School Nursing CE Course

Course preview

Syllabus

The purpose of this activity is to discuss the role of the school nurse and the benefits of having a school nurse within each school system. We will address the regulations of the school nurse position, the experience of the school nurse during the school day, and their role in promoting policy that impacts the physical and psychosocial health of the child.

According to the National Association of School Nurses (NASN, 2018), the position of the school nurse has been in existence since the early 1900s. School nursing was started to help the communicable disease plight that was affecting the United States. Many students were absent from school because of various infectious disease conditions, as well as a significant spread of illness due to poor sanitation practices. As a result of implementing nurses into the school system, the rate of illness preventing school attendance declined and children were able to attend school more regularly (NASN, 2018). The school nurse also worked in the public health setting, addressing the environmental needs of the home in which the child lived. The school nurse continues to enhance each child’s learning today by offering support in a variety of situations, such as those with acute/chronic health care needs, family crises, and psychosocial illnesses. Many families are affected by a lack of health care and the rising cost of health care interventions. Having a school nurse to assist children with healthcare concerns during the day can lessen the burden on a working family (American Academy of Pediatrics Council on School Health [COSH], 2016; Kuo, Wood, Duffee, & Paco, 2016). 

The Roles of a School Nurse

According to the NASN (2018), a school nurse is someone who works collaboratively with the child, family, teacher, and school system to enhance the quality of the child’s learning experience. School nurses can be assigned to one school or a district, dependent upon the needs of the school system and available funding. One key element of school nursing is to advocate for the child regarding social issues, both in and out of the home. Serving as an advocate for children allows the child’s voice to be augmented concerning healthcare needs and wellness initiatives. This advocacy will help the child to be self-sufficient in areas of their personal care. School nurses can be policy changers/makers, identifying situations that need policy change or the implementation of new procedures or legislation to address the many concerns facing the child in the school setting, such as bullying, nutrition, and preventive healthcare (NASN, 2018).

According to the COSH (2016), school nurses have a vast job description. School nurses continue to be primarily responsible for the decrease in the absenteeism rates of students, but the bigger picture is equally important. School nurses provide home visits for students who have physical or emotional special needs. In order for children to be their most productive selves at school, the home environment may need to be evaluated and supported. School nurses are needed for disaster preparedness. While most children spend the majority of their day in school and disasters strike at any time, the school nurse should be prepared to ensure the safety of the children. In addition, the school nurse can plan teaching sessions for children and families to discuss ways to plan for a disaster should it strike. Preparing the child for safety should be the utmost concern of the school nurse. The education that the school nurse provides to the students and staff can be one of the most important contributions that they make. Providing this information to students can save lives. Additionally, school nurses perform observations of disease incidences. This is important in times of influenza, for example. This surveillance will help the school nurse plan for illness and work on prevention strategies such as handwashing (COSH, 2016).

The school nurse also assists in the care of the chronically ill child, and those with mental health issues. It is important to allow the child with a chronic illness (physical or mental) the ability to go to school in a standard school setting despite their additional care needs. This will promote the optimal growth and development of the child (COSH, 2016).

Regulations Governing the School Nurse

School nurses are licensed under their state nursing regulatory board. The requirements of the state board of nursing may vary, so school nurses should be familiar with the Nurse Practice Act in their state. Laws governing students must be at the forefront of the school nurse’s mind. “The Privacy, Security, and Breach Notification Rules of the Health Insurance Portability and Accountability Act of 1996 (Pub L No. 104-191) and Family Educational Rights and Privacy Act (Pub L No. 93-380 [1974])” regulate the privacy of the student in regard to health information on a federal level (COSH, 2016, p. 2). Ensuring parental permission alleviates concern for these two privacy acts. School nurses are engaged in lobbying for legislation and play an active role in policy change in the government and local school systems (NASN, 2018). There is current legislative actions in development to deal with the lack of school nurses in schools that have lower-income students and child nutrition concerns. Every child has the right to good healthcare. The NASN supports the Nurses for Under-Resourced Schools Everywhere (NURSE) Act. This act is focused primarily on the need to increase the number of school nurses in areas where Title I is in effect (free and reduced lunch). Information presented to Congress illustrated that the lack of school nurses in these areas is significant. According to the NASN (2019), less than 50% of public schools have school nurses on a consistent basis. Most schools have nurses working part-time, limiting the number of hours devoted to the care of ill children. While this might not seem significant, it makes a dramatic impact when one realizes the number of uninsured children who may need interventions or assessment from a provider.  The NASN (2019) points out that without school nurses, the person responsible for administering medications and monitoring of children becomes a school staff member who is likely undertrained. Child nutrition is another area that warrants the expertise of the school nurse. Millions of children qualify for free and reduced lunches, and millions receive free breakfast. These programs are crucial, as most of the school meals are a significant contribution to the child’s nutrition. School nurses are instrumental in pushing this legislation forward to help children obtain nutritious meals in schools. These two efforts are examples of the various potential legislation that school nurses support and endorse both nationally and locally (NASN, 2019). 

Benefits of a School Nurse

The benefits of a school nurse can be multifaceted. Children spend many hours at school, with some attending before and after school programs. The school nurse can evaluate the student’s health, which influences the student academically, physically, and emotionally. Community assessments can be conducted to improve the environment in which children learn. School nurses can provide primary, secondary, and tertiary prevention programs (NASN, 2018). Immunization clinics and education programs on healthy food choices and the significance of physical activity are ways the school nurse can provide primary prevention. Secondary prevention programs could be screening for blood pressure abnormalities, hearing and vision concerns, and weight screenings. In addition, screening for respiratory conditions prevalent in childhood such as asthma can be part of secondary preventions. Tertiary prevention could be accomplished by working with children who have a physical or emotional difference to increase the child’s independence (Bergren, 2017).

An essential aspect of the school nurse’s role is