Abstract
School nursing is a unique and challenging area of practice. School nurses’ roots date back to 1902, when in New York City the first school nurse, Lina Rogers was hired to help decrease absenteeism by intervening and educating children and their families about communicable disease prevention. And so it began, school nursing has evolved over the last century. School nurses today continue to address these public health concerns of communicable diseases and absenteeism and also address a myriad of health and wellness needs of school-aged youth in grades pre-kindergarten to grade 12.
The current definition of school nursing helps to articulate this role: School nursing, a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential. (National Association of School Nurses, 2017)
The increasing complexity of the health-care needs in school and the increased responsibilities of the school nurse also create the demand for more research and literature on evidence-based practices to ensure safe, high-quality care for our nation’s most vulnerable population, our children. School nurses face acute care needs, chronic health needs, urgent needs from emerging diseases to crises on school grounds, social emotional concerns, environmental issues, and wellness challenges. This special edition highlights this shift with topics including concussion management, use of epinephrine auto-injectors in schools, overweight and obesity, unaccompanied refugee children, bullying and associated pain, and developing a visible school nurse philosophy. And these topics are just the tip of the iceberg for emerging topics in school health.
This expanding role also calls for an increased need to promote evidence-based care in the school settings. According to Schmidt and Brown (2019), evidence-based practice is a combination of clinical evidence, provider expertise (judgment), and client preferences. Evidence-based practice often results in clinical protocols and clinical guidelines; however, in school nursing, these evidence-based protocols are slower to emerge. I believe this is, in part, due to the paucity of school nurse practice research. School nursing has had to rely on other areas of practice to enhance and inform school nursing practice (e.g., public health, pediatrics, emergency care). As the challenges and needs in school nursing grow, so must the evidence specific to the practice. The National Association of School Nurses is leading this initiative in their research agenda, research grants, and publications; however, it is imperative for all school nurses to commit to the scholarship of the practice.
This scholarship also includes innovation and quality improvement efforts (one of the tenets of the Framework for 21st Century School Nurse Practice). These efforts involve evaluating outcomes. As school nurses implement new practices and care, they also need to collect and analyze data related to that outcome and evaluate its effectiveness in achieving the intended result. Again, many new quality improvement initiatives are occurring in school nursing practice, such as Every Student Counts (National Association of School Nurses, n.d.); however, more are needed.
As you read this special collection of school nursing articles, I challenge you to consider your contributions to school nursing practice. For example, consider ways to engage in the process of evidence-based practice, such as collecting data on areas of concern you experience in your day-to-day work to determine what some best practices might be to address the issue or engaging with a nearby university to develop a research project for your population. School nursing is an exciting and challenging field of practice with many opportunities to contribute.
How will you contribute?