Guest blogger Marijke Vroomen Durning, RN, is a health writer in Montreal, Canada, who enjoys demystifying the medical world for the everyday person. She also is actively involved in health awareness and is currently working with Sepsis Alliance to help raise awareness among the general public.
Chronic illnesses, emergency care, disaster preparedness, and health awareness are all important issues in healthcare today. Though most healthcare workers are familiar with these issues, over 56,000 school nurses in the United States confront their reality every day while working with approximately 56 million students. School nurses may still put on bandages and call parents as in the past, but in today’s world their job is so much more.
Nichole Bobo, RN, MSN, Nursing Education Director at the National Association of School Nurses (NASN), explains that the role of school nurses is vital to our national health in many ways, starting with prevention. According to Bobo, immunization rates drop as children get older. “There are school mandates for most of the school-entry elementary vaccines,” she says. “Those rates tend to continue to be high, but it’s the adolescent issue that school nurses focus on, because those [compliance] rates are 30 to 50 percent, depending on the vaccine.”
Low vaccine rates mean children are more vulnerable to becoming ill. When children are ill they miss school and are therefore more likely to fall behind. The further they fall behind, the lower their chances of graduating or moving on to higher education.
In addition to prevention, school nurses face situations that would not have been experienced in public schools a few decades ago. Children are living with diseases that would have forced their absence from school or, at worst, even been fatal. Now, these children go to schools which accept the responsibility of providing care. “Students are coming in to school with insulin pumps, “ says Bobo. “They are coming in maybe diagnosed on Friday and they show up at school on Monday.”
Martha Dewey Bergren, DNS, RN, Director of Research at the NASN, agrees, “This is one of the major reasons school nursing has changed.” Bergren recalls when she worked in a school in 1999, “Under my care, I had two students who were on ventilators, one of whom came to school almost every day.” This change was due to the Individuals with Disabilities Education Act, enacted in 1975, requiring public schools to provide education and support for children with disabilities.
On any given day, among their many other duties, a school nurse may also be called upon to:
* administer emergency care
* review or develop a disaster plan
* administer chemotherapy
* determine common factors between illnesses to track potential dangers
* provide counseling
Because of their expanded role, having a school nurse increases the number of days students are in school. “When there is a registered nurse in the building, children are 57 percent less likely to be sent home,” Bergren says. Additionally, if a school nurse is present to deal with health issues, school staff can focus on their own jobs.
“There was a recent study out about the number of hours that school administrators, teachers and secretaries spent on health issues when there was not a school nurse in the building, there was a pretty dramatic number of hours that could be decreased for those folks who have a very focused educational agenda,” says Bobo. “In this day and age where every dollar counts and the quality of education is in the spotlight, having a school nurse on hand may improve the students’ chances at success.”
School nurses not only have to keep up-to-date with medical and health advances, they also need to keep up with the latest in technology. Aiding students make healthy food choices, for example, could involve helping them download an “app for that.” As mentioned in a 2008 report by the American Academy of Pediatrics, the need for strong and knowledgeable nurses will therefore continue to grow.
CONNECT THE DOTS
Not sure why back-to-school physical exams are required? The American Academy of Pediatrics reviews this annual requirement and the American Academy of Family Physicians reviews childhood immunizations recommendations. The National Center for Chronic Disease Prevention and Health Promotion recommends a coordinated health strategy (CHS) in order to improve the health of students and their ability to learn in school. Also, read about the acute shortage of school nurses in the U.S. today, and how this could prevent many children (particularly those lacking healthcare) from access to medical professionals.
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