Public Health Nurses In Schools

Healthy children are successful learners. The public health nurse in schools has a multi-faceted role within the school setting, one that supports the physical, mental, emotional, and social health of students and their success in the learning process. It is the breadth of nursing activities contained within the role of the public health nurse in the schools and the unique non-medical setting that differentiates school nursing from other nursing specialties.

Richland Public Health provides School Nursing Services to: 

  • Lucas Local Schools
  • Plymouth/Shiloh Local Schools
  • Ontario Local Schools
  • Pioneer Career and Technology Center
  • Foundation Academy
  • IMAC
  • Mid-Ohio Preschool
  • Sacred Heart Catholic School
  • St. Mary’s Catholic Church School

If you would like to know more about Richland Public Health nursing services for your school, please call 419-774-4545 or aschmidt@richlandhealth.org

Hearing and Vision 

  • Vision
    Children are screened for vision in:
  • Preschool
  • Kindergarten
  • Grades 1, 3, 5, 7, and 9
  • May also be screened if they are on an Individualized Education Plan (IEP) or at any time at the request of the parent or teacher.

Parents or guardians of children who do not pass a vision screening receive a written request to have the child’s vision evaluated by a licensed ophthalmologist (eye doctor).

Hearing
Children are screened for hearing in:

  • Preschool
  • Kindergarten
  • Grades 1, 3, 5, 9, and 11
  • May also be screened if they are on an Individualized Education Plan (IEP) or at any time at the request of the parent or teacher.

Parents or guardians of children who do not pass a hearing screening receive a written request to have the child’s hearing evaluated by an ear, nose and throat doctor.

Richland Public Health provides Vision and Hearing Screenings for:

  • Richland Academy School of Excellence
  • Discovery School
  • Seventh Day Adventist School

“Good health supports successful learning. Successful learning supports health. Education and health or inseparable.” — Desmond O’Byrne (2001) Education and Public Health: Natural Partners in Learning.

Role of the Public Health Nurse in Schools
A registered professional school nurse is the leader in the school community to oversee school health policies and programs. The public health nurse in schools serves in a pivotal role to provide expertise and oversight for the provision of school health services and promotion of health education.   Using clinical knowledge and judgment, the public health nurse in schools provides health care to students and staff, performs health screenings and coordinates referrals to the medical home or private healthcare provider.  The public health nurse in schools serves as a liaison between school personnel, family, community and healthcare providers to advocate for health care and a healthy school environment.

History
The practice of school nursing began in the United States on October 1, 1902, when a school nurse was hired to reduce absenteeism by intervening with students and families regarding health care needs related to communicable diseases. After one month of successful nursing interventions in the New York City schools, Lina Rogers, the first school nurse, was able to provide leadership to implement evidence-based nursing care across the city.  The school nurse’s role has expanded greatly from its original focus, the essence and goals of the practice remains the same.

Purpose
A student’s health status is directly related to his or her ability to learn.  Children with unmet health needs have a difficult time engaging in the educational process.  The public health nurse in schools supports student success by providing health care through assessment, intervention, and follow-up for all children within the school setting. The public health nurse in schools addresses the physical, mental, emotional, and social health needs of students and supports their achievement in the learning process. The public health nurse in schools not only provides for the safety and care of students and staff but also addresses the need for integrating health solutions into the education setting.

The number of children that have a chronic condition has increased dramatically over the past four decades.  Chronic conditions such as asthma, anaphylaxis, type 1 diabetes, epilepsy, obesity and mental health concerns may impact the student’s ability to be in school and ready to learn.  

Special health care needs have also increased dramatically over the past decade. Students are coming to school with increasingly complex medical problems, technically intricate medical equipment, and complicated treatments (Robert Wood Johnson Foundation, 2010). The school nurse is defined as a registered professional nurse who has a commitment to lifelong learning.  Educational preparation for the school nurse should be at the baccalaureate level, and the school nurse should continue to pursue professional development and continuing nursing education.  The school nurse typically practice independently and are called upon to assess student health, develop and execute plans for care management, act as first responders, and engage in public health functions such as disease surveillance, immunization compliance, and health promotion.  The public health nurse in schools is a vital member of the school team that leads change to advance health and collaborates with school staff members, parents and community members to keep students safe at school and healthy to learn.

The public health nurses in schools facilitate normal development and positive student response to interventions.
The public health nurse in schools serves as the health care expert in the school to meet student health needs with an understanding of normal growth and development in children and youth as well as students with special needs.  The school nurse develops plans for student care based on the nursing process, which includes assessment, interventions, and identification of outcomes and evaluation of care (Wolfe, 2006).

The public health nurse in schools provide leadership in promoting health and safety, including a healthy environment.
The public health nurse in schools provides health-related education to students and staff in individual and group settings and provides consultation to other school professionals, including food service personnel, physical education teachers, coaches, and counselors.  Responsibilities in the provision of a safe and healthy school environment include the school nurse’s monitoring of immunizations, managing communicable diseases, assessing the school environment for safety to prevent injury and spearheading infection control measures.   The public health nurse in schools is also a leader in the development of school safety plans to address bullying, school violence, and the full range of emergencies that may occur at school (Wolfe, 2006).

The public health nurse in schools provide quality health care and intervene with actual and potential health problems.
Health care for chronic and acute illness, as well as injuries in the school setting, is a major focus of the role of the public health nurse in schools.  The public health nurse in schools is responsible for medication administration, health care procedures, and the development of health care plans.  Students often have multiple needs that should be examined in order for the student to be able to be successful in the classroom, and school nurses often engage in health screenings that include vision, hearing, body mass index, mental health index or other screening procedures (often based on local and state regulations) to address those issues (Wolfe, 2006).

The public health nurse in schools actively collaborate with others to build student and family capacity for adaptation, self-management, self advocacy and learning.
Coordinating the linkage between the medical home, family and school is an important aspect of the role of the public health nurse in schools.  The public health nurse in schools has health expertise that is essential to school educational teams, such as the Committee on Special Education, the Individualized Educational Plan (IEP) team and the Section 504 Team so that health-related barriers to learning can be reduced for each student.  The public health nurse in schools can provide families with referral information along with available community resources to improve access to health care.  The public health nurse in schools can also assist families in obtaining health insurance as needed and can represent the school on community coalitions to advocate for school-based health care (Wolfe, 2006).

The public health nurse in schools use clinical judgment in providing case management services.
The public health nurse in schools receives medical orders to guide the health care needed to assist each student to be safe and successful at school.  As in other clinical settings, the nurse develops Individualized Healthcare Plans (IHPs) in nursing language to direct nursing care for students as well as Emergency Care Plans (ECPs) written in lay language to guide the response of unlicensed personnel in a health-related emergency.  Both plans are tailored to the individual needs of a specific student to improve expected care outcomes.  The nurse makes decisions related to the appropriate delegation of healthcare tasks as directed by state laws and professional practice guidance (American Nurses Association [ANA]/National Council of State Boards of Nursing [NCSBN], 2006).  As medical and information technology advance and change, it is imperative for the school nurse to pursue professional development so the school nurse is able to provide the best possible care for the student population (Wolfe, 2006).

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