Back to Class: Perspectives on School Nursing
December 18, 2020
Response by Carol Schaumleffel to “School Nursing and Population Health: Past, Present, and Future” by Martha Dewey Bergren (September 30, 2017).
Today’s school nurses are part of a specialty practice that provide a broad scope of nursing care to school staff, students, and the community. The school nurse role is often underestimated as one who merely handles acute and chronic medical issues, however, this representation is not accurate. School nursing is grounded in population health, therefore, health promotion and illness prevention are also within the school nurse’s responsibility (Bergren, 2017). Furthermore, the twenty first century school nurse is a leader and change agent who implements quality improvement into daily practice and provides care coordination to children and families (Buswell et al, 2018).
With the recent COVID-19 pandemic, a novel coronavirus that causes severe pulmonary damage, pneumonia, ARDS, and death, (Huang et al, 2020) various disciplines are necessary to plan for safe re-opening of K-12 schools. The school nurse is ideally positioned to assist administrators, board members, and community stakeholders with the re-opening planning process. Their healthcare background and nursing experience is essential in the prevention and mitigation of COVID-19 within the school community.
In March of 2020, the COVID-19 pandemic changed numerous segments of society. Our normal, everyday approach to conducting our lives was forever altered. To flatten the curve of virus progression and decrease the load on hospitals, schools closed and students were sent home to finish the school year via online instruction. The pandemic created uncertainties and left everyone questioning if K-12 schools would re-open in the fall. Although the planning process is fluid, many K-12 schools aimed to re-open in the fall for in-person instruction.
School nurses have many questions about re-opening guidelines and how to keep everyone safe while mitigating the virus. Many have voiced concerns about the following: availability of personal protective equipment, screening protocols, the management of a suspected COVID illness, the availability of isolation rooms, treatment of students with non COVID symptoms, staffing, and protection of vulnerable students and staff. These are rational concerns. Therefore, it is imperative school nurses are included in the re-opening planning for their school.
In closing, every child and every school deserves the services of a licensed school nurse at all times. This is especially the case during the COVID-19 pandemic. This staffing would require legislative action and funding. There are frequent disparities between rural and urban schools (Ramos et al, 2014). Many urban schools routinely have additional funding providing the ability to hire additional school nurses. Conversely, rural schools often have one nurse for an entire district or none at all. In light of the COVID-19 pandemic, school nurses should be mobilized as a key component of school reopening planning and implementation. Every school should hire a school nurse for acute disease prevention as well as maintenance of staff, student and community health and welfare.
Carol Schaumleffel, DNP, RN, LSN
Bergren M. D. (2017). Expanding the sphere of school nursing influence. The Journal of School Nursing, 33(4), 257–258. doi: 10.1177/1059840517717335
Buswell, S., Lechtenerg, J., Hinkson, E., Cowan, T., Combe, L., Fekaris, N., Chau, E. (2018). The role of the 21st century school nurse. NASN. Retreived from: https://www.nasn.org/advocacy/professional-practice-documents/position-statements/ps-role
Huang, C., Wang, Y., Ren, L., Zhao, J., Hu,Y., Zang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W,. Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y..., & Coa, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 395(10223), 497-506. doi: 10.1016/S0140-6736(20)30183-5
Ramos, M., Fullerton, L., Sapien, R., Greenberg, C., & Bauer-Creegan, J. (2014). Rural-urban disparities in school nursing: Implications for continuing education and rural school health. The Journal of Rural Health, 30(3), 265–274. doi: 10.1111/jrh.12058