NASN School Nurse

An assessment tool, “Assessing a Student with a Rare Disease,” was developed by the Specialized Health Needs Interagency Collaboration program and introduced at NASN’s 51st annual conference in Denver, Colorado. The goal of the tool is to support the school nurse as the medical expert in the educational setting by using a comprehensive prompt to gather information about the student’s health condition and the possible impact on student’s medical, cognitive, and behavioral needs at school.

During May we celebrate School Nursing Day. We are often asked—What does a school nurse do? This article is a response to a recently asked request and describes the role of the school nurse in the 21st century, working in one school. The description is not meant to be all inclusive—but rather give examples of the complex role and need for a school nurse.

The ability to confidently teach a lesson to students, staff, or families is a skill all school nurses need to have. When a lesson plan is developed, a clear “road map” is created that guides the lesson and documents what is taught. Using the eight components described in this article, school nurses can develop a comprehensive lesson plan and teach with confidence.

Nurses in the 21st-century are expected to be data and information literate and proficient in data management. Nurses graduating from baccalaureate programs must be able to use computers and information systems and apply data and evidence to inform practice. Those competencies are also essential for the entire nursing workforce. That puts the onus on school nurses, school nurse supervisors, school districts, and state affiliates to take responsibility for comprehensive data and information literacy professional development. Fortunately, the National Association of School Nurses (NASN) has anticipated the needs of the membership. NASN included data and information capacity building as a part of The National School Health Data Set: Every Student Counts!, a national standardized data set and data collection initiative.

Through a presented case scenario, this article describes the assessment and management of behaviors associated with autism spectrum disorder (ASD) in the pediatric population, with mnemonics as a memory tool. Although students present mainly to the school nurses’ office with physical complaints, there are many mental health concerns in the school-age population with emotional and physical consequences, particularly among students with ASD. Typically considered a developmental disorder, ASD affects communication and behavior with a wide range of symptoms that can vary in severity from person to person. It is important to understand the presentation and management of common pediatric mental health issues at school to be on the front line of your students’ health.

Caring for the preschool population presents unique challenges for the school nurse. These challenges are multiplied when the population includes those with special needs. Challenges include multiple risks to safety related to developmental stage, increased prevalence of infectious diseases due to the development of the child’s immune system, management of chronic disease because of the student’s ability to comprehend and follow directions, and many social and emotional issues. Using evidence-based strategies, the preschool nurse can gain the confidence to care for the youngest students.

School nurses are often the primary health professional promoting children’s health—and address not just individuals, but communities. This article, featuring the key principle of community/public health, is the first in a series focusing on The Framework for 21st Century School Nursing Practice™ and presents a case study on asthma and air quality issues comparing the more traditional individual approaches to health (labeled downstream and midstream) with population-level approaches (labeled upstream). Through collaboration with key community stakeholders, school nurses can successfully implement policies and programs to address social determinants of health and, in turn, improve the health of the entire community. As we look to advance school nursing and support best practices, concentrating on population-level, upstream approaches align with recommendations outlined in the Framework for 21st Century School Nursing Practice™.

The occurrence of mass shootings in U.S. public schools is increasing. For this reason, schools have begun expanding their awareness and preparation for these crises. However, in most preparation strategies, students with disabilities are not accounted for, which leaves an already vulnerable population at further risk. Due to their expertise in working with students with diverse needs and promoting health and safety in schools, school nurses are the ideal persons to lead the discussion about safety deficits when it comes to school shootings and students with special needs. This article provides a rationale for school nurses taking leadership roles in creating school shooting policies as well as provides guidelines for how nurses can work collaboratively to keep students with disabilities safe.

Electronic, or “e”-cigarette use has been adopted by an alarming number of teens in recent years. E-cigarettes are neither legal for youth nor considered safe for use by youth. E-cigarette companies have targeted youth in their marketing strategies and developed appealing flavors with high nicotine content to ensure dependence on their products. Schools lack adequate resources and capacity to address e-cigarette use, relying mostly on punitive sanctions for what is essentially a health issue. School nurses can help their districts and schools by navigating appropriate consequences for vaping, providing accurate information and education, providing cessation resources, advocating for student support, and informing stakeholders on population health strategies to prevent initiation and reduce youth e-cigarette use.