A NURSE IS
A NURSE…..ISN’T S/HE?
By Judy Robinson
Executive Director,
National Association of School Nurses
Do you have
a nurse in your school? Have you ever wondered what qualifications
a school nurse brings to the job? Many teachers and parents
assume all school nurses are the same. In reality, nursing has a
number of different entry levels that have occurred as a result
of nursing shortage cycles in the past. The following training/educational
levels are sufficient for a person to be eligible to take the Registered
Nurse (RN) exam:
ADN (Associate
Degree Nurse): This training program became very popular in
the 80s when a nursing shortage was experienced. It usually consists
of two years of education at a technical or vocational school. ADN
programs require some general education courses and give the student
training in medical/surgical, pediatric, psychiatric and obstetric
and gynecological nursing. The emphasis of this program is on the
technical aspects of nursing and preparation for the RN licensure
exam.
RN (Diploma
programs): In the 50s, 60s and early 70s most nurses were trained
in 3 year programs directed by hospitals and physicians. These nurses
were educated in medical-surgical, obstetrics/gynecological, pediatrics
and psychiatric nursing. Additionally most had courses in nutrition,
anatomy and physiology, chemistry and microbiology. The emphasis
of this program was hospital based nursing practice. Very few diploma
nursing programs are still in existence today.
BSN (baccalaureate
programs): In the 70s, baccalaureate programs for nurses became
more common and are the level of preparation recommended by the
National Association of School Nurses. Baccalaureate programs generally
provide two years of pre-nursing courses that include general requirements
similar to all baccalaureate graduates with an emphasis on the sciences.
The upper level nursing science program often includes an additional
2.5 or 3 years. Baccalaureate nurses are educated in medical-surgical,
obstetrics/gynecology, pediatrics, psychiatric and community health
nursing. Additionally, courses in leadership and nursing history
are part of the core curriculum. The students receive didactic and
practice experience with an emphasis on assessment and critical
thinking.
Who else
might be in your school health room?
LPN/LVN:
A licensed practical nurse (LPN) or licensed vocational nurse (LVN)
might also work in your school. Most LPN/LVN training is provided
by technical or vocational schools and consists of 1 to 2 years.
The training is very technical and provides practice in the delivery
of general nursing care. State regulations prohibit practical nurses
from working independently. They must work under the direct supervision
of an RN or physician.
Health Aides:
A person trained in First Aid and CPR might be providing first
aid for students in your school. Some health aides receive additional
training from a school nurse. Health aides are not allowed to practice
independently and should be supervised by a school nurse. Some states
have programs for certification of nurses aides. These programs
vary in length but are usually no more than 3 months long. Nurses
aides are given basic information about basic care of patients such
as bathing, lifting, and monitoring health indicators.
Who makes
the best school nurse?
It depends on
the needs of students and faculty within the school and the defined
role of the school nurse.
The school nurse
role today, when designed to meet the needs of all children requires
expertise in pediatric, psychiatric and public health nursing. The
school nurse also must have current information on health laws and
rules and regulations that apply to school settings. The school
nurse works in an educational environment, frequently lacking in
other medical and nursing support, rather than a health care setting
and must be educated to make independent, critical health care judgments.
School nurses
need to have expertise in pediatrics to provide the quality care
and development of nursing care plans required for children with
multiple disabling conditions and medical procedures such as those
on ventilators. Nursing care plans are essential for those working
with students needing gastrostomy tube feedings, nebulizer treatments,
hyperalimentation supplements and clean intermittent catheterizations.
Depending on the educational background of the school nurse, s/he
has a broad understanding of growth and development and can provide
additional health education for students with chronic illnesses
as well as general health education in the classroom.
With the significant
increase of students with mental health needs the school nurse must
be able to identify, intervene and refer students with such problems
as depression, eating disorders, abuse, bi-polar disorders, attention-deficit
problems and a very complex array of other mental health conditions.
S/he may be responsible for facilitating support groups for students
with a wide variety of medical and mental health conditions.
As the public
health official in the school setting, the school nurse works to
prevent communicable diseases, provides health education and health
screenings, and evaluates the environment to provide for a safe
and healthy environment. The school nurse is often viewed as a “safe”
person within the school setting and serves as the liaison between
the parents, school and medical community. S/he often teaches parenting
classes, teen pregnancy courses and staff wellness programs as part
of her public health role. Additionally s/he serves as a student
health advocate to provide the healthiest learning environment for
all students.
If educators
allow school nurses to define a broad health role beyond first aid
and medication administration, they often find the school nurse
engaged in a number of activities that enhance the emotional and
physical environment of the school community and help students,
parents, and staff feel safe in their environment.
The school nurse
is a professional in your school to help students and staff stay
healthy so that everyone might perform at their highest level. Reports
indicate school nurses have a critical role in preventing student
absenteeism, thereby increasing learning potential. Next time you
see your school nurse ask about her/his background and recognize
the nurse for her/his contributions to your student’s health.
Learn more about
the National Association of School
Nurses.