1 wk into School Nursing ready to quit!! Is this normal?

k1p1ssk, BSN, RN · Sep 30, 2019

@StressedRN76 your story sound very familiar to me (in a way). When I first started subbing, I took on a tech school in my area; Population of around 800 7-12th grades, one nurse for the whole school. The nurse had been there for at least 15yrs.

The first day I subbed for her, at the first bell, I had 10 kids lined up outside the door. They literally walked in, 1 by 1, with their hands outstretched, seeking ibuprofen for "headache". It continued all day; I even had repeat customers. I was dumbfounded.

The nurse had built this culture of "a pill will fix it" in this already delicate population, where the risk for addiction was arguably much higher than the other public high schools in the area. Every kid argued with me about me wanting to do an assessment. If I refused to give them the meds, they demanded to lie down and would waste so much time arguing that they would end up missing most of their class period and want a note. One day, I even caught two kids making out on a cot. I started turning down subbing offers there. I felt my license was at risk. I knew as a sub, nothing would change.

As much as it sucks, I think until the nurse you're working with is willing to change her habits, you aren't going to get anywhere. It seems admin is seeing her office as her domain and that it should be run as she sees fit, and until a huge problem (legal, medical, etc.) presents itself and admin feels threatened as a result, you will find it extremely hard to make change yourself. I don't want to suggest you find something else, but it may be time to look for a different, independent school position (if you think you're up for the task... which with your varied and impressive resume, I'm sure you are ?). It is an incredibly rewarding field of nursing and if you find the right fit, it can be an amazing career. I think a lot of us love it so much because we are able to run our offices exactly how we want them to be run. It isn't for the faint of heart, but neither is ICU nursing, as you well know!!

Please keep us posted and don't hesitate to ask questions; This is a very active community and we love helping each other.

Flare, ASN, BSN · Sep 30, 2019

29 minutes ago, JenTheSchoolRN said:
Lol, when you put it that way...
(My bathroom has a back door that goes out into the hallway. When I leave my office, I unlock that door and lock the one going into my office so I'm not called out for bathroom "emergencies." All the admin know this thankfully.)

mine does too, but it also has a door that leads into my office, which i don't want to have the option of letting people wander in my office unattended.

NutmeggeRN, BSN · Sep 30, 2019

On 9/28/2019 at 5:28 AM, NRSKarenRN said:
Allnurses School Nursing forum has numerous posts that may help you.

Yes, we are a very supportive forum and very active. It is the virtual nursing station for many of us!!

EnoughWithTheIce · Sep 30, 2019

It sounds like the nurse that has been there for so long cares more about making staff happy than doing the right thing. You are most likely not ever going to be able to change the culture while she is still there.

So sorry that this was your introduction to school nursing. Like any job - there is the good, the bad and the ugly!!

nursetlm, ADN · Sep 30, 2019

Oh heck no! I remember wanting to quit my first few years. LOL I'm starting my fifth year and it's getting a ton better now! Hang in there!

nursmimi, BSN, RN · Oct 1, 2019

Welcome to the SN club! I would normally say hang in there it gets better, but if the other nurse is still there, it will never get better. Run!

StressedRN76 · Oct 1, 2019

I have decided to resign. I’m not happy that I have to give 30 days instead of 2 weeks according to the contract. I thought it was only for teachers to give that length of notice

For me not worth my sanity and energy trying to change things here... time to move on. Thanks everyone who responded.

SaltineQueen · Oct 2, 2019

On 9/28/2019 at 3:44 AM, StressedRN76 said:
the nurse I’m working alongside with. She has been there for 25 years and doesn’t see it as an issue. This is the problem she has allowed this environment and I will not be able to change it as the newbie just starting.

This right here is the problem. I think, in another environment where you could put the stop to all the nonsense, you would be happier.

ruby_jane, BSN, RN · Oct 3, 2019

On 9/29/2019 at 11:22 PM, StressedRN76 said:
Hi Just Jai,
Thanks for the reply. My co-worker is a Master's prepared RN. She has been in the same school for 25 yrs and it seems that they have had an issue with retaining a second nurse in this school. I wonder why??! I am very by the book, and on my first day I noticed there was no policy/procedure manual to follow. When I asked her about it, she was like "oh we never really had one". I asked her to see the standing orders from the school district's physician and it took her 3 days to find it and when I reviewed it, the last time it was updated and signed was 2009. I feel like I am in the twilight zone. This is not how I operate at all. Not to mention, the layout of this clinic is so backwards. Nothing flows, supplies are here and there and everywhere. I am running around looking for things. I do not understand how this clinic was set up like this and obviously it has not changed in 25+ years.
At this point, it is not worth my sanity to keep bringing up all the disorganization as nothing will change. The other day she gave a child his seizure medications with an expired MD order. She said" Its ok, I don't expect you to do this, I just know the child and they will eventually get me the paperwork'. This is not how I practice, so its creating such a conflict with me. I have decided I will be handing in my resignation this week. It is for the best, I do not feel comfortable staying at this school and the dread that I feel each night is not normal.

OH LORT. No Policy book? Giving meds with no order?? I am sorry you feel like you need to resign. You're having the same reaction to school nursing that I did to the ICU....

Nurse Lynne · Oct 10, 2019

Yes, the change to school nursing is a shock! Is the other nurse your boss?

If not, then remember this is your health office. I came up with a lot of reasons that the faculty can not use my health office RR. The MOST important of all is privacy for students. It is not the staff's biz which students are in my office. i am not their bathroom attendant. Also, our policy covers student medication. I no longer give out medication to staff. We announced it, with admin backup, at the first meeting of the year. Office is so much quieter now.

Say NO to the cooler. It's for sick people with fevers. Get out. Put a sign on it. Teachers too. Again HIPPA concerns. Let them take it out of your office. Let the water run out and don't replace the bottle. I bring my own water to school because I don't like the taste of the water at school. Tell the staff to do the same, or buy a case and keep it in their room and grow up.

You need to be ill or injured to enter the nurse's office. It is not a convenience area for staff water, rest room or chatting. I have work to do that does not involve staff rest room needs. Some nurses tell staff kids have just had diarrhea in there. I have asked staff if they would like it if I walked into their classrooms during teaching time to chat or get some paper or draw on the SmartBoard. Help them get some perspective.

Get control of your office. Unless....that other nurse is your boss. then you have another problem.

Cough drops? Once a week, then bring your own. Need to use the rest room and you're here for nothing? Boy's room is down the hall. Once you stop being nice you can start being effective for what an RN is supposed to do. Helping with feminine needs? Of course, yes. But if you're here constantly, get the pad and use the girl's room down the hall. I say it nicely of course, like, oh, dear, I'm on my way to a meeting, or need privacy for a student, would you mind...?

There are also times that I am too busy with meds or emergencies that I put a sign on my door: Emergencies only - bleeding, vomiting, can't breath. All others please return later. I don't overuse this.

Remember it's part of your job to keep the kids in class. Not really sick? Back to class now. that said, once your feet and schedule are steady, you'll have more time for the compassion visits and needs of some students. Some need rest. Some a chat.

i hope this helps. I've been at it 9 years. My first year, I worked hard but imagined myself in a ball under my desk. GOOD LUCK!!!!

beachynurse, ASN, BSN · Oct 10, 2019

On 9/27/2019 at 10:08 PM, StressedRN76 said:
Hi.
So after being in the nursing field for 20 years ( ICU, cardiac stepdown, Occupational health) I figured I would try school nursing as I heard good things about it mostly the due to hours and summers off. I knew I was going to take a pay cut ( almost 40% for me) but I figured the job would be less stressful...... Well after one week in a NJ public high school I am ready to quit!!! I have not slept for the past week DREADING to have to go to this new school nurse job. I was hoping by the end of the week, it would get better but I think I made a big mistake. I am working with a second nurse for a population of 1100+ diverse community. I really wish I subbed before taking this job, but I was desperate to leave my former job in which I had a toxic manager, so I jumped on the offer thinking it would be a nice environment to work in a high school. So please school nurses tell me if this is normal....
1. 60-70 visits a day ( cough drop, ice pack requests oh and sanitary pads alllll day long)
Depending on the size of your school this can be completely normal. It's all in how you manage it though. I'm in a High School with 2100 kids, I can see the same number or more students in a day. I keep a self serve stand for pads and tampons, band aids, saline, lotion, and cough drops. The kids sign in, but we don't chart on them because we don't do anything, they do for themselves.
2. One water cooler in entire high school in nurses office so all day long all the teachers come in and fill their bottles and then begin to tell you all their ailments and want you to diagnose them and give them OTC Meds. The nurse that I am working there has been there for 25 yrs and has created this culture of letting the teachers run the show in the health office.
This I would address with admin to get it out of the clinic and base the rationale on increased unnecessary traffic and exposure to illness.
3. Students do not want to drink from the water fountains nor buy their own bottled water so all day long they make excuses to come in to be seen and then request water from the cooler since it tastes better. Since my desk is right in front of the door, the constant In and out has me dizzy no exaggeration.
Oh, no, this needs to stop, and stop fast. I would redirect to the water fountain, and use this as another excuse to get the cooler out of the clinic.
4. the faculty do not like to use the multi-stall bathrooms in the faculty lounge, so they come into the nurses office all day long to use the 1 private bathroom we have for ourselves and the sick students. Its non-stop . I made comments to the other nurse about this and she said they are allowed by the VP
Another thing to address with the VP, clinic bathrooms are only for clinic students. Have you ever had to have students wait because teachers were usingthe bathroom? That needs to stop as well. Staff uses staff bathrooms.
5. Students who do not want to use their own hallway bathrooms and constantly come in begging to use our private bathroom. ( they do not have any medical need such as IBS.. they just complain the bathrooms are dirty and they wanna use a nice one)
Same thing here. You need to stop that. I only allow students in the clinic use our bathrooms. When we moved into a new school, we had staff, and students that tried to use our bathrooms and that came to a screaching halt. They were redirected to the appropriate bathroom until they got the idea.
6. I knew there was going to disrespectful kids and parents but for $48K a year with all the legal responsibilities of responding to all the emergencies, suspicion of drug use exams, fights constantly among the students....... I think the job is not worth it.... Maybe I am just burnt out from so many years being a nurse.... the only perk I see at this point is the holiday breaks and summers off....
School Nurses especially in NJ : Is this the norm in your school?
Listen Stressed,
When I came to my school 15 years ago, the nurse had set up such a system I tought I had made a huge mistake. I quickly learned that I had to make the clinic my own. With my own system, rules, and processes. You have to decide what you want and have a talk with your administrator. Explain what isn't working for you and be prepared to provide examples. Go in with ideas that you want to implement at least on a trial basis to see what works and what doesn't and agree to meet and re-evaluate. I am, even after 15 years tweaking things based on the population of students that I have in the building and the administrators that are in charge. But, it's become the best job! Let me know if I can help!!

Karen

rbytsdy · Oct 20, 2019

I’m a Nj SN. I’m subbing right now. I’ve been in 4 different high schools and your situation is ridiculous. I don’t blame you for resigning. If you are open to another SN job, they aren’t all that bad! They aren’t easy - the issues, the paperwork, the parents... people have no idea how intense the job is.

But $48k? You should have started higher for having so much nursing experience. That sounds like a first year teacher salary in NJ. You should’ve be “on par” with 1st year teachers.