Abstract
Over the past few decades, we have witnessed a greater understanding of many diseases, the development of innovative treatments, as well as many new medications that have contributed to the many miracles possible in today’s health care. Much time and energy have been invested in achieving these advances, which have reduced the morbidity and mortality of many life-threatening conditions. In spite of this progress, however, many Americans, both adults and children, do not achieve optimal health.
In the past few years, media reports on television and in newspapers and magazines outlining the health problems of Americans have become frequent. We hear about the stress children and families are facing as they try to balance many activities and demands. There have been reports that many Americans do not get enough sleep or relaxation, as well as concerns about tobacco, alcohol, and other drug use. Finally, the epidemic of obesity has drawn attention to the importance of good nutrition and regular exercise.
There seems to be a new urgency in tackling the physical and mental health problems that reduce our productivity and longevity. These health problems not only contribute to lifelong chronic conditions, but they also are a costly use of resources. To deal with the health problems that plague today’s population, we need to look beyond the advances of modern medicine to prevention through positive health behaviors. There is a growing realization that many health problems have their origins during childhood. Therefore, to successfully prevent long-term problems, the target audience for prevention is children and families.
School nurses, frequently the only health professional in the school setting, have the opportunity to advocate for the health of the students, families, and community they serve. They have a role to play in health education and policy development that will promote the health of the school community. They also have an obligation to serve as a role model for positive health practices.
In this issue of the Journal, a study of the health practices of school nurses is presented (Petch-Levine, Cureton, Canham, & Murray, 2003). Three hundred and eighty-eight school nurses from California reported health practices related to exercise, nutrition, relaxation, safety, substance use, and other health-promoting behaviors. The researchers found that although the school nurses reported that they ate breakfast, avoided the use of tobacco and alcohol, and engaged in safety behaviors such as wearing seat belts, they had low scores on the health practices of exercise and relaxation. In addition, most indicated that they did not get the recommended 8 hours of sleep nightly. Finally, 54% reported being overweight.
To be a credible role model, school nurses need to do more than promote health—they need to model healthy behaviors in the school setting.
In order to be an effective advocate for positive health practices, school nurses need to consider the message they convey by their health practices. To be a credible role model, school nurses need to do more than promote health—they need to model healthy behaviors in the school setting. This extends beyond the health office to the classroom, lunchroom, and meeting room. It is essential to care for oneself so that one can care for others. This begins with adequate sleep to provide the energy to cope with the demands faced in the practice setting. It extends to managing stress, maintaining a positive outlook on your job and life, and cultivating a sense of humor. School nurses can model stress management techniques by maintaining a calm demeanor in the face of stress (and chaos) and establishing and following through on priorities. Often this may entail determining what is possible in the time allotted, avoiding trying to be all things to all people, and learning to say “no” to requests that extend you beyond the time available. Try to avoid doing a little bit of everything but not much of anything. Remember, anything worth doing is worth doing well.
Another concern is nutrition. Although most (66%) of the school nurses in the study in this issue reported eating breakfast, many skip lunch. It is time for school nurses to decide that their health is important enough to take or make the time to eat lunch. Not only will this provide nutrition for the afternoon, but it will also discourage overeating later in the day. Eating lunch also provides an opportunity to observe nutrition practices of students, to collaborate with staff, and to role model good nutrition practices.
Modeling the importance of exercise is also important. The study reported in this issue of the Journal found that “school nurses were least compliant in exercise health practices” (p. 276). Only 26% engaged in moderate daily activity, and only 22% got aerobic exercise at least 3 times per week. Involvement in a regular fitness program, whether it be walking, running, lifting weights, or regular participation in some other vigorous physical activity, will promote a sense of well-being, prevent osteoporosis, promote mental health, assist in the maintenance of an optimal weight, and enhance strength and flexibility.
School nurses are busy people, but they have an opportunity and responsibility to work with children and families in providing the health education needed to assist the next generation in avoiding the chronic health problems prevalent in today’s society. They also have an obligation to promote health among staff members who have daily contact with students, because their actions will speak louder than the information they are giving in the classroom, lunchroom, or playground about health.
Mandy Mayer, a school nurse from Vermont, recently shared a program she designed for the staff at her school, “Walk Around Vermont,” with subscribers of the school nurse listserv. Pedometers were used to tally the steps taken as staff members “walked” through each county in the state of Vermont. Progress was marked on a state map with a laminated sneaker for each county completed. The final prize was a gift certificate to an athletic shoe outlet. Mandy found “that in order to encourage staff wellness, I have to live it LOUDLY. . . . I think living by example is truly the best motivator for others.”
Although school nurses in the study reported in this issue engaged in many positive health practices, such as wearing seat belts, avoiding smoking, and getting regular dental exams, over half stated that they did not maintain their optimal weight, get regular exercise, or participate in stress-reduction strategies (Petch-Levine et al., 2003). Because childhood is such an important time in forming positive lifestyle behaviors that will last a lifetime, school nurses need to reflect on what messages they are communicating about health in their daily activities and health practices. As Mandy Mayer stated, to encourage wellness, you need to live it LOUDLY!