Have you ever wondered what being a school nurse means? What skills you would need? Or what a typical day in the life would look like? Make sure you’re all caught up with Specialty Nursing: What Makes a Good School Nurse? And now let’s dive in to interview Allie, a real life school nurse!
Name and Education
Hi! My name is Allie and my credentials are: RN, BSN, MSN. School Nursing Services Credential (SNSC) in the works, which is a requirement for school nurses. I graduated from California Baptist University with my BSN and Capella University with my MSN. I am currently working on my SNSC at Cal State Fullerton.
Where Do You Work?
I am a school nurse who covers a high school and an elementary school. I typically will split my time between the schools (mornings at the elementary school, afternoons at the high school), but every school nurse is different in how they split their time. Many school nurses will cover more than one school. But sometimes at the high school, they will have a dedicated school nurse because there are so many students.
How Long Have You Worked This Position?
1 ½ years. But I have been a nurse for 3 1/2, almost 4 years.
What Made You Want to be a School Nurse?
I really like working with kids. I grew up with parents who worked in the school system, so I appreciated that they always had the same schedule as me in regards to breaks. And if/when I have a family, I want to be able to provide that to them as well. The retirement is pretty great too.
What are the Most Common Skills Needed to be a School Nurse?
Time-management, leadership, team work. You are usually split between 2-3 school sites, so you will need to be able to manage your time between the sites effectively. This way all of the students are getting properly serviced. As a school nurse you will work with and delegate different tasks to the health technicians (health techs) at each site, so you need good and effective leadership skills. You also work with different admin teams at each site, who are also involved in the overall health of the site, so you need to be able to work well with others as a team.
What Personal Qualities does a School Nurse Need to Have?
Compassion, understanding, and problem-solving. Especially with the students who are in the Special Education programs. The school nurse works directly with these students to create individualized health plans (IHP) that are used to manage the student’s medical needs while at school. These students can be extremely involved to where they are non-verbal, wheelchair bound, and have medications that need to be given at school. It is the job of the school nurse to see these students as the whole person that they are, and work with the staff and parents to develop a health plan that will optimize their health and time at school. And those can change throughout the year as the student’s medical needs change.
You also need to be understanding of different students and their family situation. For example, at my district (specifically my high school), I have a lot of families that are living on or under the poverty line. So I need to be able to provide them with resources for free clinics when needed and not judge them for their situation. We also get a lot of student who are coming from out of the country and don’t know the laws for specific medical things, like immunizations, here.
The problem-solving skills really come into play at the high school. Especially when there are students coming into the health office and are not feeling well, but don’t know why. I tend to be more involved in the daily workings of the health office compared to other school nurses. But that is because that is something I truly enjoy. So, when I am in the health office, and a student comes in and doesn’t feel well, I will typically ask them a series of questions. If they ate anything, if they have had any water, and if they need to use the bathroom. It sounds like very simple things, but most of the time a high school student doesn’t feel well because they either have not eaten anything all day, have not had any water, or they need to poop. If those things do not work, then we move to how long they have been feeling this way, and what have they done to try and feel better.
Our goal in the health office is to get students feeling good enough so that they can return to class. If we cannot figure out why they are not feeling good, and we cannot help them to feel better, then it would be time to call home to get someone to pick them up.
What Does a Typical Day as a School Nurse Look Like?
Again, every school nurse is different in how they split their time between their sites. But for me, I will start my mornings at the elementary school. I would start off by answering any emails I have. These typically are coming from different staff who are informing me of an IEP (Individualized Education Program) assessment that is due or asking a question about a student. I will look at my list of student who have IEPs coming up, and whether or not I have done my health assessment on that student yet. If I need to do one, I will wait until about 30 min after the start of the school day to do those, which involve a hearing and vision assessment on the student. Again every school nurse is different in how they do these, calling the parent to discuss any health concerns, writing everything up, and then sending the results to the IEP team for that student. I will periodically help out in the health office if needed, or I will stop in the Special Ed (SPED) classes to check in on those students and see if the teachers have any questions/concerns.
At around 11-12 I will leave the elementary school and head to the high school. I have type 1 diabetics at the high school who need insulin injections for lunch at 12:52. Because of this, I like to get to the high school before the start of lunch in case a staff member needs to talk to me, or if my health tech there has any questions or anything they need. I am lucky that my diabetic students are independent in their care (mostly) so they do not need a lot of help from me. But I still like to be there in case they have questions about their coverage for lunch. After the lunch rush, depending on the day, I will either go to my office and do work there, or I will stay in the front of the health office and help my health tech run the health office as we will typically see 30-40 students in the high school health office throughout the day.
There are also times that I am needing to either call the parents of a student regarding medical needs or medication the student has. Or I may need to call the doctor for different medication orders or for new orders regarding something else. That process can take some time.
There are also times when I need to process a Home Hospital Instruction request. This is for students who are physically incapable of being in school due to a medical reason, but obviously still need an education. That process involves me giving the paperwork to the parent to give to the doctor. The doctor will then need to fill out the reason the student is unable to be in school. I will then review the request and the reasoning from the doctor and determine if it fits the criteria for Home Hospital Instruction. If I am unsure or confused, I can talk with the doctor about it. If it is something where we could accommodate the student while at school, I would deny the request, and then inform the parent on the accommodations we could do on campus.
I am also in charge of training different staff members on different medical things or emergency medication administration. Like if a student has a G-tube, I can train the staff in that class on how to stop, start, pause, disconnect, and reconnect the g-tube pump/feeding. I can also train staff members on how to administer emergency medications such as EpiPens, diastat, or glucagon. All of these trainings need to be renewed each school year. For our returning students, these trainings are typically done before the start of the school year. But if I have a student who gets a new medication in the middle of the school year, I could do the training then.
I am responsible for all of the people I train on anything. It is on my license if they do something incorrectly. So I typically am extremely strict when I am training staff because I want to ensure they are doing everything correctly, for the safety of the student and for the safety of my license.
What is Your Most Favorite Part About Being a School Nurse?
Being able to work with students in a long-term situation where they are not acutely ill. I love working with my high school students who have medical needs and being able to show them that they can be more independent in their care than they think they can. My goal for my high school students with medical needs is to get them to a point where they are able to manage their medical needs alone. This way, once they graduate high school, they can become independent adults.
What Should Students Looking to go into School Nursing Know about the Field?
There are some really wonderful parts of school nursing. Like when a type 1 diabetic student finally understands that if he covers himself in the morning with insulin, even if he doesn’t eat, his blood sugar will not be in the 300-400 in the afternoon, and he will begin to feel better overall.
But there are some really terrible parts of school nursing. Like having to call CPS (Child Protective Services) for an elementary student who came to school with a black eye and said his mom hit him that morning. Or seeing a high school student get addicted to drugs or alcohol and you are unable to convince them that their life is worth so much more than they are giving it.
You are also the medical expert for your sites. So you are constantly the person who is making the call as to whether or not a student can be at school when they are ill, or whether or not it is time to call 911 for a student who is having a seizure. For example students with epilepsy, for the most part, will have MD orders to call 911 after a seizure has lasted longer than 5 minutes. You are the go-to person for any and all medical questions, whether that be from a student, parent, or staff member.
Anything Else You Wish to Share?
I am sure I missed a bunch of things that I do, but there is honestly so much that goes on that not everyone knows. I love working as a school nurse. It might be stressful at times, but that is what nursing is no matter where you go. I feel so privileged to be able to work so closely with these students and their families.
Thank you Allie for your loving service to your community!
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