Role of the school nurse
Ever since Oct. 1, 1902, when Lina Rogers Struthers, RN, became the first nurse to work in a public school setting, school nurses have had a vital role in keeping children healthy both in and out of school.
According to the National Association of School Nurses (NASN), the initial role of the school nurse was to lessen absenteeism by educating students and their families about common communicable diseases. “While the nurse’s role has expanded greatly from its original focus, the essence of the practice remains the same. The school nurse supports student success by providing health care assessment, intervention, and follow-up for all children within the school setting,” reports NASN.
Although today’s school nurses deal with everything from HIV, pregnancy and drug abuse to serious allergies, accidents and chronic health problems, these are not the only areas of responsibility given to the school nurse. According to NASN, there are seven major roles for the modern school nurse.
Provide direct health care to students and staff
In-school care for sudden-onset illness or injury that occurs to staff or students is part of the school nurse’s role. The school nurse also deals with chronic health conditions, like diabetes and asthma, and must “assess, plan, implement, and evaluate care” for those students with ongoing illnesses.
“The school nurse is responsible for medication administration and the performance of health care procedures that are within the scope of nursing practice and are ordered by an appropriately licensed health care provider,” says NASN. School nurses help the faculty monitor and understand chronic health conditions.
Provide leadership for the provision of health services
As the expert health care professional in the school, the school nurse must train, educate and guide the staff and faculty on how to deal with medical emergencies and how to implement disaster-training exercises. The school nurse develops an encompassing plan that will ensure all students’ health needs are met. If necessary, the school nurse must address any and all safety issues at the school with staff for the prevention of illness, accident or disease.
Provide screening and referral for health conditions
The school nurse is often the first person to become aware of a student’s health or medical condition—many times found through routine screening. “Screening activities may include vision, hearing, postural, body mass index, or other screening,” says NASN. State and federal laws, cost factors and reliability of the screening procedure dictate what screening tests are given in each school. Follow-up and support, help with locating resources, information and referrals are all part of the school nurse’s job.
Promote a healthy school environment
The school nurse keeps track of student vaccinations and immunizations “and reports communicable diseases as required by law.” The school nurse also decides when a child should be removed from the school setting due to health issues like strep throat, pinkeye or other diseases that are highly contagious and decides when it’s safe for the student to return. The school nurse assesses the school environment from the playground to the indoor air quality to look for and remediate any potential health or safety problems.
Besides the physical health of the students, the school nurse also has the additional responsibility of being aware of the “emotional environment” of the school and its students. If bullying, violence or any other condition exists that may lead to the impairment of a healthy productive school day, the nurse is on the frontline in recognizing and battling negative influences in the school.
Promote health
Health education is another vital role for the school nurse. The school nurse consults on health education curriculum; provides health information to students, classes and staff; and initiates and supports health-related activities and programs that promote healthy lifestyles, safety and wellness.
NASN states, “The school nurse is a member of the coordinated school health team that promotes the health and well-being of school members through collaborative efforts.”
Serve as a leader for health policies and programs
The school nurse has a leadership role in coordinating school “health programs, crises/disaster management teams, and school health advisory councils.” The school nurse advances nursing as a career first by being a role model. He or she answers students’ questions about the career path to nursing and mentors students with an interest in the medical field.
Serve as a liaison between school personnel, family, community and health care providers
The school nurse consults on individualized education plans (IEPs) and other student and family support teams. He or she communicates with a student’s family by phone and e-mail as necessary. The school nurse ensures “appropriate confidentiality, develops community partnerships, and serves on community coalitions to promote the health of the community.”
Each year, the role of the school nurse expands to address school, neighborhood and family health topics while keeping abreast of the latest information on health and wellness. Children become successful learners when their health needs are identified and met.
