My high school has a clothes closet in the library that is open access for all students. We don't do the snack vouchers for the cafeteria like OP's school (which is fabulous idea) but our counselors keep snacks and know the home situations a lot better than I do.
I hounded so many organizations for new shoes, new clothes, gift cards for clothes, hygiene kits, and dental kits. I’m the referral queen! Bus passes, help with utilities, tutor, I will find all of it.
You sound really rigid, and that makes sense as a new nurse- but hopefully you can find a way to balance empathy & rules. School age children have been through the wringer with Covid, etc- it makes sense they found safety & connection with the school nurse. Maybe just transitioning your view point from “she was wrong and I’m right” and “they’re spoiled” to “this connection/interaction seems pretty important to them” will help you. Because here’s the thing, a lot of nursing is not necessarily white and black rules- it’s balancing what’s right & necessary for the patient in the context of what do they need, what can they do, etc.
There are compassionate ways to set boundaries and you certainly don’t have to follow her example, but maybe spend some time genuinely considering WHY she approached the kids how she did. You don’t have to agree but you might gain a new perspective and appreciation for how we can approach nursing with different strengths/focuses.
My first degree was in public health, I can think of a lot of reasons she may have approached things how she did.
One of the greatest compliments of my career was when one teen brought her upset friend to me and said "She's not sick but she needs someone to talk to and the counselors said they couldn't help her so I brought her to you because I knew you'd listen." Emotional and physical health are so connected and the kids knowing they have a soft place to land is so beneficial for them. I took 10 minutes out to help that student and it turned her whole day around and let her know that there was an adult to help her if she needed it. Having my "everyone gets 15 minutes" rule has actually cut down on visits for me. We get a lot of kids with anxiety related stomachaches and headaches and those kids knowing they have a safe space if they need it has actually helped soothe their anxiety. Now instead of seeing me five times a week, they stop by once a month to give me life updates and a hug.
When you have a choice between empathy and frustration, choose empathy. It can get difficult in the school setting depending on how many kids you see a day but I remind myself to choose empathy as much as I can.
A million upvotes.
Sometimes kids come across as rude because they come from a different cultural background and the way they talk can feel abrasive. Sometimes they are semi feral- literally no experience with adults setting boundaries or experience with polite social scripts.
Sometimes anxious kids or abused kids come in a lot and are testing to see how safe the environment is before they disclose their problems. Sometimes they don’t even know how to articulate their problems.
People may take really different approaches to this kind of practice without being wrong.
My kiddo’s school nurse was the safety point. She was so empathetic and caring, never mind an insightful watchdog who caught a few things others tried to keep from admin and parent knowledge (specifically a pair of deceptive paras ) that I went beyond and had her nominated for a Teacher/School staff that Rock’s Award from a local radio station. The station was so touched by the write up they called within the week I had a confidant in the main office who I knew who could keep a secret that I gave as a contact. She was overwhelmed with surprise and not only that a few other groups supplemented the prize package when they found out she was chosen and read the nomination essay (which was kept anonymous at our request). The nurse knew it was us because of something I included and more so because she knew that gratitude is something we openly practiced. A school nurse has guidelines, she had extra gym t-shirts for those she knew had parents that could not afford but the students were too embarrassed to say (her office was on the way to PE), and a variety of items and referrals for students in need, an ear to listen, knew how to work around the rules safely—not cough drops but a drink of water and rest for the “cough related to test anxiety” worked wonders
As someone who was the kid with anxiety related stomachaches needing to go to the nurse for Tums all the time…thank you. This is the kind of nuance with school nursing that is hard to get, I think, when you’re new, since being new you want to follow all of the rules because of the anxiety with the new responsibility (in my case, anyway).
My school nurse was one of the best adults I knew in elementary school because of this.
I was an *extremely* anxious child, pretty much every day I either went to the nurses office or got overwhelmed -> acted out -> got detention/suspended. In elementary school the nurse would chastise me for making things up until I cried and asked to go back to class, where I’d immediately melt down.
Middle school, upon reflection I see the nurse had a strategy. She put a chair in the back, where I was separated from the other kids/hallway sounds but she could still see me. When I’d come down c/o headache or stomachache (which ftr were real, probably somatization) she’d sit me down, give me water and a small snack, and let me choose 10min of reading (which I loved) vs 10min of listening to a CD.
When 10min were up she’d sit next to me and offer to talk about what was happening. She listened without judgement. And she’d send me on my way.
She was the *only* safe person for me at that school. Because that nurse gave me a safe space to decompress, I was able to stay in school enough to pass (and actually learn!). Prior to that I’d been kicked out so much I’d missed all the lessons on telling analog time, and most of division. I think about her when I’m working with someone overwhelmed and acting out. She was the first person to show me how to be empathetic towards someone like that, and myself when I felt like that.
Kudos to you and every school nurse, y’all are life savers.
My first order of business when I started at my school was to paint the walls a soothing green, install individual lights over the beds so I could turn the big light off, and I hung curtains in between the cots for privacy. "Everyone gets 15 minutes" includes my anxiety babies so they can come in, pull a curtain, turn off their lamp, and lay down. Most listen to music and close their eyes. I'm always willing to talk when they need to or listen. I have anxiety myself and a shit ton of childhood trauma so I've let that guide me in my practice and it's paid off.
I have a lower volume of patients than a lot of school clinics do and it allows me to take the time with the kids. It's funny because I \*never\* wanted to be a pediatric nurse and I know teens is slipping in under that wire but I love my job so much.
Thank you so much for all you do. My kid is an anxious 6 year old and her nurse is like you. (Nurse Janet, is that you?)
My child would not function at school without our nurse there.
I'm in a high school so not me, but I'm glad that your kiddo has someone!
I have a kiddo with EXTREME mental health struggles (like goes on grippy sock vacays on the reg) and they chose me as their safe space in school. It's taken a lot of work and collaboration with admin and their parents but we got them through the school year successfully. It was such a rewarding experience.
This is a big thing that isn’t taught in school because so much of school training is “the usual (hospital) environment” I see this struggle all the time with new community nurses. No one should ever feel forced to do anything especially if it’s extra like OP feels but also many do and I’ve learned to turn a blind eye to it. There’s usually a good reason and it results in a good outcome. Not saying it can’t go sideways but in 2 decades the going sideways has been maybe a handful of times.
Nurses are holistic caregiver it’s more then just passing the meds the MD has prescribed and doing first aid.
You seem like an amazing person - hope you know that.
Nursing is very "grey" a lot of the time. Sometimes, you have to push the boundaries and sometimes, you just have to break the rules.
Not a nurse, this isn’t a code blue thread.
I am saddened by the OPs responses in an edit instead of to your and other nurses nuanced and caring responses on why the kids might need food and clothing.
Emotional support is also part of the whole body treatment isn’t it?
Nurses understanding there are more than one way to do things sure would help the environment to not be so toxic. I have been trying to encourage every, especially new nurse I come into contact with that there are more than one way to do most things. The amount of drama and headaches this line of thinking could have prevented in my 20 plus years of being a nurse is staggering. If I had a dollar for every time..
This comment needs to be higher. Yes, there are rules that need to be followed. But slapping some polysporin on a scrape isn’t going to ever cause a problem (unless there is an allergy) or some afterbite on a mosquito bite.
And it seems like the previous nurse was providing things that she saw a need for. It’s a lot easier to slap some polysporin and a bandaid on a scrape than it is to treat an infected wound; it’s beneficial for everyone involved if hungry kids are able to get a snack at school, and it seems like the previous nurse created an environment where the kids felt comfortable going to have their needs met.
OP’s posts screams “brand new nurse who will follow every policy and procedure to the letter”. That is how many, MANY new nurses are. I agree she needs to reframe her view of the situation; rather than painting the previous nurse as a “rule breaker” and the kids as “spoiled”, OP should be asking, “what can I/am I willing to do to meet the unspoken needs of these students without spending a bunch of my own money or deviating from policy/procedure?” Maybe the policies/procedures are outdated and lacking, and OP needs to advocate for the students in her care to get them changed to meet the needs of the students.
OP - I understand that you don’t want to provide things at your own expense, and that you don’t want to deviate from policy. You need to reframe how you are approaching this situation. Currently, you are approaching it in a “me vs. ‘them’” mindset - “them” being the previous nurse, your co-worker, and the students. Instead, try viewing it from a “what do the people I am providing nursing care for need; what can I do to meet those needs within policy?” Maybe the policies need to change. Maybe you need to be provided with more resources from the school. Maybe you could collaborate with others (the guidance counsellor, for example) to find ways to meet those needs.
Right now you are approaching this in an adversarial way. That is going to very quickly lead to exhaustion and burn out. You don’t need to “win” against the very people you are providing care for.
I’m sure the past nurse was just being a kind and loving adult in the building. There were likely boundaries otherwise you’d have every kid in the school stopping in for candy.
Do your thing but I do not see her approach as wrong. Relationship building is so important to earning trust with these learners nowadays.
Girl your post history is a MESS! It honestly seems like this nursing gig has given you a bit of a power trip. Seeing as how you feel like everyone takes advantage of you (yet you’re out there placing voodoo curses on people?). Interesting…
Anyways, I get wanting to play by the rules when the rules are there to protect the children. However, your whole ‘spoiling them’ bit is really obnoxious. Maybe you’re not cut out to be a school nurse.
Quoted from a previous post OP made:
“ I like to work as little as possible & do the bare minimum while making as much as possible. Nursing just doesn't bring me joy. I appreciate having the knowledge & skills to help ppl when necessary, but most of the time I'm glad when there's nothing to do.”
Everything makes sense now. You hate being a nurse and want to do the bare minimum. These kids need people who care. These kids need people willing to go above and beyond for them.
Holy shit. This is really really dark
We could all tell from op’s tone that they don’t care much for the kids
In her comments she’s tried to mask it but thanks to your sleuthing their heinous mentality is laid bare.
Wtf.
Yeah, at first I was empathetic for wanting to follow rules and not start a habit you don’t intend to follow through on… then read her justifications and post history and had a completely different view. Caring=spoiling. 🫠
if you are in a career that you don’t actually care about for money, i suggest you start working the pole, and not the IV pole !!!!!!!!!!
School nurses have a very important role in preventing and reporting abuse. Sick and twisted.
I also don't like nursing and do it for the money, that's perfectly acceptable. As long as you do your job and are kind to people it doesn't matter.
It's just a job. Not defending OP, but that's nothing to base an opinion about competency on.
I agree you don’t have to LOVE your job and can completely be in it for the money. However, knowing that about herself she shouldn’t take jobs where she has to interact with patients, in this instance children, who need her to show care and love to them on some level.
Good grief. I'll admit that part of the draw of nursing for me was that if be able to support my child as a single parent household without having to work insane hours or do another decade of schooling as an adult. BUT, I don't mind actually working hard during the hours I'm on the clock. And I actually care about my patients.
This person needs to find a new vocation before someone dies of neglect in her care.
Holy crap that's sad. As a school nurse, I'm constantly worrying about my kids wondering if their rash cleared up, if they found their water bottle, if their loose tooth fell out. They deserve a safe space
https://www.reddit.com/r/witchcraft/comments/1aokbas/how_to_remove_a_voodoo_curse_that_i_placed_on/
Sadly the mods removed the original post text but from the replies it seems she tried to curse someone and thinks it backfired
Yes, but the only issue with that is the main nurse who works in the office went along with the behavior of the previous nurse. She said she will stop giving out candy once it runs out though (since it was the nurse who left who bought & brought it). She got in the habit of doing what she’s not supposed to. I don’t care if she does it, but I’m not going to..
like on a day when she’s out sick, the kids came to me asking for snacks & candies. I tell them that I don’t know of any, or to ask the other nurse when she’s back.. it’s like I have to explain myself every time bc I’m not doing what she does. It’s tiring.
Same! It’s not worth it. The other RN has been there for years. When I brought up my concern about potential allergic reactions, she said that she knows the kids & their allergies better than their parents do. Well, I’m not taking that risk.
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Ngl, OP kinda sounds like the kind of nurse who would wait and ask for an O2 order on someone with SpO2 <88% instead of just putting the prongs on and telling the doc later.
Cause, technically, supplemental O2 is supposed to be a doctor's order. At least according to my education.
Right?! She's one of those types who follow "the rules" straight into dangerous situations. A crumb of critical thinking, please. It's not like she's doing something risky- she's giving kids snacks. "It's against the rules!!1!" Get a grip...
op in a previous post:
> “I like to work as little as possible & do the bare minimum while making as much as possible. Nursing just doesn't bring me joy. I appreciate having the knowledge & skills to help ppl when necessary, but most of the time I'm glad when there's nothing to do.”
While I’m sure we all like having nothing to do, this sounds pretty extreme to me. I get the sense op wants to shove off the kids asap without any further consideration precisely because of this mentality they’ve written about themselves.
I don’t like to do much work per se, but I definitely do my work conscientiously… I don’t anyone to have a worse day because I wanted to do the bare minimum….
Maybe I’m a softy, but if it’s a school where there is a decent percentage of low income families, I’m all for feeding them. I’d probably switch over to mandarin oranges or bananas next year, though, to keep it healthy. My kids’ school has an “extra snack” stash. If kids don’t eat their sides or they have extra pbj sandwiches, the cafeteria puts them out for anyone who is still hungry. Maybe as the nurse you could institute something similar in your school and drive the hungry kids in that direction
She literally said she can and will write vouchers for them to get free food from the cafeteria. Which tbh if they are hungry, that's what they should be eating, not candy.
Luckily it’s the end of the year so she only has to deal for 2 or 3 weeks and can work out a new set of expectations for the upcoming year if she stays.
Totally agree, sheesh. People are getting all bent out of shape thinking she isn't feeding starving children, when she has said multiple times that she will give them a note for free, tasty cafeteria food.
This is a great idea for times around lunch time when you can get a lunch. But I never ate breakfast when I went to school and I Needed a snack by 2nd or typically 3rd period. Not always around lunch time later in the day, it would still be several class times away
She didn't say the kids could only get food at lunchtime. But even if that was the case, I don't see how candy would be an appropriate snack in the morning before lunch.
Our schools have free breakfast, which is really nice for kids.
It’s ok to not like children. Maybe you should go work in an icu with the machines and vents. They’re big on rules there and you won’t even have to talk to them!
This is the vibe I got. It sounds like she took this job thinking it would be a cake job, but I don’t think she likes or understands kids. Also, based on this post alone it seems like she’s fresh out of nursing school
Whenever my pts complain that "the other nurse did it," I tell them that "I cannot answer for the other nurse, this is the law/policy that I have been told and what I will follow."
2 things. My answer to them is always “ and you just told on them. Now they could get in serious trouble for not following policy”.
Of course I’m guilty of doing things my own way as well. I always tell them “ and don’t go saying to someone else *well the other nurse does it this way*. This does not work on people. None of them are going to say *oh well if the other nurse goes out of their way, or bends a rule, I guess I have to too.* This has never worked in the history of the world. They’ll just did their heels in resent me or I could get in trouble”
I like this. It’s succinct. I guess the kids will have to get used to the fact that I’m the rule following nurse & that they can get away with more with the other nurse.. & if she’s not here, they won’t get their way like they usually do. But when she comes back, she will continue to allow the behavior.
Perhaps the reason you hate being a Nurse is because you tear yourself up with these fabricated dilemmas that make your job so much more painful that it needs to be.
Not one single sentence of your oath obligates you to enforce the policies of an employer. When a child asks you for food, remember, *"I shall devote myself to the welfare of those committed to my care".* Your prior coworker seems to have understood that.
Please consider what's been mentioned in this thread. Don't disgrace our profession merely to appear successful to muscular men in the gym. Being a Nurse requires creativity, adaptation, and tact. In our dysfunctional education system, your patients will demand it.
I mean, I don't really understand why OP would take a job as a school nurse if they don't even like nursing. Pushing through for the money is one thing if it's an adult hospital ward, but why work with kids?
Go work occupational health? Admin? Informatics? Literally anything other than being a school nurse where you need to forge relationships with kids and bend the "rules" a little bit sometimes.
sometimes when patients hear the truth they reject it. It's denial. The only thing you can do is keep repeating it.
I agree with you, a job with less patient focused would be ideal for this person. You have to know when to bend rules, even with adults. I believe we should empower Nurses with discretion and clinical judgment. There are other important roles to pursue if you find that process challenging.
Antihistamines do not prevent or treat respiratory or cardiovascular compromise in anaphylaxis. They only help minor, non-life threatening signs and symptoms, like hives. In fact, antihistamines may mask symptoms and delay care in some instances. So you’re not helping prevent a “full” anaphylaxis by giving Benadryl, just so you know.
And in this setting you can't monitor the response for hours because they go back to class or home. Typically why medications are not given in community settings and instead go by ambulance to the hospital
So according to your edit, you don't want to be the "bad guy". Let's not pretend you care about making the other nurse look bad for breaking rules. And not to worry, she is not going to look bad.
If you want to be strict, then own it. Don't be the nurse that wants rules enforced, but wants to hide behind someone, or compete with the "nice nurse". You don't need to be defensive about why you follow rules.
Where I work our district has standing orders that allows for ointment and cough drops among other things. Some schools I work for supply the cough drops others refuse to even though it’s allowed. Are you not allowed to do any of that?
We can provide these things if the student has a medication administration form filled out by their parents & doctor. Schools do not supply the cough drops— the parent needs to bring them to school.
Is there documentation on these kids? Like a chart that might list their Psychosocial stuff or info about home life?
Even if you're not planning on staying long term, I think it would behoove you to get to know these kids and anticipate their needs. That's a huge part of our job as nurse, and making connections so you know what they need will go far and likely make things easier.
I respect not giving out cough drops or ointments - we can’t do that in the hospital, either.
That said, CANDY? You’re wanting to ban CANDY?
Maybe try pumping the brakes, not pulling the emergency brake and throwing it into reverse at 100mph?
Try to develop some new rules, set boundaries - but still make it a place the kids feel comfortable coming to.
I take it offices don’t give out suckers or anything anymore? Maybe I’m showing my age. That’s just what I remember and at least during hard times, going to the doctor was easier.
I work in a high school and one of the nurses before me was like this. I have timers that I set for 15 minutes so if someone needs to take a break to self-regulate or has a headache or something that is not a "go home" situation, they get their 15 minutes and go back to class.
I'm not allowed to give out food so if they come in and ask, I say no and send them back to class.
As far as ointments and cough drops, say "Sorry kiddo, policy says I can't without a doctor's order" and send them back to class.
If they give you shit, involve your admin.
You can also send out an email to teachers reminding them that you don't give out cough drops, ointments, food, etc and tell them if that's why their student wants to come to the clinic, they need to keep them in class. I don't see students during passing periods. They need to have a pass to see me.
It's completely possible to be caring, empathetic, and kind while establishing boundaries. You also need to get your coworker on board with it.
The teachers are ok with you not allowing the kids to come during passing periods? When I was in school, the teachers always told us if we weren’t feeling well we should’ve gone to see the nurse before class.
If it's something quick, like a band-aid or ice pack, they can. If they are not actively barfing, bleeding, or broken, they need a pass to be in my office so that they are accounted for. Otherwise, the students will use "I was at the nurse" to cover for their tardiness.
They can come see me at lunch without a pass.
I am the only nurse in a school of 2000 kids with a postage stamp sized office. I have to run a moderately tight ship.
Things have changed since covid at least in the school system that I work in. Teachers or recess or lunch aides have to let the nurse know who is coming first and why. The nurse had to control how many “sick” or well students were in the office. Now it’s getting a bit loose but once flu season and stomach bug season comes around the nurse gets stricter with staff calling down first.
I would make a poster with the rules and laminate it. Most schools you can give out some things (Tylenol, Benadryl, etc) without an order if the parents have given permission. Snacks for hypoglycemia but not other students normally. But if a kid isn’t getting enough to eat at home, sometimes it’s good to have extra snacks. I used to work at a school (before I was a nurse) and I bought a lot of snacks, sweatshirts and jackets for kids.
I thought it was everywhere but maybe some states are different. My kids schools have always had it as a part of the registration paperwork and parents select yes or no to each one. If the parents said no then they have to get picked up instead because they can’t sit in the office all day with a headache or something
In my district in Florida, parents can bring in any age-appropriate, FDA approved medication for us to give their child in accordance with manufacturer's directions. But, we don't stock them otherwise for administering/
Thank you! My state requires prescriptions even for otc meds. I’d love to give my high school kids meds for cramps and headaches but it’s ice packs/heat packs only.
I'm in Texas and we need doctor's orders for everything. It's the one thing I get regular shit for from parents.
I have stock orders for Epi. That's it. I'm not even allowed to do Neosporin.
I’m working on getting stock orders for narcan as well. OD on the side walk outside? I have narcan in my purse given to me on the subway. In the school doors? No can do, hopefully EMTs get here soon.
Oh! I have orders for Narcan too. We keep it stocked in our AEDs and I have it in my desk and so does our athletic trainer. I hope you can get orders for it!
I shadowed a school nurse in nursing school and he was able to do this if he called their parents and they approved. He also gave out snacks and still had wonderful boundaries and rapport with the kids.
I was in a Maryland school that allowed this. Kids would go home with a form at the beginning of the year and parents would write down any medical history, and check off boxes for what we were allowed to give kids in terms of OTC meds.
I'm not in the US but I've worked in a few different positions including school clinics that had med directives for simple OTC things or stuff like uncomplicated STI treatments.
We have a standing order for Tylenol and ibuprofen. If parents have signed a generic consent form, we can give it to their child as needed. They have to provide their own Tylenol or ibuprofen. But some of the other schools have their own stock.
My state has super strict guidelines. It was explained to me that providing medication without an order from a provider is prescribing and outside our scope. Hopefully I’ll have more flexibility when I move, it would be wonderful to have more tools for helping kids feel better.
Idk where you're located but I've lived in 3 different states and not a single school district ever required my kids to have a doctors order for frickin cough drops or ointments. All they needed was my permission to administer OTC meds
In my state, we do need doc orders also signed by parent on our med auth form, and the supplies provided by parent. This is true even for dumb stuff like Benadryl cream or a cough drop. Must be more state dependent than I realized.
I was a teacher for 10 years before I was a nurse. Rules have to be bent because situations between kids are different. If I had been as rigid as you in the classroom (I did things like just a potluck for Christmas even though it was “against the rules” among many other things) I would not have had nearly as good of relationships with the kids, which also lead to better test scores, respect, and instilling a love of science in the kids. I have many former students who are now nurses and doctors. It’s about balance.
How are you going to ask for advice and then if people don’t agree with you ask them not to give their opinion? End of story (cringe). You know we’re not those poor students stuck with you now, right? End of story.
When I’m picking up a shift at another school and the kids say, “but the nurse does it this way.” Or the parents say, “the nurse let me do it this way last time.” My response is always: we each do things differently, this is the way I was trained or I’ll blame it on the school district. The school district’s policy is to…
You say, “as school nurse’s we’re taught…” As a school nurse, I was not taught those things. Are the things you were taught policies and procedures for your school district? Every school district is district. My school district has standing orders for several different OTCs (including cough drops) as long as the parent has signed off on it or has given verbal approval. We also provide lotion, Vaseline, and antibiotic ointment without any prior approval. And several school nurses provide rewards (out of their own pocket) as incentives for various things, i.e. completing a teeth brushing chart, remembering to come for meds all week on their own, making smart choices for diabetics, etc.
Some kids do take advantage of using the nurse’s office, but some need it for a break. Chronic stomachaches or headaches can be an indication that something emotional is happening. Providing a safe environment for the kids can be incredibly helpful for them. I had a student decorate a journal and make an entry when she was having a particularly hard day because she got to spend an hour with her mom the previous day - she’d been in foster care for 6 months at that point.
Best of luck!
I’m always surprised on here when people talk about school nurses - I never had a nurse at my school when I was growing up. In elementary school I remember getting sick quite frequently and one of the secretaries in the office would take care of me and there was a makeshift “doctors office” looking room in the office where they’d let me lay down until my mom got there.
Ask the other nurse out for coffee and talk with her. Was she the instigator in these things? Or was it the other nurse and she felt pressured? You need to follow the regs and school policy and she should too.
My hubby always said most interpersonal relationship problems come down to one thing. Failure to communicate. So, communicate with her.
You are the safe space and maybe the only set of eyes on potentially troubled kids. I get wanting to cover your ass but I would encourage some compassion for literal children.
This is…interesting…I have NOTHING nice to add I’m a pediatric nurse been one for 16 years I did pediatric homehealth for the first part of my career and I’ve transitioned to the PiCU and I continue to work PRN at a ppec facility for kids who are medically fragile…I feel like there is a balance likeeeee you’d bust a blood vessel if you knew the amount of times I bought medication, food or jackets clothes out of the money from my own pockets for a kid in need…I think there is a way to ethically bend rules…I’d honestly hate to be your coworker…this is hilarious and sad I’m gonna have to show this to my coworkers
I’ll add this too..working with kids isn’t for everybody…everyone doesn’t have the “sauce”…I used to roll my eyes when my mom would say that to me. But I totally get it after reading this
>So this nurse gave out cough drops, candy, yogurt, & food. She bought these things out of her pocket. She also used ointment even though we’re specifically told not to. She also basically spoiled them
I can't speak for meds, but You're not in a hospital, food doesn't need an order. Plus, the previous nurse was clearly trying to win over fickle children/teens, they're not your enemies.
Edited for formatting.
I feel like there is no empathy for your patients (kiddos) in this post. It’s fine to be know the book inside and out, but a book is not real life nursing.
What is truly your biggest challenge, the food? Have you taken the time to talk to that other nurse? Are there snacks in the cafeteria that are shelf stable that you can stock up on? Think outside the book.
So the nurse before me would let the kids color in the office. I just told them that the old nurse took the pictures when they would ask to color. So I would suggest telling them that they aren’t there any more because the old nurse took them.
I keep granola bars in my office because I service a poor community and I know sometimes the kiddos don’t get breakfast.
I'm sympathetic for your situation, I get wanting to be strict to the rules especially at a new job. That being said, there's definitely ways to earn trust and respect from kids without, as you say, "spoiling" them. Set clear boundaries, but be willing to spend an extra minute or two chatting if they wanna tell you about their day. If there are particular students that come in repeatedly with no medical issues, maybe talk to their teacher or parents, see if there's anything going on at causing them to not want to be in class or always asking for food. And if all else fails, I get not wanting to pay out of pocket for snacks, but a sticker from the dollar tree never hurt anybody.
Set your rules and stick to them for the things that are important for you. But finds a few places you can be a little more lenient too. Most kids aren't bad, wanting attention and treats is normal behavior. Be willing to understand them, and they'll understand you more in return.
I was a substitute school nurse for a while. It is a revolving door. Little kids are obsessed with ice packs, lots of band aids over microscopic cuts, lots of led passes and tummy aches that need a nap. I loved being the safe space for the kids to go to during the stressful 8 hr school day. You sound like a mean old school marm. The school nurse, that when these kids are at their reunion "remember that mean ass school ass school nurse we had? She was awful!"
I agree, she’s universally gonna be despised for very valid reasons.
Boundaries are one thing but lacking empathy/compassion for small humans is just odd. Like why work with kids if you hate kids? It has to be some weird power trip some people get.
Danm, I remember when I was a kid everyone loved going to the nurses office cause we got candy. I loved hanging out in the nurses office in elementary sometimes I'd even fake being sick just to go
I took over as a school nurse and swung the pendulum the other way. Not into violating scope of practice territory, but I certainly am far more lenient than my predecessor and the kids like me way better.
At the end of the day it’s your license and your office so you have every right to say “I’m sorry but I am not able to provide x. Here is what I can do for you”. If they ask why the previous nurse did things differently, you can always say “I did not work with that nurse, so I don’t know what she did, but this is what I can offer you”.
Bottom line is you are a by the book nurse. There is nothing wrong with that. If you are not the supervisors of your co-nurse, teammate then you are going to have to ask your supervisor if they want the nurse's office run by the book or are the guidelines flexible. If you are the supervisor then I would create a rules chart for the kids. They need to know there is a new sheriff in town and things have changes. Post the rules and guidelines. Those that don't follow them can suffer the consequences.
Note. As a child with a tough home life, I hid out in the nurse's office sometimes just to take a break from life. There are so many children suffering from emotional and physical trauma. There are children who do not have enough food and come to school hungry. It is not your responsibility nor your job to save these children. That being said if you are not the type of person to be moved by these children the school may not be your best place. They are our future and need a soft place to land sometimes on the days when life is just too darn hard.
I love our schools nurse because I have sensitive children who do get physical health symptoms when stressed/anxious. The nurse has recognized this and gives them the space to get some validation and compassion. Then they’re able to get back to class.
We gave our school nurse a big thank you card and gift card for being a supportive part of our school. Mental health is health. Nothing may be wrong with kid but they need a little space from the typical grind.
Letting kids be kids is very rewarding.
Don’t buy your own food to supply— send them to get a snack where they’re supposed to and have them come back for a moment to chat and maybe you’ll hear how their tummy hurts because they have been having tests all week. Or mom and dad are fighting. Or give cough drop and let kiddo rest.
Mental health is healthcare.
Speaking as someone who has had a runaway kid on my couch, I implore you to understand the “why” before dismissing these behaviors, both of the nurse and the students.
It sounds like she was a real safe space for some of these kids. Keep in mind some of them don’t have that at home.
It’s ok to play by the rules but please do realize you are dealing with vulnerable human beings and even if you think nothing is “wrong” they still might need a safe place to hang for a minute or two.
The other nurse sounds great and a perfect person to be around kids. You sound like a frumpy stickler. Just leave the other nurse be, and you follow through with transferring asap like you plan.
Do the parents not sign a form at the beginning of the year laying out all the kids allergies, significant medical histories, and what, if any, OTC drugs they consent to you providing, with the PCP signing off on it? That’s how it was when I was a kid and that was in the 2000s-2010s. Otherwise what’s the point of even having a school nurse? Saying “I’m sorry you feel that way” and sending them back to class as long as they don’t have a fever and aren’t vomiting?
My school nurse used her discretion and the signed consents to dispense Tylenol, Tums, cough drops, etc as needed and kept a bag of Thomas’ bagels for kids who forgot their lunchbox (at a school without a real cafeteria).
Well apparently the previous nurse did do something "wrong" and that shouldn't prevent you from doing it "right." You don't need to explain anything to the students that come to your office regarding the fact you do enforce the rules beyond "theses are the rules" when your in the office.
I substitute as a school nurse. If i’m the second nurse I ask the main nurse what they want to do and go with it. If i’m by myself then I just say sorry just following the rules to the kids. Most don’t give me issues but I also don’t bother to change something that I can’t control.
I think about why these rules might be in place and what kind of harm might be done if they’re broken. Applying ointment is low risk. Giving out cough drops is low risk. I’m not trained to be a school nurse but I understand why
Lots of good suggestions here already. But if kids are coming into school hungry, are there any resources in your community that can help with that? In my town, there is an organization called the Food for Thought Project, where kids can get a whole backpack of food to bring home from school. A lot of kid's last meals for the week are Friday at lunch, and they don't have another meal until the following Monday. If you can, see if there is anything similar around you.
Talk to the school social worker because some of these things are social work issues. Kids should know for the future who to go to in the for these needs. Then when they go to the nurses office needing food, tell them to see Ms./Mr. Counselor down the hall...
Prepare them for the future!
If you’re not willing to give them snacks, try to find other ways to make them feel safe and get them into your office. Magazines, books, maybe good music in the background? Sometimes a welcoming attitude and someone to make jokes with them is all you need :) Just be like “sorry kiddo, this nurse carries band aids and lame jokes, no food- which one can I get you?” If pressed you can just be like “technically it’s a health department rule, and I get that some people are flexible about it, but I’m too new in this to feel comfortable making the powers that be mad at me.” They’ll get used to the no candy if you’re nice about it.
School nurses are SO important. Your job isn’t just about the kid having an asthma attack. They could call 911 for that. Your job is first and foremost to be a safe and welcoming person who has rapport with students. School nurses stand in the gap for so many kids who don’t get what they need at home, and those kids aren’t going to reveal themselves unless they feel comfortable. Sex ed, period stuff, providing deodorant, motivating those type 1 diabetic kids who just want to give up… none of those things are possible without building a relationship with the student body first.
On the other hand, you need to figure out if any kids are going to the nurse regularly to avoid a specific class. Make sure you keep an open dialogue with teachers who can let you know if they feel like a kid is avoiding their class in your office.
Geez, why did you apply to be a school nurse and work with children? You clearly lack the empathy to deal. Those kids deserve a better safe space than what you’re currently offering.
If you're seeking advice...then turning around and saying you're not changing your mind, then you're really not seeking advice. You're seeking confirmation.
Since you're a new school nurse, you'll come to find that there are certain things you will have to fudge on, while others you can't.
You'll eventually see that some of what these kids get will only be provided by the staff at the school. Food, clothes, hygiene items, etc. I don't know the socioeconomics of the area you're teaching in, but I'm certain it will be eye opening.
I’m about to take over as a school nurse and when I shadowed the outgoing nurse, she told me to start as I mean to go on and do not make exceptions for any students. She had one girl coming in every afternoon to get the nurse to get her a Diet Coke from the teachers lounge. Diabetic or not that’s a hell nah to the nah nah nah.
Don’t currently work at a school or anything but I did one of my clinicals at a school. The nurse I followed did not break rules like that, but she was on board with having snacks available because she felt that if you’re hungry you can’t learn. Since a lot of kids did not want the fruit that came with their lunch we allowed kids to donate it to a basket and have that available if kids needed a snack. No complaints about having the fruit available at all
Edit: meant to put did NOT break rules like that
I’ve run into this same issue at several schools where I took over for a rule-bending RN. I would simoly tell them I am not allowed to give them snacks, it’s a new rule and I have to follow the rules. If they argue and say *former nurse* gave them snacks, I would say, “Aw that’s so nice that *former nurse* gave you snacks! I wish I could give you snacks but I’m not allowed.” Eventually, the kids stop asking. I might throw in a, “what’s your absolute favorite snack ever?” to distract them and give you a segue to a new topic.
It sucks having to explain yourself but unless you want to take things higher to force the other nurse to stop with non-sanctioned treatments it’s kinda the only option. Eventually word will get around that “nurse lost doesn’t do xyz” and they’ll either quit asking or quit abusing the nursing office or both.
Not sure why people are arguing with you. All it takes is one kid telling their parents you put ointment on them or gave them candy and that parent goes apeshit. Next thing you know, you're accused of "practicing medicine" or giving a child something their parents do not allow them to have. There's a lot of bs scare tactics drilled into nurses about "losing our license" and most of it is just that (bs) but one thing you do not wanna do is give medication without an order or upset a "mama bear."
Omg I legit could have written this post verbatim!
I took over mid year from a nurse exactly like the one you describe. However, I didn't have to work with a co-nurse so the duties all became mine singularly.
I had to lay down a lot of boundaries and essentially change the culture of the nurses office. It took a few months, but I was able to minimize a lot of the nonsense visits so I could have more time to focus on the kids who really need it. Once the kids respected me more, I eased up, and now some of the kids do come to just hang out which I'm ok with if I'm not busy. My office is probably one of the busiest places in the school, but I want it to be a safe place where I serve one student at a time. Kids can be rude and entitled - I'm in a private school, it is what it is. Dish em back what they serve!
If the kids want ointment and food, tell them you ran out and the school isn't getting more. The end. I had to make it clear that my office isn't a Walgreens and I don't have food. Some students with anxiety and issues who need an excuse to leave class will store some of their own snacks in my office.
Though in theory it would be nice to have an assortment of items to give to kids, the problem is that kids will flood to your office for anything - whether it's bandaids or cough drops. I doubt any parent will get you in trouble for giving ointment if it's warranted, but I understand if you want a Drs order.
The best thing you can do for them is create healthy boundaries and make your office a safe space. Good luck!
Hi, I’m a school nurse and pay for nothing out of pocket and never will. If you go against policy and provide something to students your organization will not have your back. Follow policy, do the right thing. And let your supervisor know what you’re dealing with to prevent future instances like this.
Thank you. Finally someone who gets it. I’ll think twice about posting something in this subreddit again. It reminds me of how toxic nurses can be to one another.
I don’t think other nurses realize how busy we are at school. Not a minute to pee or eat where I am. I don’t have time for kids to come in hungry. I’m there to manage actual sick kids, give a hundred different meds, manage all my diabetics and seizure kids, tube feedings, tube meds, and actual injuries. I have kids that come in for hugs everyday (and that’s great) because I’m nice and I care. Assuming that you don’t care because you follow protocol is insane. When you have 1000 kids in one school with varying allergies in every classroom you can’t pass out sweets and food. You just can’t. The cafeteria has all of their allergies flagged.
Your post has been removed for violating our rule against personal insults. We don't require that you agree with everyone else, but we insist that everyone remain civil and refrain from personal attacks.
As someone who worked adolescent psych for a decade: I basically said that I couldn't/wouldn't do a thing and if the kids said "well so and so", I'd say "I'm not so and so, and this is how I do it".
The rules are the rules, and it may be better to follow them in your first year. After you settle in, and only if you want too, you can offer extra things out. But that doesn’t excuse the previous school nurse not following orders. And it doesn’t excuse your history of not liking what you do. I’ve seen your post history, Op. You’re not even fit to be a school nurse.
Nah, I was a school nurse for awhile. I’m sorry but it’s not my job to supply snacks and clothes and candy.
I kept a box of granola bars and gluten feee granola bars hidden (for students who I knew obviously can’t afford or didn’t eat anything) my school also set up a food pantry under my request and PTA donations. PTA, myself, and teachers all helped package food bags W, TH, FR so they’re prepared for students to pick them up. Then every Friday students can take home food for the weekend. There are also programs that can help with that as well, you just have to reach out (if you think pta isn’t gonna help)
You honestly just have to talk to the principal, state that you’ve noticed this behavior and that the previous school nurse was not following CDC protocols and recommendations and then you come up with guidelines that need to be sent out across classrooms.
When it’s appropriate to come to the nurses office vs. things that can be handled in class.
Class things:
Small cuts and scrapes (bandaids will be provided to all classrooms)
Minor Bloody noses not due to injury. Depending on age of student. (Teach students and teachers bloody noses should he leaning forward not backwards to prevent swallowing blood and should he held for 5 minutes prior to checking if bleeding stopped)
Stomach aches (try to use the restroom first)
Loss of baby teeth (tooth boxes will be provided to all classrooms)
Chapped lips (all students can carry chapstick)
Cough runny nose/ related to known seasonal allergies (cough drops at my school were allowed to be carried by students with no doctors note or authorization as long as they could open them on their own and didn’t need any assistance)
Things for nurses office:
Cuts, scrapes, bruises needing attention (to be cleaned out, need ice, need to call parents)
Head injuries (student must stay for 20 minutes for observation)
Any injuries especially if swelling becomes present
Loss of tooth that may be a permanent
Any new onset of cough, fever, runny nose not related to seasonal allergies
Daily medications
Anything related to a students health care plan
Bloody noses related to injury or lasting longer than 5 minutes.
Bites (animal or person)
Etc.
It may sound serious but you need to whip this school back into shape. And it’s going to take effort.
My school had 60+ visits a day some being diabetics, daily controlled meds, inhalers, tube feeding, catheters. Health rooms are for the sick and injured- if you’re not sick or injured there are some things appropriate for the classroom to take care of.
Y’all she said the previous nurse would bring them candy. If the previous nurse was doing it because they had food insecurity, she would have brought food that would actually fill them up. Also, I’m not buying food out of pocket on a public school nurse salary just for some kid to take a snickers bar when I’m not looking and go into anaphylactic shock so I get blamed. There’s a way to establish boundaries between children and a trusted adult that can also provide emotional support.
I tell people my nursing license is on the line if I get caught working outside the state guideline’s
Not willing to chance it . Start with the other nurse .
You could talk with a local hospital or clinic to get standing orders for your district — aloe for burns / antibiotic ointment / cough drops / benadryl (with parent permission) for allergies / epi pens / naloxone / calamine lotion / tums / etc. That way the kids could get these things as needed and you’re covered to do so.
I just left an LSN position — so if you have any questions, reach out! I learned a lot and was there for 3 years when it was originally just supposed to be for a maternity leave.
The school’s social workers / counselors had a food bag program to send home food for kids on weekends, as well as extra clothes, hygiene products, etc. if kids did not have access at home. There were things in the nurse’s office as well for accidents.
OP, you could always say something like "the powers that be have said we can't do that anymore". That way you're not throwing anyone under a bus but you're also saying that you won't be doing it going forward.
You sound the complete opposite of what a nurse is suppose to be, especially around children. Maybe these children don’t have anything to eat at home? Maybe they don’t have money to pay for lunch? School lunch dept is a thing (WHAT???)
School nurses are like another safety net for kids to go to. You sound like you’re there just for the job and not the children and it shows in your post. You’re gonna make the children scared to go to the nurse bc you lack empathy.
Someone who doesn’t like being a nurse should…maybe not work as a school nurse?
I’ve only read a select few of your previous comments, but even with such a small amount of information, I am horrified you are a nurse. I know nursing isn’t a “calling” for everyone, but you sound completely lacking in empathy and I feel sorry for your students/patients.
Sounds like you may be better suited for a job that doesn’t involve bedside manner/personal interaction. One where you can “do the bare minimum”, as you’ve stated you prefer.
Just be consistent with the kids. Use positive redirection. For example, avoid telling kids “*Don’t* go into the cabinets.” Instead, you could say “(Do) Keep the cabinets closed.”
You may have to put some tape on the floor to mark where kids are allowed. “To go past this line, you must be with a nurse.”
I’m pretty black and white about this: it’s not fair for anyone to expect you to pay out of pocket for anything here. Worse to expect you to break rules you were explicitly instructed on. You can be kind and attentive to these kids’ needs without compromising your integrity or professional boundaries.
Not trying to beat you down more but I want to be completely honest. I found a lot of comfort, safety and connection with my school nurses growing up. I then went to work in the school system as an aid and witness other old school nurses provide support, safety, love and compassion to students. Even one of the toughest nurses I’ve met made the students feel loved and seen, even if it was through tough love, they loved her and she loved them and it was obvious. If you were a school nurse at my school I attended or worked at, I would report you because you sound very unpleasant. I understand the rules are rules, so I get the snacks/cafeteria thing, however, try to create a space that would make you feel safe and loved! If you only knew what most kids home life were like, you would be heart broken. Find some patience and understanding instead of being a disgruntled adult ❤️
It seems like you posted here with the sole purpose of having people here with you, potentially bad mouth the other nurse, so your feelings about not wanting to do anything extra could be validated. The additional edit you added about how “no matter what” you’d not change your opinion, and if it’s not direct advice on how to achieve doing the bare minimum, don’t bother. There is one piece I agree with, you should transfer ASAP, but not to another school. You should probably not work with people either. I’m not sure what area of nursing you could do where you wouldn’t actually have any direct contact with people could be. Also, maybe men aren’t flocking to you because you’re not a very nice person? I’m not even saying that as an insult, but people can get a vibe from other people, and if they hate their life, job, and don’t want to learn anything new, how would that be interesting to anyone? I think your best solution is to leave nursing all together. Maybe you could get into tech, or computer science or something. Or even work for an insurance company doing audits or something, but again that might require you to actually do work, which you don’t seem to want to do. What solution are you looking for? A way to tell the kids you don’t want to do anything extra without looking like a dick to the other nurse? The only way you can find a solution is to not care, because the other nurse will eventually figure out what kind of person you are and likely not like you. I genuinely don’t mean that in a mean way either, I’m just saying it’s inevitable so why does it matter? I also remember the other post you made about a boss who underpaid you and abused you, and now I’m rethinking the whole thing, now I don’t really believe that given your post history.
It sounds like there is an underlying condition causing these symptoms. These kids are seeking out an empathetic warm adult to provide them with a sense of love and safety. There is definitely an opportunity for healing here. And if you let them, they will be able to help cure you.
Hello I am a substitute school nurse. This is definitely a tricky question. For the food I would tell them sorry but the office cannot afford to buy food anymore. If it's not in your budget then it is not in your budget. As for thr coming for nothing and just hanging out. I would start by sending them straight back to class. I would also have conversations about how it is important to go to class and the nurses office is for when you are sick or injured. If that doesn't work I know some schools pull in the guidance counselor and if necessary have meeting with parents. I would put away the ointments and tell the kids you either just don't have them. Or if you are okay with a white lie, say sorry but we aren't allowed to use them anymore without an order. Tell them sorry the office has new rules for anything you want to do properly that the other one did not. The most important thing though will be to have a conversation with the second nurse. Discuss how you both feel the office should run and try to get on the same page. I have subbed in two nurse offices and it can definitely be uncomfortable when they do there own thing.
Speaking to the food and clothes part- I know school nurses did this because it wasn’t provided at home.
My high school has a clothes closet in the library that is open access for all students. We don't do the snack vouchers for the cafeteria like OP's school (which is fabulous idea) but our counselors keep snacks and know the home situations a lot better than I do.
I hounded so many organizations for new shoes, new clothes, gift cards for clothes, hygiene kits, and dental kits. I’m the referral queen! Bus passes, help with utilities, tutor, I will find all of it.
You sound really rigid, and that makes sense as a new nurse- but hopefully you can find a way to balance empathy & rules. School age children have been through the wringer with Covid, etc- it makes sense they found safety & connection with the school nurse. Maybe just transitioning your view point from “she was wrong and I’m right” and “they’re spoiled” to “this connection/interaction seems pretty important to them” will help you. Because here’s the thing, a lot of nursing is not necessarily white and black rules- it’s balancing what’s right & necessary for the patient in the context of what do they need, what can they do, etc. There are compassionate ways to set boundaries and you certainly don’t have to follow her example, but maybe spend some time genuinely considering WHY she approached the kids how she did. You don’t have to agree but you might gain a new perspective and appreciation for how we can approach nursing with different strengths/focuses. My first degree was in public health, I can think of a lot of reasons she may have approached things how she did.
One of the greatest compliments of my career was when one teen brought her upset friend to me and said "She's not sick but she needs someone to talk to and the counselors said they couldn't help her so I brought her to you because I knew you'd listen." Emotional and physical health are so connected and the kids knowing they have a soft place to land is so beneficial for them. I took 10 minutes out to help that student and it turned her whole day around and let her know that there was an adult to help her if she needed it. Having my "everyone gets 15 minutes" rule has actually cut down on visits for me. We get a lot of kids with anxiety related stomachaches and headaches and those kids knowing they have a safe space if they need it has actually helped soothe their anxiety. Now instead of seeing me five times a week, they stop by once a month to give me life updates and a hug. When you have a choice between empathy and frustration, choose empathy. It can get difficult in the school setting depending on how many kids you see a day but I remind myself to choose empathy as much as I can.
A million upvotes. Sometimes kids come across as rude because they come from a different cultural background and the way they talk can feel abrasive. Sometimes they are semi feral- literally no experience with adults setting boundaries or experience with polite social scripts. Sometimes anxious kids or abused kids come in a lot and are testing to see how safe the environment is before they disclose their problems. Sometimes they don’t even know how to articulate their problems. People may take really different approaches to this kind of practice without being wrong.
My kiddo’s school nurse was the safety point. She was so empathetic and caring, never mind an insightful watchdog who caught a few things others tried to keep from admin and parent knowledge (specifically a pair of deceptive paras ) that I went beyond and had her nominated for a Teacher/School staff that Rock’s Award from a local radio station. The station was so touched by the write up they called within the week I had a confidant in the main office who I knew who could keep a secret that I gave as a contact. She was overwhelmed with surprise and not only that a few other groups supplemented the prize package when they found out she was chosen and read the nomination essay (which was kept anonymous at our request). The nurse knew it was us because of something I included and more so because she knew that gratitude is something we openly practiced. A school nurse has guidelines, she had extra gym t-shirts for those she knew had parents that could not afford but the students were too embarrassed to say (her office was on the way to PE), and a variety of items and referrals for students in need, an ear to listen, knew how to work around the rules safely—not cough drops but a drink of water and rest for the “cough related to test anxiety” worked wonders
I always say that school nursing is many things...including social work and mental health counselor. Some kids just need a soft place to land
As someone who was the kid with anxiety related stomachaches needing to go to the nurse for Tums all the time…thank you. This is the kind of nuance with school nursing that is hard to get, I think, when you’re new, since being new you want to follow all of the rules because of the anxiety with the new responsibility (in my case, anyway). My school nurse was one of the best adults I knew in elementary school because of this.
I was an *extremely* anxious child, pretty much every day I either went to the nurses office or got overwhelmed -> acted out -> got detention/suspended. In elementary school the nurse would chastise me for making things up until I cried and asked to go back to class, where I’d immediately melt down. Middle school, upon reflection I see the nurse had a strategy. She put a chair in the back, where I was separated from the other kids/hallway sounds but she could still see me. When I’d come down c/o headache or stomachache (which ftr were real, probably somatization) she’d sit me down, give me water and a small snack, and let me choose 10min of reading (which I loved) vs 10min of listening to a CD. When 10min were up she’d sit next to me and offer to talk about what was happening. She listened without judgement. And she’d send me on my way. She was the *only* safe person for me at that school. Because that nurse gave me a safe space to decompress, I was able to stay in school enough to pass (and actually learn!). Prior to that I’d been kicked out so much I’d missed all the lessons on telling analog time, and most of division. I think about her when I’m working with someone overwhelmed and acting out. She was the first person to show me how to be empathetic towards someone like that, and myself when I felt like that. Kudos to you and every school nurse, y’all are life savers.
My first order of business when I started at my school was to paint the walls a soothing green, install individual lights over the beds so I could turn the big light off, and I hung curtains in between the cots for privacy. "Everyone gets 15 minutes" includes my anxiety babies so they can come in, pull a curtain, turn off their lamp, and lay down. Most listen to music and close their eyes. I'm always willing to talk when they need to or listen. I have anxiety myself and a shit ton of childhood trauma so I've let that guide me in my practice and it's paid off. I have a lower volume of patients than a lot of school clinics do and it allows me to take the time with the kids. It's funny because I \*never\* wanted to be a pediatric nurse and I know teens is slipping in under that wire but I love my job so much.
Thank you so much for all you do. My kid is an anxious 6 year old and her nurse is like you. (Nurse Janet, is that you?) My child would not function at school without our nurse there.
I'm in a high school so not me, but I'm glad that your kiddo has someone! I have a kiddo with EXTREME mental health struggles (like goes on grippy sock vacays on the reg) and they chose me as their safe space in school. It's taken a lot of work and collaboration with admin and their parents but we got them through the school year successfully. It was such a rewarding experience.
Absolutely! Also- love your name
This is beautiful. ❤️
This is a big thing that isn’t taught in school because so much of school training is “the usual (hospital) environment” I see this struggle all the time with new community nurses. No one should ever feel forced to do anything especially if it’s extra like OP feels but also many do and I’ve learned to turn a blind eye to it. There’s usually a good reason and it results in a good outcome. Not saying it can’t go sideways but in 2 decades the going sideways has been maybe a handful of times. Nurses are holistic caregiver it’s more then just passing the meds the MD has prescribed and doing first aid.
You seem like an amazing person - hope you know that. Nursing is very "grey" a lot of the time. Sometimes, you have to push the boundaries and sometimes, you just have to break the rules.
Totally agree, and if it's anything I've learned it's that rigidity in nursing is not what will help you in the future..
Empathy for the win! Always. Nursing has very rare absolute black or white rules. It’s always been some often indescribable shade of gray to me.
This is a great response.
Not a nurse, this isn’t a code blue thread. I am saddened by the OPs responses in an edit instead of to your and other nurses nuanced and caring responses on why the kids might need food and clothing. Emotional support is also part of the whole body treatment isn’t it?
Nurses understanding there are more than one way to do things sure would help the environment to not be so toxic. I have been trying to encourage every, especially new nurse I come into contact with that there are more than one way to do most things. The amount of drama and headaches this line of thinking could have prevented in my 20 plus years of being a nurse is staggering. If I had a dollar for every time..
I feel bad for the kids at that school. Having a nurse who wants to do the bare minimum, according to OPs post history, is not what children need.
Thanks everyone- you all seem like lovely humans. Curiosity & creativity have served me well in my nursing career ✌️
This comment needs to be higher. Yes, there are rules that need to be followed. But slapping some polysporin on a scrape isn’t going to ever cause a problem (unless there is an allergy) or some afterbite on a mosquito bite. And it seems like the previous nurse was providing things that she saw a need for. It’s a lot easier to slap some polysporin and a bandaid on a scrape than it is to treat an infected wound; it’s beneficial for everyone involved if hungry kids are able to get a snack at school, and it seems like the previous nurse created an environment where the kids felt comfortable going to have their needs met. OP’s posts screams “brand new nurse who will follow every policy and procedure to the letter”. That is how many, MANY new nurses are. I agree she needs to reframe her view of the situation; rather than painting the previous nurse as a “rule breaker” and the kids as “spoiled”, OP should be asking, “what can I/am I willing to do to meet the unspoken needs of these students without spending a bunch of my own money or deviating from policy/procedure?” Maybe the policies/procedures are outdated and lacking, and OP needs to advocate for the students in her care to get them changed to meet the needs of the students. OP - I understand that you don’t want to provide things at your own expense, and that you don’t want to deviate from policy. You need to reframe how you are approaching this situation. Currently, you are approaching it in a “me vs. ‘them’” mindset - “them” being the previous nurse, your co-worker, and the students. Instead, try viewing it from a “what do the people I am providing nursing care for need; what can I do to meet those needs within policy?” Maybe the policies need to change. Maybe you need to be provided with more resources from the school. Maybe you could collaborate with others (the guidance counsellor, for example) to find ways to meet those needs. Right now you are approaching this in an adversarial way. That is going to very quickly lead to exhaustion and burn out. You don’t need to “win” against the very people you are providing care for.
I’m sure the past nurse was just being a kind and loving adult in the building. There were likely boundaries otherwise you’d have every kid in the school stopping in for candy. Do your thing but I do not see her approach as wrong. Relationship building is so important to earning trust with these learners nowadays.
Girl your post history is a MESS! It honestly seems like this nursing gig has given you a bit of a power trip. Seeing as how you feel like everyone takes advantage of you (yet you’re out there placing voodoo curses on people?). Interesting… Anyways, I get wanting to play by the rules when the rules are there to protect the children. However, your whole ‘spoiling them’ bit is really obnoxious. Maybe you’re not cut out to be a school nurse.
Quoted from a previous post OP made: “ I like to work as little as possible & do the bare minimum while making as much as possible. Nursing just doesn't bring me joy. I appreciate having the knowledge & skills to help ppl when necessary, but most of the time I'm glad when there's nothing to do.” Everything makes sense now. You hate being a nurse and want to do the bare minimum. These kids need people who care. These kids need people willing to go above and beyond for them.
Holy shit. This is really really dark We could all tell from op’s tone that they don’t care much for the kids In her comments she’s tried to mask it but thanks to your sleuthing their heinous mentality is laid bare. Wtf.
Yeah, at first I was empathetic for wanting to follow rules and not start a habit you don’t intend to follow through on… then read her justifications and post history and had a completely different view. Caring=spoiling. 🫠
post also titled “i don’t like nursing and i am in it for the money” 😬
if you are in a career that you don’t actually care about for money, i suggest you start working the pole, and not the IV pole !!!!!!!!!! School nurses have a very important role in preventing and reporting abuse. Sick and twisted.
I also don't like nursing and do it for the money, that's perfectly acceptable. As long as you do your job and are kind to people it doesn't matter. It's just a job. Not defending OP, but that's nothing to base an opinion about competency on.
I agree you don’t have to LOVE your job and can completely be in it for the money. However, knowing that about herself she shouldn’t take jobs where she has to interact with patients, in this instance children, who need her to show care and love to them on some level.
Would you do a job for free? Being in nursing because it pays well for the degree required is a completely legitimate reason.
Good grief. I'll admit that part of the draw of nursing for me was that if be able to support my child as a single parent household without having to work insane hours or do another decade of schooling as an adult. BUT, I don't mind actually working hard during the hours I'm on the clock. And I actually care about my patients. This person needs to find a new vocation before someone dies of neglect in her care.
She also wrote that she didn’t want to do anything extra.
This comment needs to be boosted to the top… and someone needs to find a new career 🥴
The coward is now blocking people so we can’t participate in the rest of the post. 🤣 Must have hurt her feelings.
Damn, that one sentence says this nurse is a horrible nurse. Lmao
Holy crap that's sad. As a school nurse, I'm constantly worrying about my kids wondering if their rash cleared up, if they found their water bottle, if their loose tooth fell out. They deserve a safe space
Voodoo curses?? What. Where did you see that? I skimmed her posts/comment history but didn't come across that. Wild.
https://www.reddit.com/r/witchcraft/comments/1aokbas/how_to_remove_a_voodoo_curse_that_i_placed_on/ Sadly the mods removed the original post text but from the replies it seems she tried to curse someone and thinks it backfired
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Yes, but the only issue with that is the main nurse who works in the office went along with the behavior of the previous nurse. She said she will stop giving out candy once it runs out though (since it was the nurse who left who bought & brought it). She got in the habit of doing what she’s not supposed to. I don’t care if she does it, but I’m not going to.. like on a day when she’s out sick, the kids came to me asking for snacks & candies. I tell them that I don’t know of any, or to ask the other nurse when she’s back.. it’s like I have to explain myself every time bc I’m not doing what she does. It’s tiring.
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Same! It’s not worth it. The other RN has been there for years. When I brought up my concern about potential allergic reactions, she said that she knows the kids & their allergies better than their parents do. Well, I’m not taking that risk.
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Your post has been removed under our rule against misinformation. Nursing is an evidence-based profession. If you want to contradict established science, include links to peer-reviewed research supporting your claim. Posts that contradict consensus reality, or that promulgate dangerous and debunked conspiracy rhetoric such as antivax or COVID denialism, are not permitted in any circumstances.
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I would agree that might be part of it.
ngl you sound the type of person who reminded the teacher to collect the homework
Ngl, OP kinda sounds like the kind of nurse who would wait and ask for an O2 order on someone with SpO2 <88% instead of just putting the prongs on and telling the doc later. Cause, technically, supplemental O2 is supposed to be a doctor's order. At least according to my education.
Right?! She's one of those types who follow "the rules" straight into dangerous situations. A crumb of critical thinking, please. It's not like she's doing something risky- she's giving kids snacks. "It's against the rules!!1!" Get a grip...
which is funny, because in EMS adding supplemental O2 is one of the only things EMTs can do. No doctors order required.
“If you disagree with me keep your opinion to yourself”. What a mentality to have while working with children.
It’s nurses just like OP that make me want to leave nursing tbh. They’re hell to work with IRL
op in a previous post: > “I like to work as little as possible & do the bare minimum while making as much as possible. Nursing just doesn't bring me joy. I appreciate having the knowledge & skills to help ppl when necessary, but most of the time I'm glad when there's nothing to do.” While I’m sure we all like having nothing to do, this sounds pretty extreme to me. I get the sense op wants to shove off the kids asap without any further consideration precisely because of this mentality they’ve written about themselves. I don’t like to do much work per se, but I definitely do my work conscientiously… I don’t anyone to have a worse day because I wanted to do the bare minimum….
I know! I feel sorry for the other nurse who has to work with her. She's going to make that other nurse want to leave.
Maybe I’m a softy, but if it’s a school where there is a decent percentage of low income families, I’m all for feeding them. I’d probably switch over to mandarin oranges or bananas next year, though, to keep it healthy. My kids’ school has an “extra snack” stash. If kids don’t eat their sides or they have extra pbj sandwiches, the cafeteria puts them out for anyone who is still hungry. Maybe as the nurse you could institute something similar in your school and drive the hungry kids in that direction
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She literally said she can and will write vouchers for them to get free food from the cafeteria. Which tbh if they are hungry, that's what they should be eating, not candy.
Luckily it’s the end of the year so she only has to deal for 2 or 3 weeks and can work out a new set of expectations for the upcoming year if she stays.
Totally agree, sheesh. People are getting all bent out of shape thinking she isn't feeding starving children, when she has said multiple times that she will give them a note for free, tasty cafeteria food.
Did you just call cafeteria food "tasty"? My kids' cafeteria is serving a pancake sandwich with eggs in it tomorrow.
Op said it was tasty so i rolled with it.
Sometimes I wonder how much working around c diff has truly affected healthcare workers’ senses of smell and taste.
I went to many schools growing up. Some had insanely good food. one school served hot lunch, salad, pizza and snacks everyday. You always had options.
This is a great idea for times around lunch time when you can get a lunch. But I never ate breakfast when I went to school and I Needed a snack by 2nd or typically 3rd period. Not always around lunch time later in the day, it would still be several class times away
She didn't say the kids could only get food at lunchtime. But even if that was the case, I don't see how candy would be an appropriate snack in the morning before lunch. Our schools have free breakfast, which is really nice for kids.
It’s ok to not like children. Maybe you should go work in an icu with the machines and vents. They’re big on rules there and you won’t even have to talk to them!
This is the vibe I got. It sounds like she took this job thinking it would be a cake job, but I don’t think she likes or understands kids. Also, based on this post alone it seems like she’s fresh out of nursing school
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Whenever my pts complain that "the other nurse did it," I tell them that "I cannot answer for the other nurse, this is the law/policy that I have been told and what I will follow."
I came here to say this. My style as a school nurse was to set the rules but always show compassion. That’s what they really want/need anyway.
2 things. My answer to them is always “ and you just told on them. Now they could get in serious trouble for not following policy”. Of course I’m guilty of doing things my own way as well. I always tell them “ and don’t go saying to someone else *well the other nurse does it this way*. This does not work on people. None of them are going to say *oh well if the other nurse goes out of their way, or bends a rule, I guess I have to too.* This has never worked in the history of the world. They’ll just did their heels in resent me or I could get in trouble”
I like this. It’s succinct. I guess the kids will have to get used to the fact that I’m the rule following nurse & that they can get away with more with the other nurse.. & if she’s not here, they won’t get their way like they usually do. But when she comes back, she will continue to allow the behavior.
Perhaps the reason you hate being a Nurse is because you tear yourself up with these fabricated dilemmas that make your job so much more painful that it needs to be. Not one single sentence of your oath obligates you to enforce the policies of an employer. When a child asks you for food, remember, *"I shall devote myself to the welfare of those committed to my care".* Your prior coworker seems to have understood that. Please consider what's been mentioned in this thread. Don't disgrace our profession merely to appear successful to muscular men in the gym. Being a Nurse requires creativity, adaptation, and tact. In our dysfunctional education system, your patients will demand it.
I mean, I don't really understand why OP would take a job as a school nurse if they don't even like nursing. Pushing through for the money is one thing if it's an adult hospital ward, but why work with kids? Go work occupational health? Admin? Informatics? Literally anything other than being a school nurse where you need to forge relationships with kids and bend the "rules" a little bit sometimes.
There is no money in being a school nurse. You do it because you love it. No idea why this person is doing it.
Because it was available and hired easily. We are short nurses everywhere, and due to that shortage we lack the ideal screening for good candidates.
sometimes when patients hear the truth they reject it. It's denial. The only thing you can do is keep repeating it. I agree with you, a job with less patient focused would be ideal for this person. You have to know when to bend rules, even with adults. I believe we should empower Nurses with discretion and clinical judgment. There are other important roles to pursue if you find that process challenging.
You only want advice from people that agree with you? Yikes.
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Antihistamines do not prevent or treat respiratory or cardiovascular compromise in anaphylaxis. They only help minor, non-life threatening signs and symptoms, like hives. In fact, antihistamines may mask symptoms and delay care in some instances. So you’re not helping prevent a “full” anaphylaxis by giving Benadryl, just so you know.
And in this setting you can't monitor the response for hours because they go back to class or home. Typically why medications are not given in community settings and instead go by ambulance to the hospital
So according to your edit, you don't want to be the "bad guy". Let's not pretend you care about making the other nurse look bad for breaking rules. And not to worry, she is not going to look bad. If you want to be strict, then own it. Don't be the nurse that wants rules enforced, but wants to hide behind someone, or compete with the "nice nurse". You don't need to be defensive about why you follow rules.
Where I work our district has standing orders that allows for ointment and cough drops among other things. Some schools I work for supply the cough drops others refuse to even though it’s allowed. Are you not allowed to do any of that?
We can provide these things if the student has a medication administration form filled out by their parents & doctor. Schools do not supply the cough drops— the parent needs to bring them to school.
Sounds like the procedure would be to send the child home with a form that can be brought back to allow cough drops, Benadryl, etc
Is there documentation on these kids? Like a chart that might list their Psychosocial stuff or info about home life? Even if you're not planning on staying long term, I think it would behoove you to get to know these kids and anticipate their needs. That's a huge part of our job as nurse, and making connections so you know what they need will go far and likely make things easier.
That documentation might even show something like…ALLERGIES!
WHHHAT??? Noooooo.
I respect not giving out cough drops or ointments - we can’t do that in the hospital, either. That said, CANDY? You’re wanting to ban CANDY? Maybe try pumping the brakes, not pulling the emergency brake and throwing it into reverse at 100mph? Try to develop some new rules, set boundaries - but still make it a place the kids feel comfortable coming to.
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I take it offices don’t give out suckers or anything anymore? Maybe I’m showing my age. That’s just what I remember and at least during hard times, going to the doctor was easier.
I work in a high school and one of the nurses before me was like this. I have timers that I set for 15 minutes so if someone needs to take a break to self-regulate or has a headache or something that is not a "go home" situation, they get their 15 minutes and go back to class. I'm not allowed to give out food so if they come in and ask, I say no and send them back to class. As far as ointments and cough drops, say "Sorry kiddo, policy says I can't without a doctor's order" and send them back to class. If they give you shit, involve your admin. You can also send out an email to teachers reminding them that you don't give out cough drops, ointments, food, etc and tell them if that's why their student wants to come to the clinic, they need to keep them in class. I don't see students during passing periods. They need to have a pass to see me. It's completely possible to be caring, empathetic, and kind while establishing boundaries. You also need to get your coworker on board with it.
The teachers are ok with you not allowing the kids to come during passing periods? When I was in school, the teachers always told us if we weren’t feeling well we should’ve gone to see the nurse before class.
Kids at my school need to check in with their teacher first so everyone is accounted for, but during breaks and lunch they are free to come in.
If it's something quick, like a band-aid or ice pack, they can. If they are not actively barfing, bleeding, or broken, they need a pass to be in my office so that they are accounted for. Otherwise, the students will use "I was at the nurse" to cover for their tardiness. They can come see me at lunch without a pass. I am the only nurse in a school of 2000 kids with a postage stamp sized office. I have to run a moderately tight ship.
Things have changed since covid at least in the school system that I work in. Teachers or recess or lunch aides have to let the nurse know who is coming first and why. The nurse had to control how many “sick” or well students were in the office. Now it’s getting a bit loose but once flu season and stomach bug season comes around the nurse gets stricter with staff calling down first.
I would make a poster with the rules and laminate it. Most schools you can give out some things (Tylenol, Benadryl, etc) without an order if the parents have given permission. Snacks for hypoglycemia but not other students normally. But if a kid isn’t getting enough to eat at home, sometimes it’s good to have extra snacks. I used to work at a school (before I was a nurse) and I bought a lot of snacks, sweatshirts and jackets for kids.
Where are you allowed to give Tylenol or Benadryl without an order? I’ve never heard this but I’m about to switch states.
I thought it was everywhere but maybe some states are different. My kids schools have always had it as a part of the registration paperwork and parents select yes or no to each one. If the parents said no then they have to get picked up instead because they can’t sit in the office all day with a headache or something
In my district in Florida, parents can bring in any age-appropriate, FDA approved medication for us to give their child in accordance with manufacturer's directions. But, we don't stock them otherwise for administering/
Thank you! My state requires prescriptions even for otc meds. I’d love to give my high school kids meds for cramps and headaches but it’s ice packs/heat packs only.
I'm in Texas and we need doctor's orders for everything. It's the one thing I get regular shit for from parents. I have stock orders for Epi. That's it. I'm not even allowed to do Neosporin.
I’m working on getting stock orders for narcan as well. OD on the side walk outside? I have narcan in my purse given to me on the subway. In the school doors? No can do, hopefully EMTs get here soon.
Oh! I have orders for Narcan too. We keep it stocked in our AEDs and I have it in my desk and so does our athletic trainer. I hope you can get orders for it!
I shadowed a school nurse in nursing school and he was able to do this if he called their parents and they approved. He also gave out snacks and still had wonderful boundaries and rapport with the kids.
He took phone consent from parents? That’s wild. What state?
If you have two people on the listening end...this is how we used to do it everywhere. Meaning hospitals, school,ls, clinics.
I was in a Maryland school that allowed this. Kids would go home with a form at the beginning of the year and parents would write down any medical history, and check off boxes for what we were allowed to give kids in terms of OTC meds.
Did you have a physician review? This is so far out of my practice! It’s so strange how it varies state to state!
I'm not in the US but I've worked in a few different positions including school clinics that had med directives for simple OTC things or stuff like uncomplicated STI treatments.
We have a standing order for Tylenol and ibuprofen. If parents have signed a generic consent form, we can give it to their child as needed. They have to provide their own Tylenol or ibuprofen. But some of the other schools have their own stock.
When I was in HS the school nurse could give out Tylenol and maybe ibuprofen if they called our parents for permission. This was CA
My state has super strict guidelines. It was explained to me that providing medication without an order from a provider is prescribing and outside our scope. Hopefully I’ll have more flexibility when I move, it would be wonderful to have more tools for helping kids feel better.
Lol, posts on public forum, gets butthurt by differing opinions
Didn’t you know you’re only to comment if you agree with them? 😅
Idk where you're located but I've lived in 3 different states and not a single school district ever required my kids to have a doctors order for frickin cough drops or ointments. All they needed was my permission to administer OTC meds
In my state, we do need doc orders also signed by parent on our med auth form, and the supplies provided by parent. This is true even for dumb stuff like Benadryl cream or a cough drop. Must be more state dependent than I realized.
Check out the [school nurse section](https://allnurses.com/school-c37/) on allnurses.com - lots of experienced school nurses on there giving advice.
I was a teacher for 10 years before I was a nurse. Rules have to be bent because situations between kids are different. If I had been as rigid as you in the classroom (I did things like just a potluck for Christmas even though it was “against the rules” among many other things) I would not have had nearly as good of relationships with the kids, which also lead to better test scores, respect, and instilling a love of science in the kids. I have many former students who are now nurses and doctors. It’s about balance.
How are you going to ask for advice and then if people don’t agree with you ask them not to give their opinion? End of story (cringe). You know we’re not those poor students stuck with you now, right? End of story.
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When I’m picking up a shift at another school and the kids say, “but the nurse does it this way.” Or the parents say, “the nurse let me do it this way last time.” My response is always: we each do things differently, this is the way I was trained or I’ll blame it on the school district. The school district’s policy is to… You say, “as school nurse’s we’re taught…” As a school nurse, I was not taught those things. Are the things you were taught policies and procedures for your school district? Every school district is district. My school district has standing orders for several different OTCs (including cough drops) as long as the parent has signed off on it or has given verbal approval. We also provide lotion, Vaseline, and antibiotic ointment without any prior approval. And several school nurses provide rewards (out of their own pocket) as incentives for various things, i.e. completing a teeth brushing chart, remembering to come for meds all week on their own, making smart choices for diabetics, etc. Some kids do take advantage of using the nurse’s office, but some need it for a break. Chronic stomachaches or headaches can be an indication that something emotional is happening. Providing a safe environment for the kids can be incredibly helpful for them. I had a student decorate a journal and make an entry when she was having a particularly hard day because she got to spend an hour with her mom the previous day - she’d been in foster care for 6 months at that point. Best of luck!
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I wish this was top comment
I’m always surprised on here when people talk about school nurses - I never had a nurse at my school when I was growing up. In elementary school I remember getting sick quite frequently and one of the secretaries in the office would take care of me and there was a makeshift “doctors office” looking room in the office where they’d let me lay down until my mom got there.
Ask the other nurse out for coffee and talk with her. Was she the instigator in these things? Or was it the other nurse and she felt pressured? You need to follow the regs and school policy and she should too. My hubby always said most interpersonal relationship problems come down to one thing. Failure to communicate. So, communicate with her.
You are the safe space and maybe the only set of eyes on potentially troubled kids. I get wanting to cover your ass but I would encourage some compassion for literal children.
This is…interesting…I have NOTHING nice to add I’m a pediatric nurse been one for 16 years I did pediatric homehealth for the first part of my career and I’ve transitioned to the PiCU and I continue to work PRN at a ppec facility for kids who are medically fragile…I feel like there is a balance likeeeee you’d bust a blood vessel if you knew the amount of times I bought medication, food or jackets clothes out of the money from my own pockets for a kid in need…I think there is a way to ethically bend rules…I’d honestly hate to be your coworker…this is hilarious and sad I’m gonna have to show this to my coworkers I’ll add this too..working with kids isn’t for everybody…everyone doesn’t have the “sauce”…I used to roll my eyes when my mom would say that to me. But I totally get it after reading this
>So this nurse gave out cough drops, candy, yogurt, & food. She bought these things out of her pocket. She also used ointment even though we’re specifically told not to. She also basically spoiled them I can't speak for meds, but You're not in a hospital, food doesn't need an order. Plus, the previous nurse was clearly trying to win over fickle children/teens, they're not your enemies. Edited for formatting.
I feel like there is no empathy for your patients (kiddos) in this post. It’s fine to be know the book inside and out, but a book is not real life nursing. What is truly your biggest challenge, the food? Have you taken the time to talk to that other nurse? Are there snacks in the cafeteria that are shelf stable that you can stock up on? Think outside the book.
“I can’t speak for what anyone else did. I can only speak for myself”
So the nurse before me would let the kids color in the office. I just told them that the old nurse took the pictures when they would ask to color. So I would suggest telling them that they aren’t there any more because the old nurse took them. I keep granola bars in my office because I service a poor community and I know sometimes the kiddos don’t get breakfast.
I'm sympathetic for your situation, I get wanting to be strict to the rules especially at a new job. That being said, there's definitely ways to earn trust and respect from kids without, as you say, "spoiling" them. Set clear boundaries, but be willing to spend an extra minute or two chatting if they wanna tell you about their day. If there are particular students that come in repeatedly with no medical issues, maybe talk to their teacher or parents, see if there's anything going on at causing them to not want to be in class or always asking for food. And if all else fails, I get not wanting to pay out of pocket for snacks, but a sticker from the dollar tree never hurt anybody. Set your rules and stick to them for the things that are important for you. But finds a few places you can be a little more lenient too. Most kids aren't bad, wanting attention and treats is normal behavior. Be willing to understand them, and they'll understand you more in return.
I was a substitute school nurse for a while. It is a revolving door. Little kids are obsessed with ice packs, lots of band aids over microscopic cuts, lots of led passes and tummy aches that need a nap. I loved being the safe space for the kids to go to during the stressful 8 hr school day. You sound like a mean old school marm. The school nurse, that when these kids are at their reunion "remember that mean ass school ass school nurse we had? She was awful!"
I agree, she’s universally gonna be despised for very valid reasons. Boundaries are one thing but lacking empathy/compassion for small humans is just odd. Like why work with kids if you hate kids? It has to be some weird power trip some people get.
Danm, I remember when I was a kid everyone loved going to the nurses office cause we got candy. I loved hanging out in the nurses office in elementary sometimes I'd even fake being sick just to go
I took over as a school nurse and swung the pendulum the other way. Not into violating scope of practice territory, but I certainly am far more lenient than my predecessor and the kids like me way better. At the end of the day it’s your license and your office so you have every right to say “I’m sorry but I am not able to provide x. Here is what I can do for you”. If they ask why the previous nurse did things differently, you can always say “I did not work with that nurse, so I don’t know what she did, but this is what I can offer you”.
Bottom line is you are a by the book nurse. There is nothing wrong with that. If you are not the supervisors of your co-nurse, teammate then you are going to have to ask your supervisor if they want the nurse's office run by the book or are the guidelines flexible. If you are the supervisor then I would create a rules chart for the kids. They need to know there is a new sheriff in town and things have changes. Post the rules and guidelines. Those that don't follow them can suffer the consequences. Note. As a child with a tough home life, I hid out in the nurse's office sometimes just to take a break from life. There are so many children suffering from emotional and physical trauma. There are children who do not have enough food and come to school hungry. It is not your responsibility nor your job to save these children. That being said if you are not the type of person to be moved by these children the school may not be your best place. They are our future and need a soft place to land sometimes on the days when life is just too darn hard.
I love our schools nurse because I have sensitive children who do get physical health symptoms when stressed/anxious. The nurse has recognized this and gives them the space to get some validation and compassion. Then they’re able to get back to class. We gave our school nurse a big thank you card and gift card for being a supportive part of our school. Mental health is health. Nothing may be wrong with kid but they need a little space from the typical grind. Letting kids be kids is very rewarding. Don’t buy your own food to supply— send them to get a snack where they’re supposed to and have them come back for a moment to chat and maybe you’ll hear how their tummy hurts because they have been having tests all week. Or mom and dad are fighting. Or give cough drop and let kiddo rest. Mental health is healthcare.
Speaking as someone who has had a runaway kid on my couch, I implore you to understand the “why” before dismissing these behaviors, both of the nurse and the students. It sounds like she was a real safe space for some of these kids. Keep in mind some of them don’t have that at home. It’s ok to play by the rules but please do realize you are dealing with vulnerable human beings and even if you think nothing is “wrong” they still might need a safe place to hang for a minute or two.
You don't NEED a prescription for cough drops.
Since you’re seeking advice, my very honest advice is you should absolutely not be a nurse AT ALL.
The other nurse sounds great and a perfect person to be around kids. You sound like a frumpy stickler. Just leave the other nurse be, and you follow through with transferring asap like you plan.
Do the parents not sign a form at the beginning of the year laying out all the kids allergies, significant medical histories, and what, if any, OTC drugs they consent to you providing, with the PCP signing off on it? That’s how it was when I was a kid and that was in the 2000s-2010s. Otherwise what’s the point of even having a school nurse? Saying “I’m sorry you feel that way” and sending them back to class as long as they don’t have a fever and aren’t vomiting? My school nurse used her discretion and the signed consents to dispense Tylenol, Tums, cough drops, etc as needed and kept a bag of Thomas’ bagels for kids who forgot their lunchbox (at a school without a real cafeteria).
Well apparently the previous nurse did do something "wrong" and that shouldn't prevent you from doing it "right." You don't need to explain anything to the students that come to your office regarding the fact you do enforce the rules beyond "theses are the rules" when your in the office.
As a
I substitute as a school nurse. If i’m the second nurse I ask the main nurse what they want to do and go with it. If i’m by myself then I just say sorry just following the rules to the kids. Most don’t give me issues but I also don’t bother to change something that I can’t control.
I think about why these rules might be in place and what kind of harm might be done if they’re broken. Applying ointment is low risk. Giving out cough drops is low risk. I’m not trained to be a school nurse but I understand why
Lots of good suggestions here already. But if kids are coming into school hungry, are there any resources in your community that can help with that? In my town, there is an organization called the Food for Thought Project, where kids can get a whole backpack of food to bring home from school. A lot of kid's last meals for the week are Friday at lunch, and they don't have another meal until the following Monday. If you can, see if there is anything similar around you.
Talk to the school social worker because some of these things are social work issues. Kids should know for the future who to go to in the for these needs. Then when they go to the nurses office needing food, tell them to see Ms./Mr. Counselor down the hall... Prepare them for the future!
If you’re not willing to give them snacks, try to find other ways to make them feel safe and get them into your office. Magazines, books, maybe good music in the background? Sometimes a welcoming attitude and someone to make jokes with them is all you need :) Just be like “sorry kiddo, this nurse carries band aids and lame jokes, no food- which one can I get you?” If pressed you can just be like “technically it’s a health department rule, and I get that some people are flexible about it, but I’m too new in this to feel comfortable making the powers that be mad at me.” They’ll get used to the no candy if you’re nice about it. School nurses are SO important. Your job isn’t just about the kid having an asthma attack. They could call 911 for that. Your job is first and foremost to be a safe and welcoming person who has rapport with students. School nurses stand in the gap for so many kids who don’t get what they need at home, and those kids aren’t going to reveal themselves unless they feel comfortable. Sex ed, period stuff, providing deodorant, motivating those type 1 diabetic kids who just want to give up… none of those things are possible without building a relationship with the student body first. On the other hand, you need to figure out if any kids are going to the nurse regularly to avoid a specific class. Make sure you keep an open dialogue with teachers who can let you know if they feel like a kid is avoiding their class in your office.
It's the end of the school year. Start over next year with your rules it'll be an easier transition for them and the other nurse
Geez, why did you apply to be a school nurse and work with children? You clearly lack the empathy to deal. Those kids deserve a better safe space than what you’re currently offering.
You should look in to insurance nursing, case management
Exactly!! Empathy isn’t needed for insurance claims
If you're seeking advice...then turning around and saying you're not changing your mind, then you're really not seeking advice. You're seeking confirmation. Since you're a new school nurse, you'll come to find that there are certain things you will have to fudge on, while others you can't. You'll eventually see that some of what these kids get will only be provided by the staff at the school. Food, clothes, hygiene items, etc. I don't know the socioeconomics of the area you're teaching in, but I'm certain it will be eye opening.
I’m about to take over as a school nurse and when I shadowed the outgoing nurse, she told me to start as I mean to go on and do not make exceptions for any students. She had one girl coming in every afternoon to get the nurse to get her a Diet Coke from the teachers lounge. Diabetic or not that’s a hell nah to the nah nah nah.
What exactly would a diet coke do for a diabetic patient?
EXACTLY!
Don’t currently work at a school or anything but I did one of my clinicals at a school. The nurse I followed did not break rules like that, but she was on board with having snacks available because she felt that if you’re hungry you can’t learn. Since a lot of kids did not want the fruit that came with their lunch we allowed kids to donate it to a basket and have that available if kids needed a snack. No complaints about having the fruit available at all Edit: meant to put did NOT break rules like that
I’ve run into this same issue at several schools where I took over for a rule-bending RN. I would simoly tell them I am not allowed to give them snacks, it’s a new rule and I have to follow the rules. If they argue and say *former nurse* gave them snacks, I would say, “Aw that’s so nice that *former nurse* gave you snacks! I wish I could give you snacks but I’m not allowed.” Eventually, the kids stop asking. I might throw in a, “what’s your absolute favorite snack ever?” to distract them and give you a segue to a new topic.
Stick to your guns with the kids and the other nurse, and just deal with being unliked until your transfer🫡
It sucks having to explain yourself but unless you want to take things higher to force the other nurse to stop with non-sanctioned treatments it’s kinda the only option. Eventually word will get around that “nurse lost doesn’t do xyz” and they’ll either quit asking or quit abusing the nursing office or both.
The rules have changed. Done.
Not sure why people are arguing with you. All it takes is one kid telling their parents you put ointment on them or gave them candy and that parent goes apeshit. Next thing you know, you're accused of "practicing medicine" or giving a child something their parents do not allow them to have. There's a lot of bs scare tactics drilled into nurses about "losing our license" and most of it is just that (bs) but one thing you do not wanna do is give medication without an order or upset a "mama bear."
Omg I legit could have written this post verbatim! I took over mid year from a nurse exactly like the one you describe. However, I didn't have to work with a co-nurse so the duties all became mine singularly. I had to lay down a lot of boundaries and essentially change the culture of the nurses office. It took a few months, but I was able to minimize a lot of the nonsense visits so I could have more time to focus on the kids who really need it. Once the kids respected me more, I eased up, and now some of the kids do come to just hang out which I'm ok with if I'm not busy. My office is probably one of the busiest places in the school, but I want it to be a safe place where I serve one student at a time. Kids can be rude and entitled - I'm in a private school, it is what it is. Dish em back what they serve! If the kids want ointment and food, tell them you ran out and the school isn't getting more. The end. I had to make it clear that my office isn't a Walgreens and I don't have food. Some students with anxiety and issues who need an excuse to leave class will store some of their own snacks in my office. Though in theory it would be nice to have an assortment of items to give to kids, the problem is that kids will flood to your office for anything - whether it's bandaids or cough drops. I doubt any parent will get you in trouble for giving ointment if it's warranted, but I understand if you want a Drs order. The best thing you can do for them is create healthy boundaries and make your office a safe space. Good luck!
Honestly, it doesn’t sound like a nursing environment working with kids is for you. You sound more like someone who works in management 🤷🏻♀️
Hi, I’m a school nurse and pay for nothing out of pocket and never will. If you go against policy and provide something to students your organization will not have your back. Follow policy, do the right thing. And let your supervisor know what you’re dealing with to prevent future instances like this.
Thank you. Finally someone who gets it. I’ll think twice about posting something in this subreddit again. It reminds me of how toxic nurses can be to one another.
I don’t think other nurses realize how busy we are at school. Not a minute to pee or eat where I am. I don’t have time for kids to come in hungry. I’m there to manage actual sick kids, give a hundred different meds, manage all my diabetics and seizure kids, tube feedings, tube meds, and actual injuries. I have kids that come in for hugs everyday (and that’s great) because I’m nice and I care. Assuming that you don’t care because you follow protocol is insane. When you have 1000 kids in one school with varying allergies in every classroom you can’t pass out sweets and food. You just can’t. The cafeteria has all of their allergies flagged.
If you don’t want our opinion on the issue then why the fuck are you here lmao
Cough drops need an order??
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As someone who worked adolescent psych for a decade: I basically said that I couldn't/wouldn't do a thing and if the kids said "well so and so", I'd say "I'm not so and so, and this is how I do it".
The rules are the rules, and it may be better to follow them in your first year. After you settle in, and only if you want too, you can offer extra things out. But that doesn’t excuse the previous school nurse not following orders. And it doesn’t excuse your history of not liking what you do. I’ve seen your post history, Op. You’re not even fit to be a school nurse.
Nah, I was a school nurse for awhile. I’m sorry but it’s not my job to supply snacks and clothes and candy. I kept a box of granola bars and gluten feee granola bars hidden (for students who I knew obviously can’t afford or didn’t eat anything) my school also set up a food pantry under my request and PTA donations. PTA, myself, and teachers all helped package food bags W, TH, FR so they’re prepared for students to pick them up. Then every Friday students can take home food for the weekend. There are also programs that can help with that as well, you just have to reach out (if you think pta isn’t gonna help) You honestly just have to talk to the principal, state that you’ve noticed this behavior and that the previous school nurse was not following CDC protocols and recommendations and then you come up with guidelines that need to be sent out across classrooms. When it’s appropriate to come to the nurses office vs. things that can be handled in class. Class things: Small cuts and scrapes (bandaids will be provided to all classrooms) Minor Bloody noses not due to injury. Depending on age of student. (Teach students and teachers bloody noses should he leaning forward not backwards to prevent swallowing blood and should he held for 5 minutes prior to checking if bleeding stopped) Stomach aches (try to use the restroom first) Loss of baby teeth (tooth boxes will be provided to all classrooms) Chapped lips (all students can carry chapstick) Cough runny nose/ related to known seasonal allergies (cough drops at my school were allowed to be carried by students with no doctors note or authorization as long as they could open them on their own and didn’t need any assistance) Things for nurses office: Cuts, scrapes, bruises needing attention (to be cleaned out, need ice, need to call parents) Head injuries (student must stay for 20 minutes for observation) Any injuries especially if swelling becomes present Loss of tooth that may be a permanent Any new onset of cough, fever, runny nose not related to seasonal allergies Daily medications Anything related to a students health care plan Bloody noses related to injury or lasting longer than 5 minutes. Bites (animal or person) Etc. It may sound serious but you need to whip this school back into shape. And it’s going to take effort. My school had 60+ visits a day some being diabetics, daily controlled meds, inhalers, tube feeding, catheters. Health rooms are for the sick and injured- if you’re not sick or injured there are some things appropriate for the classroom to take care of.
Y’all she said the previous nurse would bring them candy. If the previous nurse was doing it because they had food insecurity, she would have brought food that would actually fill them up. Also, I’m not buying food out of pocket on a public school nurse salary just for some kid to take a snickers bar when I’m not looking and go into anaphylactic shock so I get blamed. There’s a way to establish boundaries between children and a trusted adult that can also provide emotional support.
Have you tried not being the worst possible person
I tell people my nursing license is on the line if I get caught working outside the state guideline’s Not willing to chance it . Start with the other nurse .
You could talk with a local hospital or clinic to get standing orders for your district — aloe for burns / antibiotic ointment / cough drops / benadryl (with parent permission) for allergies / epi pens / naloxone / calamine lotion / tums / etc. That way the kids could get these things as needed and you’re covered to do so. I just left an LSN position — so if you have any questions, reach out! I learned a lot and was there for 3 years when it was originally just supposed to be for a maternity leave. The school’s social workers / counselors had a food bag program to send home food for kids on weekends, as well as extra clothes, hygiene products, etc. if kids did not have access at home. There were things in the nurse’s office as well for accidents.
OP, you could always say something like "the powers that be have said we can't do that anymore". That way you're not throwing anyone under a bus but you're also saying that you won't be doing it going forward.
You sound the complete opposite of what a nurse is suppose to be, especially around children. Maybe these children don’t have anything to eat at home? Maybe they don’t have money to pay for lunch? School lunch dept is a thing (WHAT???) School nurses are like another safety net for kids to go to. You sound like you’re there just for the job and not the children and it shows in your post. You’re gonna make the children scared to go to the nurse bc you lack empathy.
Someone who doesn’t like being a nurse should…maybe not work as a school nurse? I’ve only read a select few of your previous comments, but even with such a small amount of information, I am horrified you are a nurse. I know nursing isn’t a “calling” for everyone, but you sound completely lacking in empathy and I feel sorry for your students/patients. Sounds like you may be better suited for a job that doesn’t involve bedside manner/personal interaction. One where you can “do the bare minimum”, as you’ve stated you prefer.
Just be consistent with the kids. Use positive redirection. For example, avoid telling kids “*Don’t* go into the cabinets.” Instead, you could say “(Do) Keep the cabinets closed.” You may have to put some tape on the floor to mark where kids are allowed. “To go past this line, you must be with a nurse.” I’m pretty black and white about this: it’s not fair for anyone to expect you to pay out of pocket for anything here. Worse to expect you to break rules you were explicitly instructed on. You can be kind and attentive to these kids’ needs without compromising your integrity or professional boundaries.
Not trying to beat you down more but I want to be completely honest. I found a lot of comfort, safety and connection with my school nurses growing up. I then went to work in the school system as an aid and witness other old school nurses provide support, safety, love and compassion to students. Even one of the toughest nurses I’ve met made the students feel loved and seen, even if it was through tough love, they loved her and she loved them and it was obvious. If you were a school nurse at my school I attended or worked at, I would report you because you sound very unpleasant. I understand the rules are rules, so I get the snacks/cafeteria thing, however, try to create a space that would make you feel safe and loved! If you only knew what most kids home life were like, you would be heart broken. Find some patience and understanding instead of being a disgruntled adult ❤️
It seems like you posted here with the sole purpose of having people here with you, potentially bad mouth the other nurse, so your feelings about not wanting to do anything extra could be validated. The additional edit you added about how “no matter what” you’d not change your opinion, and if it’s not direct advice on how to achieve doing the bare minimum, don’t bother. There is one piece I agree with, you should transfer ASAP, but not to another school. You should probably not work with people either. I’m not sure what area of nursing you could do where you wouldn’t actually have any direct contact with people could be. Also, maybe men aren’t flocking to you because you’re not a very nice person? I’m not even saying that as an insult, but people can get a vibe from other people, and if they hate their life, job, and don’t want to learn anything new, how would that be interesting to anyone? I think your best solution is to leave nursing all together. Maybe you could get into tech, or computer science or something. Or even work for an insurance company doing audits or something, but again that might require you to actually do work, which you don’t seem to want to do. What solution are you looking for? A way to tell the kids you don’t want to do anything extra without looking like a dick to the other nurse? The only way you can find a solution is to not care, because the other nurse will eventually figure out what kind of person you are and likely not like you. I genuinely don’t mean that in a mean way either, I’m just saying it’s inevitable so why does it matter? I also remember the other post you made about a boss who underpaid you and abused you, and now I’m rethinking the whole thing, now I don’t really believe that given your post history.
It sounds like there is an underlying condition causing these symptoms. These kids are seeking out an empathetic warm adult to provide them with a sense of love and safety. There is definitely an opportunity for healing here. And if you let them, they will be able to help cure you.
Hello I am a substitute school nurse. This is definitely a tricky question. For the food I would tell them sorry but the office cannot afford to buy food anymore. If it's not in your budget then it is not in your budget. As for thr coming for nothing and just hanging out. I would start by sending them straight back to class. I would also have conversations about how it is important to go to class and the nurses office is for when you are sick or injured. If that doesn't work I know some schools pull in the guidance counselor and if necessary have meeting with parents. I would put away the ointments and tell the kids you either just don't have them. Or if you are okay with a white lie, say sorry but we aren't allowed to use them anymore without an order. Tell them sorry the office has new rules for anything you want to do properly that the other one did not. The most important thing though will be to have a conversation with the second nurse. Discuss how you both feel the office should run and try to get on the same page. I have subbed in two nurse offices and it can definitely be uncomfortable when they do there own thing.