School Nurse

Nevada RNformation, Aug 2006

No two days are alike for 35 Washoe County School nurses who work each school day to help 63,000 children stay healthy at school and ready to learn.

Students with a wide variety of health conditions attend school including some who need nursing intervention on a daily basis. Before lunch, the nurse may supervise a student with diabetes as he tests blood glucose, counts the carbohydrates he will eat, and then calculates the proper insulin dosage. If the student is not able to inject insulin, the nurse will do it. Many medical procedures are performed at school: a nurse may feed a student via gastrostomy, suction a student with a tracheostomy, or catheterize a student with spina bifida.

School nurses serve all students, not only those with health problems. They provide the state-mandated screening for vision, hearing, and scoliosis. Organizing the date, the place, and the staff and equipment to screen 200 adolescents can be challenging.

In nursing, there is frequent discussion of delegation of nursing duties to unlicensed assistive personnel (UAP). Most school nurses in Washoe County have two or three schools. The nurse cannot be at each school to give every dose of Ritalin or be there at the moment a child needs an inhaler for asthma. School nurses pay close attention to appropriate delegation as outlined by the Board of Nursing and then work diligently to train UAPs so they can safely carry out delegated tasks. Most often nurses train the Clinical Aide who is a school employee trained in First Aid and CPR who cares for the daily illness and injuries in students.

School nurses work independently. Some tasks must be done at a certain time, but mostly, it is the nurse who decides how she will structure the day and prioritize responsibilities. Although the nurse may be the only health professional on campus, the support and knowledge of a group of colleagues with broad professional experience is as close as the telephone or email.

There are no night shifts in school nursing! Most school nurses work 185 days per year and many follow the traditional schedule with summers off. Other nurses work in year round schools and their time off is distributed throughout the year in four week blocks. Hospitals are able to offer higher salaries than school districts. However school nurses can advance significantly on the pay scale with continuing education and graduate classes.

The health issues that are frequently in the public eye, such as obesity, lack of access to health care, and the effects of substance abuse, are made visible in our children. School nurses work with parents, children, and educational personnel to provide the best environment for a child's success.

From asthma to zoster, and ADHD to varicella, if it has to do with children and health it is part of a school nurse's day.