Hospitals, the end destination for seemingly all nursing students after they have braved the storm of nursing school and conquered the NCLEX. We are conditioned to work in hospitals first and foremost. For most nursing students, the thought of community nursing makes them shudder. No hustle and bustle up and down the unit? No heavy wow cart to push to and fro? No symphony of alarm bells? Then it must not be “real” nursing. Unfortunately, that was my mindset until I was able to experience a bit of community nursing with a school nurse.
At first I did not know what to expect. As a grade school student, I really only saw the school nurse when screenings were being done or if I got a “boo-boo.” As a high school student, I would go into the nurse’s office and be welcomed to hoards of students cutting class. I never really understood the concept of being a school nurse. I always assumed, like the general public, that it was all about band-aids, runny noses, and stomach aches. But I was in for a pleasant surprise during my senior capstone project at a school in Bloomfield, New Jersey.
So, what exactly is school nursing? The National Association of School Nursing defines it as “a specialized practice of professional nursing that improves the well-being, academic success and life-long achievement and health of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy, and learning.”
School nurses have a crucial role within the school health system. Care must be given seamlessly to provide excellent services to children and youth alike. There has been an increase in the number of students with chronic health conditions that require the best nursing management daily. Critical thinking, proper assessment and good judgment skills are imperative because this job is very autonomous.
Understanding of school nursing is needed to promote the work of school nurses everywhere. Individuals are very misinformed and school nurses must work to increase the knowledge of school nursing practice as well as the unique culture that exists within the school setting. To help promote the work of school nurses, I am going to share with you a little bit about the lessons I learned during my preceptorship:
1. School nursing is highly autonomous.
When school nurses encounter an emergency, there is no code cart, no rapid response team or code blue. Their clinical judgment carries them. Those quick judgments save lives.
2. School nurses know their students.
During my clinical preceptorship, the experience showed me how much this is true. My preceptor knows all of her students inside and out. She knows who her “frequent flyers” are and this gives her an advantage when taking care of students. She is able to tell when one of her students “doesn’t look right” because she knows them intimately and they all know her.
3. School nurses do a lot.
You are probably thinking, what nurse doesn’t? The days would be busy and nonstop. From the minute my preceptor would clock in she would be running around. We would do attendance; administer medications; follow up on immunization records; have vision, hearing, weight, and height screenings; provide health programs; take care of the 20+ students coming in; and occasionally breathe when we had the chance. My preceptor sometimes would even become the receptionist if the receptionist was not in. Frankly, I think she was superwoman.
4. School nurses are advocates.
When a child in the school needs specific intervention or class needs, the school nurse is a major advocate. I watched as my preceptor advocated on behalf of students to administrators, teachers, and school staff. She understood family dynamics as well as the student holistically and could give a different perspective that was needed at staff meetings.
5. School nurses have to be culturally (and medically) competent.
During my preceptorship, we took care of children with a range of health issues. Within the school we had children with autism, asthma, ADHD, speech and language problems, physical disabilities, mental health issues, and so much more. She had children of all nationalities and backgrounds. She was not afraid to attempt Spanglish with students and family members to assess their needs. She was able to connect with many children and families and give them the best care possible.
School nursing is completely different from the nurse’s life you are taught about in nursing school. Sure, you don’t have IV lines to assess or the joy of inserting a Foley catheter to get excited about, but it can be a very rewarding job. I hope that many more people look into community health positions like school nursing. It’s more than just band-aids—it is about holistic care of students and their families. Would you look into being a school nurse one day?