School Nurse

In some ways school nursing is overlooked by the RN population.    The nursing degree can be used in so many facets, that some of the more classical areas of nursing fail to occur to us.

Some folks may think that school nursing might be less rewarding then say working in a hospital and working on in depth, multi faceted cases.  Judy Hightower will tell you quite the opposite.   It would seem that Judy has found her career as a school nurse quite challenging as well as rewarding.

Judy works to advocate for school nursing by trying to show graduates that this field exists, is in need of nurses, and is a great place to have a career.

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Can you tell us a little bit about yourself? How long have you been a school nurse?

Currently, I am the Dean of Academic Operations at Chamberlain College of Nursing’s Phoenix campus. Before becoming a nurse educator, I was a school nurse for nine years. I started as a substitute school nurse until a friend of mine was offered a principalship at an elementary school. She asked me to join her staff as her school nurse. I worked for that particular school district for six years in a variety of roles at both the elementary and high school levels, including head nurse of the district.

At the time, I was raising two boys – one in middle school and one in elementary school – so it was the perfect job because the work hours, days off and vacation days, coincided with their school schedules. During my time as a school nurse, I had the opportunity to precept community health student nurses and was later asked by the instructor if I would like to be a clinical instructor. An entirely new career opened up for me, but I continued to substitute as a school nurse when time allowed, because I enjoyed it so much. I spent almost 15 years as a clinical educator before I moved into administration, which has led to my current role at Chamberlain.

What led your career in this direction or inspired you to become a school nurse?

I always enjoyed working with children, so I started my nursing career as a pediatric nurse. After I had children of my own, I stopped working for a while. When my boys were in school, I ran for a school board seat and was elected. It was my first taste of what it’s like to be involved in education. As my children got older, I decided it was time to go back to work. School nursing was the perfect career opportunity.

Describe a common day on the job as a school nurse; what are some of the things you encounter?

School nursing is different depending on the age group. When I worked in the elementary school, I saw a great deal of injuries at recess and common childhood illnesses. I administered a lot of medication during the day. School nurses are also often tasked with immunization compliance and health screenings, including vision, hearing, and scoliosis. I facilitated a great deal of health teaching in the classrooms. In high school settings, the school nurse also administers medications, conducts health screenings and leads health teaching. I dealt with teen pregnancy and behavioral issues, leading to more counseling.

Are there any aspects of the school nurse career that you consider your favorites?

I loved all of it but I probably have two favorites. I enjoyed going into the classrooms to teach and working with the students. I was able to instruct on a number of topics, including nutrition, oral and overall hygiene, healthy choices and different body systems. I also loved working at the high school level, because I had many students that would come to see me every day.

As a school nurse, what is the most interesting thing you’ve ever had to handle?

When I worked as a high school nurse, I had a male student who came in with puncture wounds in his forehead. I asked him what happened and he said another student head-butted him. The other student was wearing a hat filled with outward-pointing thumbtacks, and when he head-butted the injured student, it caused dozens of puncture wounds.

In a separate incident, a student was injured after touching a cactus “just to see what it would feel like.”

 If you were speaking to an individual who was considering becoming a school nurse, would you offer up any warnings?

I often speak to students about working as a school nurse, but I don’t offer any warnings, because it’s a wonderful job. I guess the only “warning” would be that you have to work hard. Much of the general public is unaware of the depth and levels of responsibilities unique to school nursing. Many people have the perception that nurses only work in hospital settings, but nurses actually work in many diverse environments.  School nursing is hard work but very rewarding.

 You have concerns about the shrinking career field of school nurses, how do you think we can change this? 

There is definitely a need for school nurses. According to the National Association of School Nurses, only 45% of schools, on average, have a full-time registered nurse on staff, and 25% of students do not have access to a registered nurse. Every school should have a school nurse with a Bachelor of Science in Nursing degree (BSN) in their health office. In fact, large schools should have more than one. The health issues of students on school campuses have become more complex in recent years, and nurses are the only individuals qualified to case manage these students.

 Do you have any additional suggestions or advice you’d offer someone who wanted to pursue this career?

The best part about my job at Chamberlain is I have the opportunity to share with student nurses and new graduate nurses the wonderful career opportunities in school nursing. For nurses who enjoy challenges, are flexible and work well with kids, I would suggest they consider becoming a school nurse.

In order to be an effective school nurse, I believe these individuals should at least receive their Bachelor of Science in Nursing (BSN) degrees. Unlike a traditional healthcare setting, school nurses are often practicing autonomously, so they need to have great critical thinking and clinical reasoning skills, which can be developed during BSN degree programs. Practical clinical work experience is preferred.