The role of the school nurse in special schools for pupils with severe learning difficulties

The work of two paediatric nurses working full-time in special schools was monitored over a full school year. Most of their time was spent on routine tasks with small numbers of pupils who required enteral feeding and suctioning. They were also responsible for administering medications to around 1 in 6 of the pupils. Both nurses had an involvement in staff training and health promotion classes; more so in one school than the other. In two similar schools which did not have a nurse, the routine tasks were done mainly by teachers or assistants with support from visiting community nurses. Health promotion formed part of the school curriculum. The presence of the nurses in schools was valued by school staff, parents and other health and social care professionals. The implications of these findings are discussed in the context of the British Government's aspirations for school nurses to play a key role in reducing health inequalities.     

The health of the school nurse community: a framework.

School nursing is based on a conceptual foundation of community health nursing. Using community health nursing as a reference point, this article describes a viewpoint of school nurses as the population of care. With this perspective, school nurses will better understand how to foster the health of their community. Developed on the basis of McKenzie, Pinger, and Kotecki's community health model, the Health of the School Nurse Community Framework has been designed to (a) facilitate understanding of the concept of "school nurse community" and (b) organize the factors that affect the health of the school nurse community. Essential to its use is the identification of the school nurse community's assets and capacities as well as its needs. Application of the framework to strive to improve the health of one state's school nurse community is also presented.     

Exploring district nursing competencies in health promotion: the use of the Delphi technique

Aims and objectives. The research outlined in this paper aimed to establish a consensus view amongst primary healthcare professionals about the competencies that district nurses need in order to fulfil an effective role in health promotion. Background. In recent years there has been a growing emphasis on health promotion in primary care in the United Kingdom and health promotion is becoming increasingly important to nurses who work in the community. However, consideration of the role of the district nurse in health promotion is rather restricted and consequently district nurses have limited access to empirical evidence, from which they can develop their work in health promotion. Design and methods. The Delphi technique was used for this study. Seventy‐two primary healthcare professionals were mailed a series of three questionnaires, which achieved response rates of 86, 87.5 and 78.9%. Results. There was a consensus amongst the panellists that district nurses require a range of competencies to engage effectively in health promotion. These were categorized to produce a definitive list of eight knowledge‐, seven attitude‐ and eight skill‐related competencies. Conclusions. For the first time, this study achieves a consensus on the competencies needed by district nurses to engage in health promotion. Relevance to clinical practice. District nurses should feel encouraged to develop their health promotion role in light of the fact that many of the competencies that they require for this activity have been identified as essential for their day‐to‐day nursing practice. The research highlights the fact that new paradigm health promotion is a concept that has moved beyond the academic arena and is recognized as significant by practising health professionals.     

A student health advocate program.

School nurses are in a unique position to influence health education in the school system. However, it is likely that school nurses have varying opportunity, due to staffing patterns, to effectively use their health education background to reach large numbers of students. This article explores the benefits of providing a school nurse-facilitated student health advocate program. The student health advocate program is a creative approach, designed to access a greater audience of students for health education and health promotion activities. It also cites research supporting the choice of peer education as a health education/health promotion strategy. The initiation of a student health advocate program, the role of the school nurse, student activities, program evaluation, and nursing implications are discussed. Positive benefits accrued for both the student health advocate and the mentored student.     

Enhancement of Community Health Nursing Services to Schools

This investigation sought to determine whether the effectiveness of the school nurse could be enhanced through a planned program of inservice education. An intensive program for community health nurses was initiated by a County Health Department in 1982 to improve the performance of the community health nurse in delivering school health services. Because many school districts throughout the nation utilize community health nurses in the provision of school health services, the study outcomes can contribute to improved school health services.     

School Nurses’ perspectives on the role of the school nurse in health education and health promotion in England: a qualitative study

Background

The role of the school nurse is complex with many possible elements identified by previous research. The aim of this study is to understand perceptions of the role of the school nurse in order to support school nurses in the delivery of health education.

Methods

The study used an inductive, qualitative research design involving semi-structured interviews and focus groups. Participants were recruited from four NHS trusts across England and final sample size was thirty one school nurses. Three focus groups and two interviews took place in person, and three interviews were over the phone. Data was thematically analysed.

Results

School nurses described six main themes. Four themes directly related to the school nurse role: the main roles of a school nurse, school nurses' role in health education, prioritisation of workload and activities, and community work. A further two other themes related to the delivery of health education: the school nursing system and educational resources.

Conclusions

The role of the school nurse in England is very diverse and the school nurse role in health education is primarily to advise and support schools, rather than to directly deliver education. The study identified that tailored public health educational resources are needed to support school nurses.

     

The United Kingdom National Healthy School Standard: a framework for strengthening the school nurse role.

The purpose of this review is to analyze the school nursing role within the National Healthy School Standard (NHSS) in the United Kingdom with a view toward clarifying and strengthening the role of school nurses globally. Within the National Healthy School Standard framework, school nurses serve an integral role in linking health and education partnerships to promote effective school health programs. School nurse contributions to the National Healthy School Standard, as well as barriers and supports, are discussed. Additionally, the methods school nurses implement to partner, to manage service delivery, and to work with schools are outlined. The central role of school nurses within the National Healthy School Standard framework provides a guide for school nurses in the United States to demonstrate their importance as key players in healthy schools that promote health and education. The framework deserves recognition as a foundational model to help strengthen both the school nurse role and school health programs around the world.     

A follow-up study of former student health advocates.

Student health advocates (SHAs) are high school students who, under the supervision of the school nurse, provide health education and health promotion activities to other students via a peer education model. This 3-year follow-up study explored how the SHA experience influences career choice and attitudes of the participants. It also examined what motivates students to become SHAs, the benefits and drawbacks of SHA participation, how SHA involvement influenced career plans, and how SHAs perceive the role of the school nurse. Study results indicate that this innovative health education/promotion experience offered an opportunity for SHAs to express their interest in health and enhanced their sense of belonging, meaningful involvement, connection to learning, and caring relationships in the school setting.     

A discourse and Foucauldian analysis of nurses health beliefs: implications for nurse education

AIMS OF STUDY: The aim of this study was to investigate nurses' constructions of health in order to determine what influence these have on their health education practices and their implications for nurse education. BACKGROUND: Burgeoning literature on health promotion claim that health promotion is central to nursing practice. This is a role that has grown in the context of a rapidly ageing population, emergence of new diseases and variants of old diseases, ecological and environmental concerns and apparent social fragmentation. Within the United Kingdom this has led to nurses being identified by agencies, such as the UK government, as having a leading role to play in what has become the 'holy grail' of patient lifestyle change. But this role has been based on the seemingly uncritical assumption that the UK nurse education system engenders the necessary knowledge, attitude and skills required by nurses for them to effectively promote lifestyle choices. This study draws upon discourse and Foucauldian social analysis to uncover, through nurses' narratives, how they construct health and enact their health education practices. METHODS: Twelve newly registered UK nurses were interviewed using hierarchical focused interviews. Data were analysed using discourse analysis. FINDINGS: The process of discourse analysis unearthed two opposing value positions held without any feeling of contradiction by respondents: a holistic view--the role-based/public account, and a victim blaming view--personal agency/private account. CONCLUSION: This dual set of values raises important concerns over the teaching of health promotion. Nurse education may need to revise its approach to health promotion by taking into account the power of private accounts of health promotion that prevail among some nurses.     

Adult learning center: a unique adventure for a school nurse.

The school nurse's role in an Adult Learning Center presents a unique challenge. The learning center serves clients who range in age from infancy to elderly adults. The population includes low-income children in day care to alternative high school or adult education classes. Many participants have no health insurance or source of primary health care. The school nurse provides care to meet individual health needs, needs that may be illness related or involve health promotion or primary prevention. The nurse's involvement includes health assessment and appropriate nursing care. This learning environment, although non-traditional for a school nurse, offers health services to those who are at risk due to lack of health education, poor health habits, or lack of access to health care. The school nurse is an essential bridge to people who need care and who may have no other source of health information or care in the community.     

Staff perceptions of community learning disability nurses' role

AIM: This study examines the views of health and social care staff in relation to their perception of the role of community learning disability nurses. METHOD: A total of 40 staff completed a questionnaire to identify the role and rate the effectiveness of community learning disability nurses. Inter-rater reliability was assessed and themes were identified. FINDINGS: Staff see community learning disability nurses as having service development, liaison and consultancy roles. However, respondents also continued to emphasise nurses' direct clinical role, with over 40 per cent identifying assessment and treatment. The perceived effectiveness of the community learning disability nurse was 4.09, SD = 0.71, indicating that staff generally perceived the service to be effective. CONCLUSION: Community learning disability nurses are viewed by their multidisciplinary colleagues as having a broad and varied role, which is consistent with the role, identified by nurses themselves. They may need to consider how to further develop their services in relation to clients' physical health. Overall, all participants rated the nursing service as effective.     

社区护士发挥角色功能现况及影响因素调查

目的：了解目前社区护士的主要工作内容,各种角色职责的履行情况及其相关因素,为社区卫生服务管理者更好地设置社区护士岗位,明确职责,有针对性地对社区护士进行培训,充分发挥社区护士的角色功能提供科学依据。方法：使用问卷方式对北京市7所社区卫生服务中心（站）195名社区护士进行调查。结果：被调查的195名护士中,72.82%主要从事治疗性工作,32.31%从事预防保健工作。制约社区护士履行角色功能的主要因素依次为：人力不足,缺乏相关知识技能,自身综合能力不足,岗位限制,领导支持力度不够,缺乏服务意识等。结论：社区护士的观念已经发生改变,但社区护士在社区卫生服务中没有充分履行其应有的角色职责,应引起社区卫生服务管理者的重视,采取切实可行的措施,提高社区护士的综合素质,以充分发挥其角色功能。     

Partnering with schools: a win-win experience

In many states, budget cuts have influenced school systems to question whether school nurses are necessary. Consequently, many schools no longer have a nurse to coordinate school health services. Creighton University School of Nursing saw this situation as an opportunity. Using schools as clinical sites for nursing students has resulted in positive outcomes for all involved. Competencies successfully demonstrated by nursing students have included understanding concepts of health and illness, identification of strategies to promote and protect the school-age population, and the ability to provide population-focused prevention within the community. Faculty think the school population is healthier and school personnel have increased knowledge of health promotion and protection strategies for school-age children as a result of the school health project. The education provided serves to promote the well-being of students, families, and the community and prepares them to make health-related choices. The project has also resulted in health benefits for the community.     

Health Jeopardy: a game to market school health services.

Health Jeopardy was developed by members of the School Nurse Organization of Minnesota to present information about health and to market the role of the school nurse. Although it was created for the Minnesota State Fair, it has been used in a variety of community settings. This interactive and fun game has been popular with both children and adults. Contestants were selected from the state fair audience, and each competed for prizes by answering questions about school health under the five categories of first aid and safety, nutrition, immunizations, communicable diseases, and school nurse facts. In addition to the state fair, Minnesota school nurses have used this game as both an informational and promotional tool in their school and community fairs.     

Nurses as role models and health educators

This paper focuses on the role of the nurse as both a role model and as a health educator and examines some key areas where tension between these two appear to exist. The context is the changing British National Health Service and the expectations of both the providers of the care and the consumers. The concept of the nurse as a role model for health is explored: the use of the term 'role' and its implications for nurses; what being a role model might mean for nurses and some of the stresses which living up to these role models might impose; the extra burden of an implied healthy role model and the expectations which are placed on nurses from both within and outwith the profession. Communication theory and the view of the nurse as a 'credible source' may add to these pressures and this paper tries to offer to nurses an alternative standpoint from which they may begin to tackle their health promotion/education activities. The traditional role of the nurse as a health educator is examined and a variety of options are offered to encourage nurses to consider their approach to dealing with clients within the context of health education. Some different models of education which are more suitable for the flexible approach which is required for health education are outlined. The paper closes with some discussion points which suggest that self-awareness and personal developments may be among the most important qualities which nurses need to be effective health educators.     

Knowledge and attitudes of primary care nurses and midwives towards health promotion in rural South Africa

This study was designed to study knowledge, attitudes and views about health promotion among nurse clinicians in rural South Africa. The sample included 90 nurse clinicians (73 primary health care nurses and 17 midwives) in the age range of 24 to 59 years (M age 38.4 yr., SD = 9.3) in the Northern Province. Results indicate that nurses (66.6%) had an inadequate knowledge score on health promotion in this sample. Higher knowledge scores on health promotion were not associated with age and years of experience. However, male nurses had significantly higher knowledge scores on health promotion than female nurses. The majority strongly supported the centrality of their role in health promotion acknowledging the time constraints involved. Better knowledge on health promotion was associated with more positive views on health promotion. More nurses had a satisfactory positive attitude towards health promotion (63.3%) than knowledge about health promotion (33.3%). Finally, the study found that compliance with health promotion was seen as a problem but health counselling was nevertheless seen as cost effective.     

Nurse practitioner: redefining the role of the community nurse?

Currently there is considerable uncertainty regarding the future for community nurses in the United Kingdom (UK). Within the present social and political context the development of the nurse practitioner is examined as one possible means of redefining the role of some community nurses. The historical development of the nurse practitioner in the United States of America (USA) and the UK reveals that such a role has, previously, been a response to changing health trends and to deficits in the provision of care to communities. The evolution of an independent nurse practitioner role is suggested as a way forward for different groups of community nurses and should enable them to meet the health demands of people in a variety of settings. The 'needs' of patients and clients and a multidisciplinary approach are emphasized as being important to the redefinition of community nursing roles. The preparation of community nurses as nurse practitioners would have obvious implications for community education; this matter is briefly discussed. The future of nursing as a whole is set to change; it is imperative that all nurses delivering patient care in this arena should examine the changing needs of society in the context of political reform, and consider how their roles may be developed and redefined.