Working in Private v. Public School

[arnoldlayne]

Hi. I just got hired at a private school which pays a little better than my previous public school position (both through an agency). On my first day at the private school, I noticed, there were very few medications with proper medication forms (by that I mean, the NYC medication 504 form) and we're already in February; some of the medications in the cabinet had Dr. prescriptions vaguely scribbled on script pads, some of the meds had no order at all, and some of the medications did not match what was on the order be it script or 504. It's all pretty atrocious to me. On top of this, the principal and the HR coordinator both criticized the last nurse for being overzealous when it came to contacting parents for walk-ins, and too rigorous in following vaccination schedules, and lice protocol, also told me she called 911 when it wasn't necessary---it all sounded to me like she was actually doing a good job and standing her ground amidst a staff that was possibly oblivious. Administration also told me she had been very unpopular with staff and parents, but they seemed to ascribe all of that to her being too rigorous in following protocol.

All this makes me worry because I feel like first and foremost, I'm walking into a job where I will not be supported and it seems like this is all too common for nurses in schools, the lack of support and understanding of what nurses have to do on our ends to safeguard the school as well as our license. Second of all, coming straight out of public school, I've never been in an office that was so lacking in proper documentation and paperwork and ironically administration is giving out vibes that they'd prefer me to be a little slack. I'm really rather confused by the lack of standardization in private schools. How do private schools get inspected? I'm assuming the city doesn't come to inspect private schools. I feel like we have a hundred violations and I just want to practice legally. I'm also worried by the lack of support. For example, when I worked in public school, I had two nurse supervisors I could reach, plus trainings and other nurses I could speak to. Are private school med. rooms standardized at all or is it up to each school to create their own policies? Please give me any insight. Thank you.

[GmaPearl BSN RN]

My first school nurse job was in a large private school. Meds were kept in an open drawer in the main office and dispensed by office staff.

We did have orders and a check off sheet. I got them to install a lock on the drawer by suggesting the school could be liable if someone got into the drawer and took or gave the wrong medication. Vision and hearing screenings were done per state mandate. We also required families follow state law for immunizations… It took a lot of my time on the phone to get compliance, but finally did. Admin was supportive as it was state law. Concerning head lice, they were thankful to have a nurse to handle the issue :)

I think you need to stress to admin. the themes of "it is the law", "this could cost you big $$$ in a lawsuit", and "best practice = safety for our entire school". (they could tout the safety theme on their PR fliers). Maybe admin would give you a time during a staff meeting to meet "the new sheriff in town".

Good luck to you!

[GdBSN, RN]

Yes, you do need to stress what is the law and take a firm stance. Maybe just ease into the change, most teachers and admin don't like change. Remember, it is your license that would be in jeopardy. Good luck!

[MrNurse(x2), ADN]

Working in a private school has positives and negatives and sometimes they overlap. Private schools struggle between being educators and businesses. Money talks and the outcry of parents is ALWAYS heard by administration. Not a bad thing all the time, it's how I got my position here. I always present things in light of lawsuit/ liability, especially at my school that is always concerned about budget. Check New York state laws regarding expectations, looks like their web site is really comprehensive. Stick to your guns and always appeal to that business aspect when championing change. Good luck.

[Flare, ASN, BSN]

I worked in a private school in the beginning of my school nursing career. It ran pretty much like a public school with respect to how the office ran - orders for meds, meds locked up, vaccination laws adhered to, state paperwork filed, etc.

I am sorry that your administration is not supportive of you. My first piece of advice is to arm yourself with knowledge. Get on your state DOE website and inquire about the standards and statues that private schools need to adhere to. I don't feel comfortable stating a whole bunch of "aught to's" at you unless I know what your state requires. I knew for certain that my state required what I was doing and everything else was good practice and gravy.

As far as calling 9-1-1. My thoughts are this. I'd rather explain an ambulance bill than a funeral bill. No, I am not one to panic and call for every little thing, but i'm also not going to avoid calling because i think it will be upsetting or look bad. In fact i had to call yesterday - I got annoyed with the EMTs when they seemed to brush it off. My 12 y/o student with a cardiac hx was having 8/10 chest pain and numbness in her legs (100% o2 sat on room air) - she's been out of PE per cardio order until they can figure out what's happening with her. The EMTs scoffed at me a bit and said oh, she seems fine - just a panic attack. Well, that may be - and yes, i did consider that - but as i told them - i'm not taking any chances. But I digress... You will know what's emergent. You are the medical authority. Listen to your gut. And if you don't feel like this is a strong area for you then take a class of two - pre hospital emergencies or even a first responder class with your local fire dept can teach you how to really get down to what is EMS worthy if you think you need a brush up.