What are your thoughts?

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Specializes in Ortho and Tele med/surg.

I just started a new school nurse position about 3 weeks ago. I work for an elementary school in an inner city community. The school has a total of 360 children. I started the position as a last minute substitute nurse. I really like the school & the kids make me laugh at times.

Here's my question. The director of administration is asking me to enter all the immunization records into an excel spreadsheet in 2 weeks. She's constantly asking me if I'm done but I see more than 20 students a day sometimes. I can barely get through 10 immunizations a day!

A few days ago a gentleman came and showed me how to use machine to do auditory screening. It was a 5 minute demo. The administrator said she wants all 360 kids vision & auditory screening done in 2 months.

Now, I'm subbing and I'm not really sure if I want to stay there since I'm per diem. Honestly, this is too much for as I have no help. Am I being unreasonable? I'm thinking about moving on. Please give me some advice. Thank you.

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Specializes in Pediatrics Retired.

You are not being unreasonable.

It's time for a "come to Jesus" meeting. Considering that student health and safety is top priority, everything else comes next starting with state mandates followed by district policy.

If she can't accept the reality of your situation or contemplate other alternatives, such as hire a temporary assistant, the fact remains you simply can't do everything she is demanding; you'll have to just say thanks but no thanks...then if you leave NOTHING will get done. Maybe a reality check will bring her back down to Earth.

Best of luck. Let us know how it goes...welcome to school nursing!

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All the above....yes. If the hearing and vision was completed on the health physical I would not repeat them, and only screen those that are state mandated to be. Hopefully that will bring that number down. Also as you are still getting into your grove of seeing 20 students per day, if timing is good...I would start to screen those students and their hallway partners if they come for vision and hearing while they are with you. If you feel like the demo was not enough, check YouTube for additional support videos.

Do you have access to eschool, infinite campus, or some computer program granting you access to student data currently? There may be an easier way to create this spreadsheet if they use one.

I feel as if they realize they have a competent, consistent nurse and they are going to try to get the most out of you before you bail on them probably like the nurse before you. Maybe if they sense you are going to become part of their team for the long hall, these aggressive deadlines will relax. Good luck

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Specializes in Med-Surg; Pain Clinic; School Nurse.

No, your not being unreasonable. It's also great to arm yourself with what the State requirements list for school nurses as well as what the first response suggested...having a good come to Jesus meeting. We are fortunate to have aides in our clinics so this maybe another thing to bring up. Having an extra hand always helps, even if it's just for a few minutes. Of course you would have be careful what you delegate, but at least you would have help.

Best wishes to you.

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I have 700 students by my self in prek - 12th. You have to learn how to prioritize and organize. Vision and hearing screenings in Texas are to be conducted within the first 120 days of the school year. Those state reports are due in June. However state says you only have to screen pre k, kinder, 1st, 3rd and 5th grade at the elementary level. With that said do not be afraid to ask for help or use parent volunteers to help you. Good luck to you.

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Specializes in kids.

I would review the records for the those who are NOT in compliance and tell her your focus is on those. The others will get in as allowed by time constraints.

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Specializes in CPN.

To add to what penny said, TX prefers H/V in the first 120 days (no one is gonna come after you if it doesn't get done in that time frame though). In addition to the grades mentioned, any new students to the district/school without a recent screening will need to be screened. Fortunately, this means you won't need to screen all 360 kids.

However, it is a concern that you were only given a "demo" and expected to start screening. In Texas, you are supposed to be certified by the state (your Region training center) to complete the screenings. A 5-minute demo is not sufficient.

Do you have a Health Services Director at your district? My suggestion would be to talk with them or another district nurse about what the policies and guidelines are in your district. I've worked in 2 districts in Texas and both required the screening certifications before we could screen kids.

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So, here's my concern....I'm assuming you are taking over for a nurse that left half way through the school year. This doesn't happen very frequently, so it makes me wonder WHY the previous nurse left in the middle of the school year. Was it a health concern, maybe a job offer they couldn't pass up, maybe they won the lottery? Or, did the administrator set unrealistic expectations for them as well and they just couldn't take it anymore?

I'd first gather some data, show the administrator how many students you're seeing in a day, note how much time you're taking to take care of each student on average and make note of how long it takes to enter all this data and try to show her how unrealistic their expectation is. Also, as previously stated, most states do require a certification for vision and hearing screening, not just a 5 minute demo. That's ridiculous. Find the law that supports that and show the administrator. If they are still sticking to their unrealistic expectations, then bye bye.

If you can, pair up with another local school nurse, see if they can mentor you through the rest of your first year. They'll be able to guide you with regards to local mandates.

Good luck and hang in there!!

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Specializes in ICU/community health/school nursing.

Welcome to our little corner!

That's a staggering amount of work that was NOT done in the first half of the year. Do you have an electronic health record like Skyward? If so, you can pull that report of vaccine-noncompliant kiddos.

Regarding the screenings - well, that's also behind and the expectation you'll catch up quickly is unreasonable. Best of luck.

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Specializes in Cardiology, School Nursing, General.

Uh, no. This AP is demanding way too much in so little time and that's not going to work out. Do you have a head nurse? if you do, I would ask her opinion and ask for her to back you up because you just got hired and it's not your fault that the last nurse didn't do her job.

As well, screenings. It's not going to be all 360 kids, probably like 20% of the school would be screened. In my school I have 524 kids, 272 of them are going to be screened based on grade level. It will probably take me 3-4 days to do screenings by myself. The thing is the screening is not the difficult part, it's the inputting the information. I'll take me a while to put all students in, but not forever. Since you just started, it'll take you longer.

As well you need to be certified to screen students, if they tell you no, I'm sorry but look for another job, because they are bending all sort of rules and laws.

If by some miracle you stay there, I would suggest you get some companies that do free screenings to help you. They do it super quickly and saves time. I have vision come in and do one room and I go on another room do hearing and we just get a group of 5 kids, do their screenings and alternate.

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