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"A specialized practice of professional nursing that advances the well-being, academic success, and life-long achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self management, self advocacy, and learning." (NASN, 2009)



The School Nurse

The school nurse plays an important part in providing a healthy school environment. Their role is to promote health and provide education in order to ensure a healthy and safe learning environment. The school nurse provides care for students with injuries, acute illnesses and long term management of chronic illnesses and disabilities as well as regular screenings and vaccinations (American Academy of Pediatrics, 2008).

The following list reflects a partial description of the school nurse role:
· Ensures compliance with school entry health requirements such as immunizations;
· Provides care and case management for children with chronic health problems;
· Monitors security and safe administration of medications;
· Assures the health and safety of the school students and staff;
· Manages disaster preparedness and emergency service plans;
· Provides health education and staff wellness programs;
· Assures student compliance with state and local regulations related to health and safety; and
· Identifies school health needs and advocates for necessary resources.
(NASN, 2009)


Often parents and even school administrators fail to understand just how multifaceted the role of school nurses can be. Kathleen Rose, MHA, RN, NCSN, president of the Florida Association of School Nurses, says, "The perception a person has about school nursing reflects that person's exposure. If you have a child without health problems, you think that the nurse is there to put on Band-Aids. But if you have a child with a problem, you realize the full complexity of the role" (AJN, 2009).

Other than families and friends, school is a major influence in a child's life (Bernardo & Puskar, 2007). Healthy children learn better; therefore, the role of the school nurse is vital to student success (Bernardo & Puskar, 2007).







How and Why School Nurses Assess Students

The most common ailments that school nurses are presented with daily are:
25% Headaches
17% infection (sore throat, cough)
12% tiredness/dizziness
12% stomachache
30%other
(Bernardo & Puskar, 2007)

Evaluation of a student's health begins with an assessment of their:
A - Appearance
B - Behaviour
C - Conversation
(Bernardo & Puskar, 2007)

School nurses focus treatment of students on three levels:
1) Individual Focus – screening and teaching students;
2) Systems Focus – joining organizations which promote health advocacy;
3) Community Focus – developing education programs for concerns such as mental health support, drug and alcohol prevention, and safe sex practices
(Bernardo & Puskar, 2007)


The American National Association for School Nurses (NASN) (2009) offer a variety of information in several formats such as journals, magazines, conferences, calendars, memberships and radio. Here is a radio interview put together by the NASN with it's president Donna Mazyck discussing the importance of the school nurse.


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Interview with NASN president discussing school nurses

(NASN, 2009)




School Nurses and Health Promotion


Health promotion is defined as "directed toward increasing the level of well-being and self-actualization" (Pender et al., 2006, pg.37, as cited in Potter & Perry, 2009). Nurses in schools can use health promotion to encourage students to make informed decisions and to be well educated about certain aspects affecting their health. Adolescents are the most influenced age group because they are constantly developing and gaining a higher level of understanding in regards to all types of concepts. (Potter & Perry, 2009).

Nurses in schools focus more on health promotion and illness prevention by teaching adolescents the importance of living a healthy lifestyle which involves proper nutrition, exercise, social environments, adequate sleep, and an overall well-being. (Potter & Perry, 2009, pg. 359)

Nurses can teach adolescents and promote health in schools regarding:
- make informed decisions
- bullying and harassment
- encouraging students
- educate on alcohol, tobacco and drugs
- provide counseling
- provide sexual education
(Potter & Perry, 2009)




School Nurse Employment

Who hires school nurses?
Local Boards of Education
Departments of Health
Public Health Departments and Agencies
Hospitals, hospital districts
Private, Parochial and Charter schools
Universities
(NASN, 2009)

Average School Nurse Salary
$34,596-$54,663 (Salary.com, 2009)

The National Association of School Nurses (NASN) recommends that the school nurse to student ratio be 1:750 in the general school population.

Approximately half of the schools required have either an RN or an LPN in the school at least 30 hours a week (Brener et al., 2001).

School Nurses exist primarily in the United States and are dwindling in numbers with every economic downturn (NASN, 2009). The Canadian equivalent would be public nurses. Public nurses in Canada occasionally come into public schools to administer vaccinations or to provide sex or nutrition education.




Additional Resources for School Nurses

  • The American Academy of Pediatrics is an organization deicated to the well-being of infants, children, adolescents and young adults. It provides pediactic policies and guidelines, health resources, programs and activites to promote health and well being in the care of children (www.aap.org).
  • School Nurse is a website representing "School Health Alert", an American resource responsible for publishing current school health information. School Nurse offers an easily accessible source of literature and up-to-date developments ("School Nurse," 1999).
  • School Nurse News is a publication specifically tailored to school nurses and health care professionals who care for children. The magazine is published every other month for the duration of the school year and each issue explores current health topics (www.schoolnursenews.org).
  • Nurses for a Healthier Tomorrow is a site whose purpose is to attract people into the profession of nursing. Extensive career information and details about school nursing can be found here for anyone wanting to explore that spectrum of the profession (www.nursesource.org).






References


American academy of pediatrics. (n. d.). Retrieved December 10, 2009, from http://www.aap.org.

American Academy of Pediatrics (2008). Policy Statement: Role of the School Nurse Providing School Health Services. Pediatrics, 121(5), 1052-1056. doi: 10.1542/peds.2008-0382

Bernardo, L. M., Puskar, K. R. (2007). Journal for specialists in pediatric nursing.Mental health and academic achievement: role of school nurses. 12(4). Doi: 10.1111/j.1744-6155.2007.00117.x

Brener, N., Burstein, G., D Shaw, M., Vernon, M., Wheeler, L., & Robinson, J. (2001). Health services: Results from the School Health Policies and Programs Study 2000. Journal of School Health, 71(7), 294-304.

Healthy Chirldren Learn Better School Nurses Make it Happen. Logo retrieved from http://wah.abss.k12.nc.us/modules/groups/homepagefiles/cms/32236/Image/nurse.gif

National Association of School Nurses (NASN). (1995). Position statement: Caseload assignments. Retrieved May 13/2002, from www.nasn.org/positions/caseload.htm

National Association of School Nurses (NASN). (2009). NASN Radio. Retrieved December 8, 2009, from http://www.nasn.org/Default.aspx?tabid=597

National Association of School Nurses (NASN). (2009). Planning a career in school nursing?. Retrieved December 8, 2009, from http://www.nasn.org/Default.aspx?tabid=352


Nurse Checking Childs Vision with Light. Image retrieved from http://www.schoolnurseresources.com/images/j0313991.jpg

Nurses for a healthier tomorrow. (n. d.). Retrieved December 10, 2009, from http://www.nursesource.org.

Pender, N., Murdaugh, C., & Parsons, M. (2006). Health Promotion in nursing practice (5th ed.). Upper Saddle River, NJ: Pearson-Prentice Hall.

Potter, P. A., & Perry, A. G. (2009). Conceptualization Through Adolescence. In A. Hall, P. A. Stockert & et al. (Eds.), Fundamentals of nursing (4th ed., pp. 344-359). Toronto, Ontario: Mosby Elsevier.

Potter, P. A., & Perry, A. G. (2009). Health and Wellness. In A. Hall, P. A. Stockert & et al. (Eds.), Fundamentals of nursing (4th ed., pp. 10). Toronto, Ontario: Mosby Elsevier.

Salary.com. (2009). Average school nurse salary, school nurse job, career education & unemployment help. Retrieved December 9, 2009, from http://swz.salary.com/salarywizard/layouthtmls/swzl_compresult_national_ED03000271.html

School nurse. (1999). Retrieved December 10, 2009, from http://www.schoolnurse.com.

School nurse news. (n. d.). Retrieved December 10, 2009, from http://www.schoolnursenews.org.