NURSING - RN & LPN
From NASN Position Statement: Role of the School Nurse
School nursing has multiple components and the role of the school nurse is a broad one, dependent on many factors, including the school setting (rural, urban, suburban), health needs of the student population and the availability of specialized instructional student support services and programs.
The National Association of School Nurses defines school nursing as a specialized practice of professional nursing that advances the well-being, academic success and lifelong achievement and health of students. To that end, school nurses facilitate normal development and positive student response to interventions; promote health and safety including a healthy environment; 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, 2010).
School nurses facilitate normal development and positive student response to interventions.
The school nurse serves as the health care expert in the school to meet student health needs with an understanding of normal growth and development in children and youth as well as students with special needs. The school nurse develops plans for student care based on the nursing process, which includes assessment, interventions, and identification of outcomes and evaluation of care (Wolfe, 2006).
School nurses provide leadership in promoting health and safety, including a healthy environment.
The school nurse provides health-related education to students and staff in individual and group settings and provides consultation to other school professionals, including food service personnel, physical education teachers, coaches, and counselors. Responsibilities in the provision of a safe and healthy school environment include the school nurse’s monitoring of immunizations, managing communicable diseases, assessing the school environment for safety to prevent injury and spearheading infection control measures. The school nurse is also a leader in the development of school safety plans to address bullying, school violence, and the full range of emergencies that may occur at school (Wolfe, 2006).
School nurses provide quality health care and intervene with actual and potential health problems.
Health care for chronic and acute illness, as well as injuries in the school setting, is a major focus of the role of the school nurse. The school nurse is responsible for medication administration, health care procedures, and the development of health care plans. Students often have multiple needs that should be examined in order for the student to be able to be successful in the classroom, and school nurses often engage in health screenings that include vision, hearing, body mass index, mental health index or other screening procedures (often based on local and state regulations) to address those issues (Wolfe, 2006).
School nurses use clinical judgment in providing case management services.
The school nurse receives medical orders to guide the health care needed to assist each student to be safe and successful at school. As in other clinical settings, the nurse develops Individualized Healthcare Plans (IHPs) in nursing language to direct nursing care for students as well as Emergency Care Plans (ECPs) written in lay language to guide the response of unlicensed personnel in a health-related emergency. Both plans are tailored to the individual needs of a specific student to improve expected care outcomes. The nurse makes decisions related to the appropriate delegation of healthcare tasks as directed by state laws and professional practice guidance (American Nurses Association [ANA]/National Council of State Boards of Nursing [NCSBN], 2006). As medical and information technology advance and change, it is imperative for the school nurse to pursue professional development so the school nurse is able to provide the best possible care for the student population (Wolfe, 2006).
School nurses actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy and learning.
Coordinating the linkage between the medical home, family and school is an important aspect of the role of the school nurse. The school nurse has health expertise that is essential to school educational teams, such as the Committee on Special Education, the Individualized Educational Plan (IEP) team and the Section 504 Team so that health-related barriers to learning can be reduced for each student. The school nurse can provide families with referral information along with available community resources to improve access to health care. The school nurse can also assist families in obtaining health insurance as needed and can represent the school on community coalitions to advocate for school-based health care (Wolfe, 2006).
The school nurse may take on additional roles as needed to meet the needs of the school community.
Healthy children are successful learners. The school nurse has a multi-faceted role within the school setting, one that supports the physical, mental, emotional, and social health of students and their success in the learning process. It is the breadth of nursing activities contained within the role of the school nurse and the unique non-medical setting that differentiates school nursing from other nursing specialties.
American Nurses Association & National Association of School Nurses. (2011). Scope and standards of practice – School nursing (2nd ed.). Silver Spring, MD: Nursesbooks.org.