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Chapter 42 The Nurse in the Schools

Chapter 42 The Nurse in the Schools. Objectives. Discuss professional standards expected of school nurses. Differentiate between the many roles and functions of school nurses. Describe the different variations of school health services and coordinated school health programs.

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Chapter 42 The Nurse in the Schools

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  1. Chapter 42The Nurse in the Schools

  2. Objectives Discuss professional standards expected of school nurses. Differentiate between the many roles and functions of school nurses. Describe the different variations of school health services and coordinated school health programs. Analyze the nursing care given in schools in terms of the primary, secondary, and tertiary levels of prevention. Anticipate future trends in school nursing.

  3. History of School Nursing Late 1800s: Metropolitan Association of Nursing provided medical examinations for children in London schools 1897: New York City schools began to identify ill children Excluded ill children from class so classmate not infected Health education 1902: Henry Street Settlement nurses began going into homes and schools to assess children.

  4. History of School Nursing, Cont’d 1910: Teachers College in New York City added course on school nursing 1949s: Nurses employed by the school districts 1950s: Increased use of immunizations and antibiotics 1960s: Call for high levels of education for school nurses ANA position paper

  5. Federal Legislation Section 504 of the Rehabilitation Act of 1973 Education for All Handicapped Children Act Americans with Disabilities Act (1992) Individuals with Disabilities Education Act (IDEA) (1997) Individualized education plans (IEPs) Individualized health plans (IHPs) No Child Left Behind Act of 2001 Child Nutrition and WIC Reauthorization Act of 2004

  6. Standards of Practice National Association of School Nurses (NASN) NASN Standards (Box 42-1) American Academy of Pediatrics (AAP) AAP Guidelines (2008)

  7. Educational Credentials NASN and AAP recommend school nurses be RNs who also have bachelor’s degrees in nursing and a special certification in school nursing. Not all school nurses have been educated this way. Varies from state to state APNs in schools

  8. Roles and Functions of School Nurses Direct caregivers Educators Counselors Consultants Case managers Community outreach Researcher

  9. School Health Services Federal School Health Programs School Health Policies and Program Study 2006 School-Based Health Programs

  10. Federal School Health Programs:Eight Components of a Coordinated School Health Program

  11. School Health Policies and Program Study 2006 Student-to-school nurse ratio Recommended 1 nurse for every 750 students Access to mental health counselors Schools’ cafeteria Tended to have food high in salt and fat Parental involvement

  12. School-Based Health Programs School-based health centers Family-centered, community-based clinics run within the schools School-linked program Collaborative Model for School Health in Pitts County, North Carolina

  13. Healthy People 2020 Many objectives are directed toward the health of children. Several point directly at the care that nurses give to children in the schools. These objectives are concerned with: Children with disabilities in the schools Number of children with major health problems Ratio of nurses to children in the schools

  14. Levels of Preventions in Schools Primary Prevention Secondary Prevention Tertiary Prevention

  15. Primary Prevention Teaching health promotion concepts in the classroom For students and teachers Substance abuse and disease prevention education Preventing childhood injuries Safe Kids Campaign Preventing substance abuse behaviors Reducing the risk of the development of chronic diseases Monitoring the immunization status of children

  16. Secondary Prevention Caring for ill or injured students and school employees Nursing care for emergencies in the school Emergency plan Emergency equipment in the school nurse’s office Giving medications in school Assessing and screening children at school Vision, hearing, height, weight, oral health, tuberculosis, scoliosis Pediculosis screening Identification of child abuse or neglect

  17. Secondary Prevention, Cont’d Communicating with health care providers Efforts to prevent suicide and other mental health problems Violence at school Six characteristics of a student who may be thinking about inflicting violence School crisis teams

  18. Tertiary Prevention IEPs for students with long-term health needs Children with asthma Children with diabetes mellitus Children who are autistic or have ADHD Children with special needs in schools Children with DNR orders Homebound children Pregnant teenagers and teenage mothers

  19. Controversies in School Nursing Sex education Reproductive services Screening for STIs

  20. Ethics in School Nursing Student or parent beliefs may conflict with the nurse’s beliefs. Care should never be denied or ignored. Referral is a good option.

  21. Future Trends in School Nursing Amount of health care given in the school is increasing. Telehealth and telecounseling Internet use

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