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!

I'm at 1414,doesn't include flu clinic, dental clinic, hearing and vision screens or family life classes, or meetings with parents about their little angels' medications. Just over 200 students in this school.

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I was the person that made the comment that the OP quoted. All I have to say about this thread is that School nurses Rock!!! I love this thread way better ?

I do not need you to confirm to us that "school nurses rock".....I do hope you have nothing but sunshine filled, unicorn flying, princess giggling days, and when you don't..do not vent here, cause I will make sure I write that I don't want to read that kind of post

Specializes in School nursing.

1,568 for me and I only have ~480 students. And this doesn't count screenings, 504 meetings, and phones calls. And I am teaching sex ed/health starting after the break for 9 weeks...

I had a friend who worked nights at a relatively busy hospital sub in for me for a couple of days - she was amazed at what I kept up with! Totally changed her perspective of school nursing.

3402 visits, school of ~950. Includes daily meds but not vision hearing screenings which have been around 120 or so.

Specializes in family practice and school nursing.

I don't know how many.. would have to count them... still using paper documentation...ugh...

Specializes in Acute Care, CM, School Nursing.
bell1962 said:
I don't know how many.. would have to count them... still using paper documentation...ugh...

Me, too. *sigh*

Two more skills to put on my resume . . . Xerox fixer and paper towel filler.

Also bloodhound: tracking down the kiddos who don't want to take their daily medication is an adventure.

Specializes in School Nursing, Hospice,Med-Surg.

I double document...paper & computer. Wahoo!

I've had 1,436 documentable visits this year with just over 350 students.

But I've come to realize I have A LOT of visits I don't even document...I wonder how many students I see a day that I don't even make note of:

  • minor falls and scrapes
  • band-aids
  • ice packs for minor or non-existent injuries
  • bathroom accidents (email/computer documentation...but not paper documentation)
  • girls coming in for pads/tampons
  • middle school girls for mild to moderate drama and teenage angst
  • hunger pains (I didn't eat breakfast, do you have a granola bar, crackers, etc?)
  • tooth pulling
  • wax for braces
  • removing splinters
  • minor nosebleeds
  • K-5 chats and hugs when a kiddo misses his/her mommy
  • uniform or shoe sewing or repair
  • braiding hair
  • medicating teacher or teacher's child with teacher present before or after hours
Specializes in School nurse.

I had a teacher friend of mine say to me "Your job is to keep up with the immunizations and let the kid rest on the cot until their mom comes"

UMMMMM........

In the interest of friendship I bit my tongue and said "Well, it's a bit more involved than just that."

I have a school with prek-5th and about 660 students. I'm at 3,120 visits for the year which does include scheduled meds but does not include screenings, 504 meetings and other functions I am required to be at.

A lot of that is because they treat me like a primary care clinic...

Your back has been hurting for the last month? Go see the nurse.

You were in a minor fender bender 2 days ago? Go see the nurse.

But I suppose that is a topic for another post. :banghead:

Specializes in Acute Care, CM, School Nursing.
bluebonnetrn said:
...

A lot of that is because they treat me like a primary care clinic...

Your back has been hurting for the last month? Go see the nurse.

You were in a minor fender bender 2 days ago? Go see the nurse.

But I suppose that is a topic for another post. :banghead:

Ugh, I hate this! I, too, feel like the Urgent Care for everyone in the building, plus the parents. Some doozies:

"Johnny fell and banged his head really hard on Saturday. He was dazed and lost his memory for a little while. Can you take a look at him to make sure he's OK?" Received a note like this on a Monday morning!!

From a staff member: "I don't feel good. Can you listen to my lungs and see if I need an antibiotic? I don't want to waste a copayment." GRR!

A dad at Open House: "You know, my knee has been hurting for a week or so. What do you think it could be?"

GO TO THE DOCTOR!!!

WOW!, thank you for this, colleagues.

I'm a clinic RN, and people don't know what I do, either. But it was really incredibly interesting to hear all of what you do. I am impressed and I salute you.

Makes me think that I should write a post "What Clinic Nurses Do: Not Just Filing Our Nails in the Back Office to Ease Our Bon-Bon Feast" :p ?

Really interesting thread.

1876 visits this year, does not include diabetic care and daily meds.Probably another 1000 or so if you figured those in.