NASN School Nurse

Asthma is a common chronic disease in children. Uncontrolled asthma is a significant contributor to school absenteeism, emergency room visits, and hospitalization, all of which can lead to low school performance, financial burdens, and emotional problems for children and their parents. Asthma in children restricts the activities of school-aged children, such as participating in before- and after-school activity and extracurricular activities such as sports. Uncontrolled asthma has the potential to impact a student’s self-confidence and social interactions. This article reviews the physical, emotional, and social burden of asthma on school-aged children/parents as well as recounting school asthma intervention programs. One of the roles of the school nurse is to be the leader of the intervention programs, manage asthma, and provide education for the students, parents, and school community to promote knowledge about asthma and its management.

The Advisory Committee on Immunization Practices recommends that the Tdap, HPV, and meningitis vaccines be administered to youth beginning between the ages of 11 and 12. The school nurse, knowledgeable about vaccine schedules and the rationale for the schedules, is in a unique position to advocate for all adolescent vaccines and their timely administration through addressing parent-guardian concerns and supporting other healthcare providers in completing the adolescent vaccines. This article reviews current recommendations for adolescent vaccinations and the actions needed to improve vaccination rates with a focus on Human Papillomavirus vaccine, the vaccine with the lowest completion rates among this age group. Additionally, school nurses are introduced to Middle School Health Starts Here, a program for school nurses designed to address the whole child as students progress from 5th grade to middle school. Public policy issues including school mandates, along with possible barriers to vaccine completion in adolescents, are discussed.

This article describes the author’s advocacy experience at a press briefing on Capitol Hill. At stake is the continuation of Medicaid and Children’s Health Insurance Program-funded health insurance to our most vulnerable children—those living in poverty and those with chronic health conditions. Current legislation proposes to impose block grants or per capita caps on federal funding for Medicaid and will put the reauthorization of the Children’s Health Insurance Program at risk. Schools stand to lose over 4 billion dollars in reimbursement for services that students need to succeed in school.

The passage of the Every Student Succeeds Act provides an impetus for school nurse organizations to advocate for student health and climate goals at the state level. Collaboration between state agencies and associations is a starting point for advocacy. Advocacy also includes legislative involvement. This article explores state advocacy and collaboration efforts among school nurse organizations over the past year identifying common themes, with a focus on Every Student Succeeds Act involvement, as well as listing unique activities by state.

Skin infections are a common ailment that affect all students, with increased risk to those students participating in sport and specifically contact sports. The types of skin infections that students are likely to encounter are categorized into three types: (a) bacterial, (b) viral, and (c) fungal. All three types of infection can appear benign at onset but can grow into serious disease and illness if not correctly identified and treated in a timely manner. A strong prevention program should be in place at all schools with appropriate resources in place (human and financial) to carry out proper cleaning of facilities, on-site examination by the school nurse or athletic trainer, and sufficient education of coaches, athletes, parents and administrators.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 4 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 4 offers lessons to be learned by reflecting on Ellen Johnsen’s experience when she challenged the illegal and unsafe medication administration policy in the Broken Arrow Public Schools. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

This is the second of two articles outlining the professional school nurse’s role in the special education process for students with disabilities. The Individuals with Disabilities in Education Improvement Act of 2004 mandates the special education process: identification, full and individual evaluation, eligibility determination, and development of the individual education program (IEP), including special education placement. Part 1 focused on the importance of the school nurse’s role in student identification, response to intervention, and the full and individual evaluation. Part 2 highlights the school nurse’s vital and unique contribution to the subsequent special education steps of eligibility determination, IEP development, and special education services placement and minutes.

Johnson, K. H., Maughan, E., Bergren, M. D., Wolfe, L. C., Cole, M., & Watts, H. E. S. (2017). What’s Up With Step Up!? Year 2! NASN, 32(2), 100-105. (DOI: 10.1177/1942602X17691808)

In the March 2017 issue of NASN, the following abstract and keywords were not included in the manuscript. This has been updated in the online issue:

Step Up & Be Counted! (Step Up!) is a joint initiative of the National Association of School Nurses (NASN) and the National Association of State School Nurse Consultants (NASSNC). The aim of Step Up! is for all school nurses across the nation to collect and submit specific, uniform data points for all their students. The program was initiated in 2014. In the second year of data collection, 2015-16, school nurses from more states contributed data, and many states reported on a larger number of school nurses reporting data. This article reports the progress we have made in data collection and reporting in year two.

Keywords: Step Up & Be Counted!; National data set; Data collection; Informatics; School nursing