Abstract
The beginning of a school year offers a fresh start to build upon ongoing nursing practice improvement efforts and to forge ahead with new initiatives. Although the daily activities of a school nurse trend toward the provision of care for individual students, addressing issues at the population and systems level yields broader results. This aspect of the school nursing role, the responsibility to protect and promote the health and well-being of the entire school community, is an integral part of the public health system.
Public health is a complex infrastructure (Knickman & Elbel, 2019) that encompasses multiple factors that profoundly affect the lives of American families, such as access to and the quality of food, housing, transportation, clean air and water, and education. Unless something like a pandemic disrupts normal life, most public health activities have the propensity to go unnoticed because the interventions are effective at keeping people healthy. Similarly, this characteristic as a hidden health care applies to school nursing.
However, there are a couple of silver linings to living and working through a global pandemic (Lossio-Ventura et al., 2021). One is that the role of the school nurse has become more visible and second, that the worlds of health and education necessarily aligned more closely to address the common goal of providing a healthy and safe environment for students and staff. As school nurse professionals who bridge the health care and education systems, let’s not let these positive developments fade, because as the public health challenges of the pandemic ebb, other pressing issues are rising.
In light of ongoing societal issues of gun violence and horrific school shootings, it is increasingly imperative for school nurses to cultivate their involvement as part of school leadership teams and community partners, to address and promote mental health and to work relentlessly toward the reduction and prevention of school violence. It will take monumental sustained, multi-pronged efforts to ensure safe and supportive learning environments for all students (National Association of School Nurses [NASN], 2022b; National Academies of Sciences, Engineering, and Medicine [NASEM], 2019).
To improve and strengthen both health and learning outcomes in our nation’s schools, collaborative partnerships between health and education system agencies are essential (Kolbe, 2019). As part of the educational system, school nurses’ insights and expertise are needed in the development of services, policies, and systems that support conditions in which school-age children can thrive and successfully learn. Resources such as those provided by the Association for Supervision and Curriculum Development (ASCD; 2014), a national nongovernmental education organization, are available to help schools implement the Whole School, Whole Community, Whole Child model (WSCC) for education (Centers for Disease Control and Prevention [CDC], 2021). This directive summons greater alignment between the education, public health, and school health sectors with the overarching goal to improve each child’s cognitive, physical, social, and emotional development. The approach clearly calls for school nurses everywhere to strive for unified integration between education leaders and health sectors.
In addition, a recent CDC initiative, built upon the objectives of preventing chronic disease and promoting healthy behaviors, seeks to advance health equity in K–12 schools. As one of the grant recipients, the NASN will promote work with state education agencies, districts, schools, and school nurses across the country to develop, implement, and evaluate evidence-based policies, practices, and programs. These projects will use school nursing modalities to initiate innovative approaches to expand access to physical, mental, and behavioral health services in underserved communities to improve school health services delivery for students (NASN, 2022a). Watch for opportunities to contribute to this innovative venture to build a better system to meet the needs of students.
School nurses have risen to meet many challenges, and they have the capability to serve as change agents to affect system transformation (Selekman et al., 2019). Driving collaboration and cohesiveness between health and education calls for systems-level leadership. NASN’s (2016) Framework for 21st Century School Nursing Practice™ leadership component describes school nurses as school community change agents and advocates. Health care transformation and educational reforms require ongoing quality improvement efforts. Accomplishing these endeavors has the potential to accelerate progress toward achieving health equity and closing school-age youth academic achievement gaps (Doremus, 2021).
As we launch into the new school year, take time to observe, reflect, and evaluate how the systems of health and education function together in your school community. Envision how you may lead as a school nurse to help shape and transform them. It is time to continue to advocate and seek ways to strengthen partnerships across the two systems for positive health outcomes, academic success, advancing health equity, and to be prepared to respond to ongoing and potential future challenges.
School nurses have a key presence and a resounding voice. Advocate, both individually and as a group, to drive transformation with education colleagues that makes a positive difference in the health and education of students. Make the most of state and national resources and engage the support of NASN and other organizations for inspiration and strength as we head into this next academic year.
Please feel free to reach out to me with any thoughts or comments.
Yours in service,
