The history of school nursing is more than 100 years old and began in the tenements of New York City. In 1902 Lina Rogers became the first school nurse. She was assigned by Lillian Wald to cover four schools with over 10,000 students to see if onsite care of communicable diseases would improve school attendance. Ms. Rogers made a significant impact in decreasing absenteeism by 90% within the first six months. Word quickly spread, and in the next school year there were more than 27 school nurses in New York schools. By 1914, there were over 400 school nurses assigned to NY city schools, and Los Angeles joined the trend. 1
If you’re a school nurse, you already know the importance of your role. School nurses are the dedicated, licensed health professionals in a school community, whose eyes and ears are an extension of both parents and staff. The role of school nurse has morphed into the Chief Wellness Officer (CWO), even if that is not your official title! There should be a school nurse in the building every day. If not, there are almost 56 million reasons to have one. School nurses have access to 95% of the nation’s 56 million children. But 25% of schools have no school nurse, and more than 35% of schools have only a part-time school nurse. COVID has amplified the contribution of school nurses and the need for each school district to have a comprehensive health services program.
Disease surveillance is one example of the expertise that school nurses provide. Did you know that in 2009, Mary Pappas, a private school nurse in New York, first alerted the local health department to what would become identified as the H1N1 outbreak?2 Student Wellness Services is a more comprehensive title for the enormity of the role that school nurses fill for their communities. School nurses working within the full scope of practice and available resources create a safe and healthy learning environment. They provide a safe place to land and bridge the gap between home and school.
However, to be successful in your role, you need opportunities to lend your expert input to health-related decisions within your school community. To create those opportunities, you need to increase your sphere of influence.
Here are five ways to get started:
1. Be present inside and outside of your school health office
This required a change in my daily routine and was quickly appreciated by staff and administration. Each morning I visit classrooms and do quick assessments of any students with concerns and respond to the teachers’ questions. This one action (in the pre-COVID world) changed the way staff engaged with me. They began to look forward to my morning rounds.
Think of it as a moving shift report. This daily check-in changed the dynamics of the school day. I felt more connected to the school staff by being present outside of my health office. Seeing the school nurse in the hallway, lunchroom, all-purpose room, and gym for non-emergencies creates opportunities for engagement and increases connections.
This strategy is effective in remote learning environments, too! I often visit Google classrooms or Zoom rooms to provide mini health lessons, read to my students, or check in for any questions or concerns.
2. Share your expertise with the school community
According to the Gallup Poll, nurses are the most trusted profession year after year. Leverage that trust and use your extensive professional experience, education, and training to provide information to your school community.
Publicize seasonal health information and current trends you are seeing in school. Embracing the school district’s use of social media helps to promote the work and role of the school nurse. Contribute to health-related content on the district’s website, Facebook, Twitter, or Instagram accounts. The idea is to share your knowledge and translate health information for your school community.
I love writing on my blog The Relentless School Nurse because the messages are brief, 500 words or less. But if blogging doesn’t appeal to you, consider developing a column and naming it something fun and creative. Did you know that infographics are much more effective and widely read than articles? Create an infographic about who you are and what your background is. Let the school community get to know you!
3. Attend Board of Education (BOE) meetings
Ask to speak at a BOE meeting to share a health-related initiative. Let the decision makers know your value, and be prepared to share examples of the work you do.
Nurses have not been adept at promoting their value ― but keeping quiet has not served them well. Think of it as educating administrators and BOE members about the important role of the school nurse. Let them know how you succeed in the role of CWO. Have an “ask.” What can the BOE do together with the school nurse to support student success through a robust school health services program?
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4. Become an active member of your local, state, and national school nursing organizations
As I look back on my twenty-year school nursing career (36 as a nurse), I regret not joining my nursing organizations earlier. I actually waited 10 years to join the National Association of School Nurses and quickly recognized the value in becoming an active member. The rich, high-level professional development opportunities and the camaraderie of being with fellow school nurses are priceless. We are health professionals in an educational setting. What we bring is very valuable, but it is not always recognized or acknowledged, so finding our “tribe” is especially important.
Building leadership skills, learning about trends across school districts, and networking with colleagues are just a few of the many reasons joining professional school nursing organizations helps support your growth and deepen your practice.
5. Embed yourself in the school community
School nurses can be impactful and recognized members of their school community. This happens from being present inside and outside of school. You do not have to live where you work to make this happen; you need to be a valued member of the community. One way to accomplish this goal is to engage in conversations that matter with the experts in our students’ lives: the parents, educators, and caregivers. We are on the same team with mutual goals of having our students flourish in school and life.
For example, I use an evidence-based strategy called a “Community Cafe” to promote parent engagement and seek community-based solutions to issues that arise.3
Example: Community Cafes
Families in our community were over-utilizing the emergency room for non-emergent care. We held a series of Community Cafes to understand the reasons why this was happening. These conversations created a list of concerns that were then brought to the healthcare providers. A Community Collaborative was formed to forge better relationships among school nurses, families, and our pediatric partners. The skies are the limit when we partner with our community!
The overarching message is that school nursing must be done in collaboration with many partners. We cannot work in isolation. Visibility is key to personal fulfillment and a robust health services program. Stepping outside of our health offices and school buildings and embedding ourselves in school communities solidify our role as the CWO. In this way, administrators recognize they can lean on us to help inform crucial health-related decision making in our schools and communities.
SOURCES
1 Hanink, E. (2014). The School Nurse. Lina Rogers Struthers. The School Review, 26(4), 308-309. doi:10.1086/436913
2 Molyneux, J. (2016, November 21). AJN Speaks With Mary Pappas, School Nurse Who Alerted CDC to Swine Flu Outbreak. Retrieved January 01, 2021, from https://ajnoffthecharts.com/mary-pappas-school-nurse-just-carrying-on-despite-swine-flu-outbreak/
3 Cogan, R. (2018, June 01). Power of Community Engagement. Retrieved January 01, 2021, from https://relentlessschoolnurse.com/2018/06/01/the-relentless-school-nurse-power-of-community-engagement/