Stress Management Strategies for School Nurses
Gerri Harvey, RN, MEd
# 1 Set up your office in stations.
I adapted this idea from kindergarten teachers, who realize that you cannot just mix everything together. Chaos would reign, distractions would rule, and the kids would be frazzled, wanting the book that was buried somewhere under the blocks and the dress up feather boa. So instead, they have a reading station, a blocks station, a dress up station, etc.
As school nurses, one of our biggest stressors is the fact that we cannot complete a thought or a task without being interrupted to do something else. A kid walks in, the phone rings, you need to FAX someone an immunization record...and before you know it, the pile on your desk is monumental and you cannot even find your log.
I decided to borrow the idea of stations so that I could keep my daily worksheet on my desk and still find it and see it by 10 AM. My desk blotter is a write-on calendar I like to use as my all-purpose organizer, and I was still missing meetings because I couldn't see my calendar at all til I cleaned off my desk at the end of the day (or in some cases, at the end of the week!!) I didn't want to bury it under my med book at med time, or have it turn up days later in the middle of my mail pile.
Most school nurses probably already have a first aid station, a place where a kid can sit and where the supplies and tools are handy. Some also have a screening station where the vision and hearing is done, and perhaps can be left set up. But, have you considered stations for your paperwork?
"Paperwork" is a huge catchall name for the extensive documentation we do as school nurses. But it has great variety and different space needs, depending on what it is. Once I set up different stations for med dispensing and logging, phone calls, filing, keeping my daily log, and even projects in progress, the chaotic overwhelming aspects of all my paperwork became more manageable and much less stressful.
It does not require a lot of space to create paperwork stations, just some creativity and thought, and a talent for scavenging odd desks to entend your work space. I already had a main desk and file cabinets or records.
I created a u-shaped work space just for my paperwork. My main desk faces the room. I keep a lot less on it these days, for my goal is to see and actually be able to write things on my desk calendar as they come up, and to keep my daily worksheet visible and in use throughout the day (more later about my daily worksheet, an excellent tool I developed because I kept losing my notes to myself).
To the left of my main desk, is my computer station, residing not on my main desk, but on a student desk tucked into the corner. I can use it from my desk by setting the keyboard kitty corner. The key to this arrangement was that as my computer became more central to my daily record keeping, I needed it close by, but not so it dominated all my desk space.
To the side, is my filing station, a much better alternative than having a piling station. Mine is a verticle organizer sitting upon a second desk I scrounged from the custodian's furniture grave yard. My husband came in and replaced the broken foot, giving me a pretty good second desk. I bought and assembled the organizer myself at Staples. Although it cost $50 and my school does not purchase such non-essentials, I have found it well worth the price, saving me from many hours of unpaid overtime dealing with papers, not to mention saving my sanity when it comes to organizing and finding the hundreds of pieces of paper I must deal with as part of my job. It has 24 compartments each big enough to hold a stack of letter-sized papers. I numbered the compartments with indelible marker, and then made a master map on paper of what each compartment holds. The master map resides all by itself in a plastic sleeve in the center bottom compartment, and there is a back up copy filed elsewhere in case, God forbid, I lose it.
Using broad categories, I have a place for virtually everything from new immunization records I have not yet dealt with to unread mail, to my committee projects in progress. The best part, of course, is that I can move away from my main desk between kids' visits and work on something else. When a kid walks in or the phone rings, I can leave it and come back to it later without having to unearth it from whatever else has passed through my hands in the mean time.
To the left of my filing station is my phone station. It is a student desk with it's own chair beside it. The emergency cards and my rolodex are on it, right beside the phone. In the desk are my phone books and some note pads. I can easily roll my desk chair over to it from either my main desk or my filing station, but I usually get up and move to the other seat.
To the left of the phone station is my med station, completing the U . It consists of a 2-drawer locking file cabinet in which I have placed plastic bins holding the meds. I keep my extra medication logs here along with my med book. On top of the file is my PDR, med permission forms, and the round white labels I use to put names on the caps of my med bottles for quicker finding, since they are not stored at eye level. Of course, I always check the Rx label before giving a med.
I know that some school nurses do not need stations. They are more organized and methodical than me, and can keep things in their place as they go. But if one of your sources of school nurse stress is keeping track of all the tasks and paper work in progress and to be done, while still responding to kids, I hope my stations concept gives you some ideas you can adapt to your own situation. To see more about my filing station, click here, I have a picture.
Check back soon for a copy of my daily worksheet, a master sheet I use to keep track of everything I plan to do and actually DO do each day, all in one conveneient place. It's is another strategy I devised to increase my organization and accountability and decrease my daily stress.
