any other way. These kids are all "my kids". Sometimes it's tough when people on the outside think we have it so easy that's why it's so important for me to have the other members of this board to reinforce that what we do is important and difficult, rewarding and challenging, exhausting and uplifting all at the same time.

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And on top of all the things the OP listed, we interact with the students. Whether it's a quite talk in the office or a chat while walking down the hall. We are there for them. I am in a small school, just over 200 students, so sometimes I even have a few minutes to play ball in the gym with them!

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I copied Kittery's OP onto a word document and printed it out and hung it in my office, giving her full credit of course!

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Specializes in Pediatrics Retired.

I'm trying to figure out a way to work my school nurse job - from home.

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Spinoff on this topic: we have computerized charting so I'm easily able to pull up how many visits I've had this year. 1,493!!! We started school late August. I'm sure my numbers are on the low end, too, but that just blew my mind. Curious to see what others' total visits are year to date, please share if you'd like!

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Specializes in Pediatrics Retired.

I'm at 1,330.

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I'm at 2931

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Specializes in ED, School Nurse.

I never thought to do this!! I am at 1887, and that doesn't count the girls that come in asking for tampons/pads.

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1385 since Sept 3 . . . oh wait, now at 1386!! Revolving door today!

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Specializes in kids.

1268 and that does not include daily meds, time spent doing concussion tracking, evenings spent at preseason presentations, time spent doing a flu shot clinic and on and on and on!

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Oh, and don't forget the cleaning! With limited seating and cots, and no paper covers (at least I don't get any), Sani-Cloths are my best friend. I actually like the smell of Vo-Ban these days, as it covers up the stench of the boys' bathroom as well as vomit. And the janitors will never clean the clinic door handles as much as I would like, so those get Sani-Clothed too. Then audio wipes for the audiometer, wiping up water that gets spilled when 6 year olds try to pour their own, and spraying everything that gets bled on with the anti-HIV spray . . . cleaning takes up a good portion of the day.

Our school this year has had a few door decorating contests, and I like to keep my clinic looking as little like a jail cell as possible, so I participate in those. I also have a bulletin board that gets seasonal decorations and health or safety tips. And since my clinic is Muppet themed, I've created some paper Muppet heads to add to the walls and bulletin boards. None of that is expected of me, but it helps to give the kids something else to look at beside plain white cinderblock walls, and can open a discussion venue as well. I've had kids who clam up when they get in here, but if I get them to help me with an art project for the wall, suddenly they're chatting away.

I also have a couple of fifth graders who I mentor, though with all the yuck going around they've been avoiding the clinic this week. Can't blame them! Who wants to have the flu for Christmas?

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