School Nursing Roles

School Nursing Practice: Roles and Standards (NASN, Proctor, 1993) enfolds the Standards of Clinical Nursing into six overall role concepts which serve as conceptual umbrellas for the ten specialty standards of practice around which the professional School Nurse may define a role and design a school nursing program within the educational setting.

The School Nurse's Role
The School Nurse's role should be as a:

1. Provider of Client Care
 Focus is on the provision of direct clinical nursing services to students, families and staff using the theoretical body of knowledge fundamental to school nursing practice and framing the delivery of services within the nursing process context .

2. Communicator
 Focus is on effective communication to demonstrate caring, competence, and consideration. Addresses recording, storage, and retrieval of health data and issues related to confidential data.

3. Planner & Coordinator of Client Care
 Focus is on processes beyond delivery of direct services to individual students and families. Examines larger contexts of practice like community liaison, networking, program management, interdisciplinary collaboration, and influencing the political process. Facilitates delivery of direct school nursing services.

4. Client Teacher
 Focus is on the school nurse as educator for individual students, classes, groups, staff, family, and community.

5. Investigator
 Focus is on the school nurse observing the phenomena within the school setting, identifying issues, studying them, and sharing the findings, either formally or informally.

6. Role Within the Discipline of Nursing
 Discusses issues of role delineation, communication and augmentation. Examines professional practice issues unique to nursing in the school setting. Encourages excellence in practice through evaluation of school nursing practice and continued professional development.

10 Standards of School Nursing Practice
The ten Standards of School Nursing Practice stated succinctly are:

  1. CLINICAL KNOWLEDGE - The School Nurse utilizes a distinct knowledge base for decision-making in nursing practice.
  2. NURSING PROCESS - The School Nurse uses a systematic approach to problem-solving in nursing practice.
  3. CLIENTS WITH SPECIAL HEALTH NEEDS - The School Nurse contributes to the education of the client, planning and providing appropriate nursing care, and evaluating the identified outcomes of care.
  4. COMMUNICATION - The School Nurse uses effective written, verbal, and nonverbal communication skills.
  5. PROGRAM MANAGEMENT - The School Nurse establishes and maintains a comprehensive school health program.
  6. COLLABORATION WITHIN THE SCHOOL SYSTEM - The School Nurse collaborates with other school professionals, parents, and caregivers to meet the health, developmental and educational needs of clients.
  7. COLLABORATION WITH COMMUNITY HEALTH SYSTEMS - The School Nurse collaborates with members of the community in the delivery of health and social services, and utilizes knowledge of community health systems and resources to function as a school-community liaison.
  8. HEALTH EDUCATION - The School Nurse assists students, their families, and the school community to achieve optimal levels of wellness through appropriately designed and delivered health education.
  9. RESEARCH - The School Nurse contributes to nursing and school health through innovations in practice and participation in research or research-related activities.
  10. PROFESSIONAL DEVELOPMENT - The School Nurse identifies, delineates, and clarifies the nursing role, promotes quality of care, pursues continued professional enhancement, and demonstrates professional conduct.

The School Nursing Practice: Roles and Standards document will clearly define the relationship of the ten School Nursing Standards to each of the six role concepts, and to the American Nursing Association's Standards of Clinical Nursing Practice . The text provides a working definition of the main theme for each standard, the rationale for the standard, criteria to measure if the standard has been met, and suggestions for achieving the standard in the School Nurse's work setting.

In addition to the two Standards of Practice documents described above, the School Nurse should also have the following for ready reference:

Code for Nurses with Interpretive Statements (American Nursing Association, 1985)

State of Nebraska: Statutes Relating to Nursing (1991)

State of Nebraska: Regulations Governing the Practice of Nursing (1992)

 

diagram of school nurses role

 

Certification for School Nurses

There are two types of certification for school nurses:

-- State Certification level: legal certification by the state educational agency, and

-- National Certification level: non-governmental certification by a professional nursing organization.

Nebraska State Certification

State Departments of Education may provide mandatory' or permissive certification. The Nebraska Department of Education provides permissive certification via a School Nurse Special Counseling Services Certificate issued to registered nurses already employed by a school system in Nebraska. (For further information, please call the Nebraska Department of Education, Certification Division: 1-402-471-0739)

States providing for mandatory certification require the registered nurse assuming the role of a School Nurse to first complete a credentialing program beyond their generic nursing degree.

Such a School Nurse credentialing program is designed to assure practice competencies relative to:

  • growth and development of children and adolescents;
  • health and nutritional status;
  • vision, hearing, scoliosis, dental and immunization screening;
  • epidemiological investigation;
  • first aid and emergency care;
  • child abuse;
  • drug abuse screening;
  • exceptional child and special education;
  • evaluation, counseling, and crisis intervention;
  • human relationship skills;
  • health education and the use of audio-visual equipment;
  • use of local, state and national health resources;
  • environmental health and safety;
  • community and family health nursing;
  • sexuality and family life education;
  • cultural competency;
  • budgeting and accounting;
  • legal aspects, management and supervision of school health programs

National Professional Certification

Professional certification requires passing a national examination measuring skills and knowledge based on the above mandatory certification competencies. It is offered by the American Nurses Association (ANA) for both the school nurse and the school nurse practitioner.

The National Association of School Nurses, Inc. (NASN), the specialty organization, also certifies school nurses through the National Board for Certification of School Nurses, Inc. (NBCSN).

Professional certification is a hallmark of excellence and verification of the school nurse's ability to function at a nationally recognized level.

Information on certification may be obtained by calling the individual professional organizations listed below:

American Nurses Association (ANA), Certification Division: 800-284-CERT (800-284-2378)

National Board for Certification of School Nurses, Inc. (NBCSN), Certification Division: 212-852-0400

REFERENCES & RECOMMENDED RESOURCES For Further Information on SCHOOL NURSING ROLES

A Theory of Nursing: Systems, Concepts, Process, King, I.M. (1981). New York: John Wiley & Sons.

An Evaluation Guide for School Nursing Practice: Designed for Self and Peer Review; National Association of School Nurses, Inc. (1985), Scarborough, ME.

Code for Nurses with Interpretive Statements, American Nurses Association (1985). Kearneysville, WV: American Nurses' Publishing.

Expanding School Health Services to Serve Families in the 21st Century; Igoe, J. B., and Giordano, B. P., (1992). Washington, D.C.: American Nurses Publishing.

Guidelines for Documentation for School Nursing Schwab, N. (1991). Scarborough, ME: National Association of School Nurses, Inc.

Implementation Guide for the Standards of School Nursing Practice Snyder, A.A. (Ed.), (1991). Kent, OH: American School Health Association .

Manual of School Health Lewis, K.D., & Thomson, H.B., (1986). Menlo Park, CA: Addison-Wesley Publshing Co.

Nursing Interventions Classifications (N.I.C.), Bulechek, G.M., & McCloskey, J.C. (1992). St. Louis, MO: Mosby Publshing Co

Nursing: A Social Policy Statement, American Nurses Association (1980). Kearneysville, WV: American Nurses' Publishing.

The Omaha System: Applications for Community Health Nursing. Martin, K.S., and Sheet, J.J. (1992). Philadelphia, PA: W.B. Saunders.

School Nursing: A Framework for Practice, Wold, S.J. (1981). North Branch, MN: Sunrise River Press.

School Nursing Practice: Roles and Standards. Proctor, S.T. (1993). Scarborough, ME: National Association of School Nurses, Inc.

Standards of Clinical Nursing Practice, American Nurses Association (1991). Kearneysville, WV: American Nurses' Publishing.