"Real" Nursing, School Nursing

If you are a nurse looking for a challenging and rewarding career working with children and families, why not consider school nursing?

Nurses not familiar with school nursing usually consider school nursing a very simple specialty:  giving emergency first aid and assessing simple illnesses, then referring children to the parent or physician.  They picture an older nurse putting on band-aids and giving medication (possibly a flashback from the past).  Often school nursing is perceived as an easy job for nurses who cannot make it in other, more prestigious settings.  It may be portrayed as not "real" nursing at all, and definitely not an area in need of professional nursing knowledge; after all, these are mostly healthy kids.

Because of these misperceptions, many times a school nurse is not given the respect or remuneration she deserves.  School nursing has been overlooked and not taken seriously by nurses and other health care professionals.  Because there is a huge difference between the perceived and the actual, there is a high percentage of failure and dissatisfaction when new school nurses find out what really goes on in a school health office.  Before embarking on a career in school nursing, you must acquire an accurate knowledge of the school nurse's role.

Professional challenges

You cannot educate a child who is sick, hungry, beaten, or distraught.  The whole child must be healthy.  Healthy children learn better.  Children coming to school today have many complex social, psychological and medical problems.  Many come from poverty-level homes with inadequate or no health care.  Although these are not educational problems per se, a child with these problems with no intervention will not succeed in the classroom.  Many times the school nurse is a child's only link to solving these diverse problems.  In many districts, the school nurse must be a social worker, counselor, dietician, educator, and primary care provider all rolled into one.  The successful school nurse will find herself doing health promotion, health education, counseling, prevention and follow-up.

School nursing clients generally range from three-year-old, developmentally delayed children to the oldest of staff members, not to mention the younger sibling who is still at home.  The school nurse must have knowledge of all areas of pediatric medicine, including well-child development; genetic syndromes; communicable diseases; immunizations; developmental abnormalities; behavioral, emotional and psychiatric problems; acute and chronic illness; and the newest medications and treatments.  The latest information on vision, hearing, blood pressure and scoliosis screening techniques will also be very valuable.  A school nurse must be an expert in childhood health issues and knowledgeable of every resource available in her community.

School nurses must also be familiar with adult symptomology related to adult-onset diseases so that they can give staff members  information and direction regarding present symptoms or previous diagnoses.

Required skills

To be a successful school nurse, one will need to acquire skills in many areas.  As a school nurse, "you are it."  There are not doctors, specialists or peers readily available for you to consult.  You will be the only health care professional in a world of educators and children who will expect advice on every issue imaginable.  You will need a holistic approach as a caregiver, along with extensive community and collaborative connections.  At all times you will need to be positive, proactive, and have a cooperative, flexible personality.  You must be able to change direction and tasks at any given moment.

It's also important to write care plans that lay people can understand and follow.  If the rest of the staff cannot understand the care plan, the child will suffer.  You are the child's advocate, mentor, caregiver, confidant, and sometimes the only person this child has who really cares or understands his or her unique problems.

A related skill is being able to adapt your nursing expertise to an education system, which you must come to understand thoroughly so that you can maximize each child's opportunity to best achieve his/her educational goals.  In fact, you represent the hope that all children may reach their optimum potential.

The rewards

Successful school nurses get a strong sense of satisfaction and professional empowerment out of their work.  They embrace a philosophy of health promotion and wellness, utilizing every nursing skill imaginable.  School nursing provides an environment to intervene in a situation before it becomes a major problem.  Th