School Nurses Advocate for Healthy Environments
According to the American Academy of Pediatrics, school is the second most influential environment in a child’s life, after the child’s home. Nurses can play an important role in creating a healthy school environment for children and teens alike by identifying health and safety concerns and developing plans for management of health-related issues in the school setting.
“School nurses should feel empowered to take a leadership role in the school setting. They can look at themselves as program managers for school health services and help initiate change in all the different components of the coordinated school health model,” said Kathleen Patrick, RN, BSN, NCSN, MA, School Nurse Consultant at the Colorado Department of Education in Denver, Colo.
Since its inception in 2002, the Healthy Schools Campaign (HSC), a national not-for-profit organization, has become a leading authority on healthy school environments, with a mission “to advocate for policies and practices that allow all students, teachers and staff to learn and work in a healthy school environment.” To help create healthy school environments, HSC engages school nurses to develop and implement wellness and environmental health practices at the school and district levels.
“The Healthy Schools Campaign is very supportive of school nurses and acknowledges the work they are doing as well as the potential impact nurses have in the school setting,” said Patrick. In fact, the HSC website even houses a School Nurse Resource Center, with tips and tools designed to help school nurses in their ongoing efforts to make schools healthier places to learn and work.
Last year, HSC partnered with the Colorado Department of Education and the Colorado Health Foundation to implement the School Nurse Leadership Institute, a three-day leadership training program for Colorado’s school nurses. Training took place on October 3, 2011, January 20, 2012 and April 20, 2012, with leadership assignments and ongoing communications in between.
During the January session, participants were educated on essential advocacy skills, which were put to the test at the State Assembly that same day. School nurses had the opportunity to speak with Colorado Reps. Tom Massey and Cindy Acree as well as Sen. Jeanne Nicholson, who shared key legislation and tips for taking an advocacy role around health issues in the school environment. Sen. Nicholson is a former school nurse who has used her leadership skills to create state-level policies.
“The School Nurse Leadership Institute really helped to break down barriers and educate school nurses on how to ensure their expertise in the field shines through,” said Patrick. “School nurses learned the importance of advocating for wellness policies and the impact it can have on everyone in the school setting.”
School nurses who participated in the April session of the School Nurse Leadership Institute were required to create a persuasive PowerPoint or poster presentation on a health-related issue specific to their school. The nurses then presented that information to the school district’s Parent Teacher Association (PTA) or superintendent to help bring the issue to light and offer guidance on ways to improve student and staff health.
With the school nurse in mind, HSC developed the Quick & Easy Guide to School Wellness, a multimedia guide on creating and sustaining meaningful changes in student nutrition and fitness. The National Association of School Nurses (NASN) was a key partner in the development and distribution of the guide.
HSC also developed the Quick & Easy Guide to Green Cleaning, a guide which provides information on how to help move schools toward green cleaning, including the reduction of dangerous chemical exposures, which can help control the spread of disease while ensuring better indoor air quality (which is especially important to children who suffer from asthma).
For more information about the HSC and how school nurses are helping to improve student and staff health, visit www.healthyschoolscampaign.org.
The Vital Link Between School Nurses and Student Success
School nurses can play a pivotal role in student success while at school and help to reduce student absenteeism by managing chronic conditions. Additionally, nurses in the school setting serve as the liaison between healthcare and education, bringing together the school, home and community.
“The roles and responsibilities of the school nurse are as varied as the physical and emotional health needs of the children, youth and community he/she serves,” said Linda Davis-Alldritt, MA, BSN, RN, FNASN, FASHA, School Nurse Consultant at the California Department of Education in Sacramento, Calif. and President of the National Association of School Nurses (NASN). “But perhaps the most important role the school nurse plays is in helping to provide students with access to educational opportunities and helping them to achieve maximum potential.”
According to a study published in the Journal of the American Medical Association, the number of children and youth in the United States with chronic health conditions has increased dramatically in the past four decades. The study found that the increased prevalence of chronic conditions has greatly changed the face of child health and the types of conditions observed by healthcare professionals.
Due to the increase in students with chronic conditions such as diabetes, asthma and cystic fibrosis, it is more important than ever for school nurses to be educated in the unique aspects of the school environment. School nurses must understand a wide array of medical conditions and treatment options to ensure that they can properly determine a student’s ailment. Additionally, because school nurses distribute prescription medication, they need to be aware of proper dosing procedures and potential side effects of medication so that they can assist if a problem arises.
“It’s important for school nurses to understand that educational outcomes for students are impacted by their physical, social and emotional health,” said Davis-Alldritt. “Research has shown that healthy students, students whose health needs are well-managed/met, are better learners and consequently more successful academically. Students need to be healthy so they can spend quality time in the classroom and take advantage of what their education has to offer.”
According to the NASN’s position statement on chronic health conditions, the school nurse coordinates and conducts assessment, planning and implementation of individualized healthcare plans for safe and effective management of students with health conditions during the school day. Additionally, school nurses work with parents, healthcare providers and the community to provide a safe and supportive educational environment by ensuring that students with chronic conditions, like epilepsy or congenital heart problems, have the same educational opportunities as other students.
For school nurses to help provide the best care possible for students, it is important that they continue their education by joining a professional organization and participating in CE courses. “Joining a nursing organization promotes evidence-based school nursing practice that keeps children healthy, in school, and ready to learn,” explained Davis-Alldritt. “Additionally, being a member of a nursing organization provides connections, networking opportunities, friendships and information that all contributes to being a successful school nurse.”
NASN is a nursing organization which represents school nurses and advances the specialty to improve the health and academic success of all students. For more information on how to become a member of NASN, visit www.nasn.org/members.
To find out more about the school nursing specialty, visit www.discovernursing.com.
Nurses in Unique Position to Improve Concussion Awareness
National concern about concussions has grown in recent years as more research has shown the significant immediate and long-term effects of these injuries. “We now know that it does not take loss of consciousness to have a severe head injury,” said Cindy Galemore, MSEd, BSN, RN, NCSN, Director of Health Services at Olathe District Schools in Olathe, Kan.
To help raise awareness of proper concussion management, states across the country are taking the lead on the push for youth sports concussion legislation. In fact, more than half of all U.S. states have adopted some sort of student-athlete concussion law, and five other states have youth concussion bills pending. Roughly 20 states passed their youth concussion laws in 2011 alone.
In July 2011, Kansas enacted a new state law to help strengthen the rules regarding the safety of those suspected of having a concussion. The law, which includes the School Sports Head Injury Prevention Act, requires the School Activities Association to compile information about the nature and risk of concussions and head injuries from sports and other activities. Coaches, parents and athletes in the state of Kansas must receive the information about concussions prior to any student’s participation in athletics.
“There are many different groups in the school setting that could benefit from more education and training in concussion awareness,” said Galemore. “School nurses in particular can be key advocates for concussion awareness and help schools attain the necessary resources and education to manage student concussion injuries.”
In accordance with the Kansas law, any student participating in athletics or sports must have a Concussion and Head Injury Information Release Form signed by both a parent/guardian and the student. The form must be on file before the student participates in their first practice of the school year.
Immediate removal from play is also required for any athlete that suffers or is suspected of sustaining a concussion during competition or practices. The student may return to competition or practice after being evaluated and receiving written clearance from a healthcare professional.
For more information, be sure to check out the Kansas State High School Activities Association concussion guidelines and educational resources at www.kshsaa.org.
Get to Know:
Q. When did you decide to pursue a career in nursing and why?
A. I was seriously injured as a child and spent an extended period of time in the hospital, and being a patient brought a unique perspective to how important nursing is. The care I received from nurses during that time really helped to shape my future career.
Additionally, my mother was an LPN, and I volunteered as a teenager in one of the nursing homes she worked in. That’s when I realized that a person's emotional and psychological health is as equally as important as his or her physical health. I learned how to listen and see how one’s health affects the person as well as the family, and I discovered that nurses play a special role in delivering that kind of care.
Q. What inspired you to become a school nurse?
A. I attended orientation during my community health nursing class when I was working on my bachelor’s degree. I later decided to spend additional time with a school nurse during one of my pediatric rotations. It was an eye opening experience – I had no idea that school nursing was so interesting and complex! I was intrigued by the independence, autonomy and flexibility of the school nurse. I had worked in a variety of settings as a RN and felt that my knowledge and experiences would be a great asset.
I also spent a semester interning in a rural setting doing home visits, coordinating care and collaborating with local providers on issues clients were facing when trying to access care. I think this made the biggest impact on my career and is the building block upon which I practice. Higher education has definitely made an impact and broadened my perspective, too.
Q. What advice would you offer to nurses interested in becoming school nurses?
A. School nursing is such a unique specialty. The school nurse not only needs to have acute nursing skills, but also a solid foundation in other areas that only higher-level nursing offers. I would recommend that anyone interested in school health have a diverse background in nursing experiences, including a solid understanding of community and public health.
School nursing is not just “bandages and boo-boos” anymore. We are the only medical experts available on a given day to provide nursing care in the school, and we use every nursing skill imaginable. Our patients are not just students but the entire school as a community, which includes all school staff, students and families. For that reason, communication skills are mandatory. School nurses constantly coordinate, collaborate and – most importantly – advocate for themselves, their profession and their school.
Q. How has nursing impacted your life?
A. Whether it’s being a mother or a wife, providing direct nursing care or going to the grocery store, nursing is part of who I am. Every task, for me, seems to be tied to preventing illness, promoting health and caring for others.
Nursing has had a positive impact on my life. I don't know many people who love their jobs and can't wait to go to work every day, so I feel extremely fortunate to be a school nurse. I have the support of my nursing co-workers, school staff and family members. This has allowed me great opportunities in life, making me confident in my abilities to function successfully as a professional.
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