There Is a Standardized Impression

There is a standardized impression of a school nurse as a woman in a white dress that ministers to sick children until their mothers come to pick them up. The nurse may soothe the fevered brow or take a temperature, but little else. This impression is going by the wayside as more and more school nurses take a proactive stand in the various settings in which they are assigned.

The goal of a school nurse is to addresses acute illness in the student population, of course, but the role has expanded over the last twenty years. The school nurse is now involved in hearing and vision screening, as well as referrals for confirmation testing when tests indicate a problem. School nurses serve as evaluators of health status to include immunization status for all the children in her care, and can also act as an advocate to suggest immunization in a time of epidemic - from immunoglobulins to vaccination for Hepatitis A. The school nurse is also responsible for surveillance and notification to public health authorities when endemic or epidemic disease outbreak is seen in the school setting.

The school nurse need not only be involved in disastrous disease management. In fact, the role for the school nurse in health promotion and disease prevention is likely the most useful. From advocating the hand washing during cold and flu seasons, to educating children on sun screen use in the spring and summer, the school nurse does much to reduce the morbidity of her population. The school nurse may also provide information on smoking and drug avoidance, especially important in the middle school population. Some would say that the intervention programs on drugs and smoking are not useful, but the Centers for Disease Control and Prevention report that the rate of cigarette use in middle school students actually declined from 18.5% to 15% in the years between 1988 and 1999. The major cause of morbidity and mortality in the middle school age population continues to be accidental death - car accidents, drowning, falls, etc. The school nurse can use interaction time with students to educate them on wearing a seat belt, or a helmet when riding a bicycle. The nurse can also provide education on first aid and CPR, perhaps enlisting the Red Cross or the local fire department for assistance in the training. School nurses are also available to help children with disabilities, everything from providing glucose monitoring and insulin administration to the patency of feeding tubes, depending on the special needs population of the school.

The discipline under which the school nurse works determines the scope of practice. The nurse can either be a licensed practical nurse, a registered nurse or even in some cases, an advanced registered nurse practitioner. The degree of education preparation depends upon the degree of licensure and can go anywhere from an Associate to a Master's Degree.