BATAAN PENINSULA STATE UNIVERSITY

MAIN CAMPUS
College of Nursing and Midwifery www.bpsu.edu.ph

City of Balanga, 2100 bpsucnm_2007@yahoo.com

Bataan 2016@gmail.com

Fundamentals of
Nursing Practice
(NRCM0103)

MAHILUM, PRINCESS NICOL

MAKIDATO, KIM
MALIXI, INA CARMELA
MALIXI, JIM
BSN – 1C
Topic: School Health Nursing

Manuscript
School nurses wear many hats in the school setting. They provide care for minor
illnesses and injuries; give or supervise health care for children with special health care
needs; monitor health screenings; advocate for students; participate in multidisciplinary
teams; and counsel students, families, and school staff.

An important role for nurses in all settings is health education. In nursing education
programs, much emphasis is given in the classroom and in the clinical practice setting about
the importance of patients or clients understanding their health care requisites in order to
restore, maintain, or promote health. This information enables them to make informed
decisions, cope more effectively with temporary or long-term alterations in health, and to
assume greater personal responsibility for their health. Most nurses are quite comfortable
delivering information to patients/clients and families on the individual level. One on
one teaching, also known as patient teaching, usually focuses on the specific information
needed by an individual at this particular time. It can be customized to the individual’s
situation and his or her level of understanding, validated during the interaction, and questions
answered during the teaching session. This type of teaching is done by nurses in all
settings, including school nurses in the school health office. From a cost-effectiveness
perspective, individual patient teaching is a time-consuming and expensive nursing
intervention. A more cost-effective method of health education is to target large groups
interested in specific topics such as nutrition and weight loss, groups at risk for certain
conditions such as sexually transmitted diseases, or groups who have a need for specific
information such as hand washing or oral hygiene.

BEGINNING OF SCHOOL NURSING

 The practice of school nursing began in the United States on October 1, 1902, when
Lina Rogers, the first school nurse, was hired to reduce absenteeism by intervening with
students and families regarding healthcare needs related to communicable diseases.
After one month of successful nursing interventions in the New York City schools, she
led the
 implementation of evidence-based nursing care across the city (Struthers, 1917). Since
that time, school nurses continue to provide communicable disease management, but their
role has expanded and is increasingly diverse.

 A student’s health 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 school
nurse supports student success by providing health care through assessment, intervention,
and follow-up for all children within the school setting. The school nurse addresses: the
physical, mental, emotional, and social health needs of students and supports their
achievement in the learning process.

 Students who are medically fragile or who deal with chronic health issues are coming to
school in increasing numbers and with increasingly complex medical problems that
require complicated treatments commonly provided by the school nurse. Chronic
conditions such as asthma, anaphylaxis, type 1 and type 2 diabetes, epilepsy, obesity, and
mental health concerns may affect the student’s ability to be in school and ready to learn.

 The National Survey of Children with Special Healthcare Needs has determined that
11.2 million U.S. children are at risk for chronic physical, developmental, behavioral, or
emotional conditions. These students may require health related services in schools (U.S.
Department of Health and Human Services, Maternal and Child Health Bureau, 2013).

 School nurses address the social determinants of health, such as income, housing,
transportation, employment, access to health insurance, and environmental health.
Social determinants are identified to be the cause of 80% of health concerns. In the
United States, nearly one quarter of children attending school live in households below
the federal poverty level (United States Census Bureau, 2014). Children from lower
income families have a more difficult time accessing medical treatment for chronic
diseases

TO PRESENT

Although some of the steps in preparing teaching for individuals are the same as
preparing an educational program for a group, there are a number of factors that must be
considered when delivering health education to a group. Many baccalaureate nursing
education programs emphasize health education in community health nursing and have
 content on the process of developing, implementing, and evaluating educational
programs. Practicum students in community settings, including schools, often develop and
implement health education programs as part of their clinical experience. School nurses need
to continually develop their skills as health educators in the school setting. This not only
includes information about topics of interest that are appropriate for the school-age
population, but also encompasses the skills needed in doing a needs assessment, writing
objectives, developing programs, selecting strategies used in delivering programs, and
devising measurement tools needed to determine the outcomes or effectiveness of health
education.

As student population becomes medically delicate these days, educational

departments and establishments continue to take consideration of employing licensed
nurses in school premises, particularly delegating them in school clinics in order to provide
basic medical needs among students and school personnel.

 But what is being a school nurse exactly? Although you have already met this term in your lessons
during your nursing student years, if you were not able to set foot in a school clinic as a school
nurse, you will not know the entire roles and responsibilities of a school nurse. Basically, what you
will most likely believe about school nursing is that it is a kind of nursing job that requires you to
stay inside a school clinic and wait until a student arrives and requests you to apply dressing to his
wound or asks you for a medicine to relieve his tummy aches.

Exactly. But, school nursing is not only limited to performing basic first aid management
and administering over the counter medications to students. It generally involves a wide range of
assignment.

MAJOR TASK / OBLIGATIONS / RESPONSIBILITIES

In a school setting, students and school personnel are the main clients of a school nurse. And as
part of school nurse’s responsibilities, he or she does the following tasks:

1. Provide health assessment.

 Just like in a hospital or clinical setting, the scope of school nursing also focuses on the nursing
process which basically emphasizes the importance of health assessment. A school nurse obtains health
and developmental history to the clients by taking their weight, height, vital signs and assessing their
general well-being. The data the school nurse obtains will be recorded and will become the basis of the
clients’ health status. Furthermore, a school nurse also identifies any underlying condition by screening
the clients and determining any abnormalities that are found through physical examinations.

2. Implement nursing health plan.

Once health problems are documented and interpreted, a school nurse develops nursing plan and
provides appropriate management according to the client’s condition. A school nurse may administer over
the counter drugs for minor ailments and provide specific interventions according to the client’s health
needs. For serious illnesses and injuries that are beyond a school nurse’s scope, clients are referred to
other community health resources for further management.

3. Render health teachings.

A school nurse provides up-to-date health information to clients by doing classroom to classroom
visitations every week. Information regarding the importance and proper tooth brushing, benefits of good
nutrition and hygiene, and maintenance of a clean and healthy environment that is conducive for learning
are few information a school nurse may impart to the students as well as to the school personnel.

4. Promote control of communicable diseases.

A school nurse should also act as a health specialist by encouraging the clients to prevent
communicable and infectious diseases. He or she is expected to assist certain programs such as
immunization programs, early detection, and reporting of transmissible diseases.

5. Assist any health-related activities.

A school nurse is also tasked to assist activities that he or she conducts such as dental extraction,
medical examinations, local government health monitoring, food safety inspection, deworming programs,
feeding programs and many other health-related activities.

6. Evaluate client’s progress towards attaining better health.

 A school nurse evaluates whether his or her health plans met the desired outcome by continuously
monitoring and documenting client’s progress.

Duties:

 The school nurse is responsible to look after the health of the children and the staff of the school
 They have to tend to them if they injure themselves of fall ill
 They have to administer them simple medication but if the problems is serious they have to call
the paramedics
 They have to do regular health checks on all the students
 They have to report to the class teacher and parents if any student has taken ill
 They have to know about which student has what allergies and should know what to do in case of
a reaction
 They have to watch students closely for signs of injuries or abuse as this is quite common
 They have to keep updates on students suffering from major illnesses and are receiving treatment
 The school nurses have to make a chain of communication with the teachers and parents if any
child is unwell and requires special attention
 They have to have reports on students who regularly fall ill or injure themselves

ADVANTAGES AND DISADVANTAGES

Pros
It is safe to say that when most people start nursing school, they are excited and optimistic about
entering a rewarding career path. As nurses, you have life-changing impacts on your patients and you will
make a difference. It is a service career and there will be days that you might have the opportunity
to save someone’s life.

As a school nurse, you will be helping to care for sick children and teenagers, and this job
can be just as rewarding as any other type of nursing profession. You never know what you might
come across in a school setting, and there will be times when students will really need your help.

You will also likely be involved in educating children or teenagers on health. If you enjoy
both practicing nursing and teaching about health, becoming a school nurse could be a great option for
you.

If your dream is to work with children or young adults, being a school nurse could be a great
choice for you. Also, if you have children of your own, your hours will be closely aligned with your
schedules and this will be extremely helpful in taking care of your family.
 Many school nurses have reported that they feel less stress working in a school compared to
other nursing environments. They enjoy their own office, as well as having the weekends, holidays and
summers off. On top of that, they also get snow days. Nurses who work in hospitals cannot always take
the day off when the weather is bad.

Cons

There are also certain aspects of being a school nurse that are not as appealing. If you are not
comfortable handling bodily fluids such as vomit, you might want to look into a different route of
nursing.

Typically, people don’t go into the field of nursing for the money. However, if you are concerned
about making the most money you can as a nurse, school nurses make a lower salary when compared to
other types of nurses. Based on national surveys, school nurses make an average salary of P20, 000, staff
nurses make an average of P25, 000 annually and travel nurses can make more than P40, 000 per year.

The salary of a school nurse can also vary depending on the school’s budget. This is not
always comforting, as school budgets are frequently changing, and at times they are cut. All nurses have
very major, even life-depending responsibilities. School nurses often have to oversee the health of the
whole school, sometimes on their own, along with all of the other tasks they perform. Before accepting a
job as a school nurse, be sure to inquire if you are the only nurse at the school and what additional
responsibilities you will have.

QUALIFICATIONS / REQUIREMENTS
School nurses are registered nurses (RNs). Beyond this basic requirement, every state has different
education and certification standards, so it’s important to learn your state’s requirements before choosing
a school nursing program.
 To become a school nurse, you will need to acquire these skills and meet these requirements:

 You will need to develop advanced skills, including the ability to practice independently,
supervise others and delegate care in a community setting.
 You will need either a bachelor’s degree in nursing (BSN) or a master’s degree (MSN). Some
states require a bachelor’s degree and others require a master’s degree, so you’ll need to research
the requirement in your state.
 You may be required to achieve certification as an RN as well as teacher certification.
 You may also pursue an interdisciplinary education to earn a Master’s Degree in Education,
Public Health or Counseling.

AVERAGE SALARY
 The average salary for a school nurse is ₱13,954 per month in Philippines.

OTHERS
- How many hours do school nurses’ work?
 A school nurse typically works fewer than eight hours a day, a time frame that
corresponds to the length of the school day. That typically means a routine
Monday through Friday workweek, with time off over summers and other school
breaks.

- What conditions can a school nurse expect to treat?

 In the midst of all those job duties, school nurses do still treat patients who fall ill
during the school day. As you might imagine, they may encounter childhood
illnesses more often than nurses who work in other settings. Chicken pox, head
lice and asthma attacks are all part of a day’s work for a school nurse.

But just like other types of nursing, school nurses aren’t exempt from the
occasional unusual case. In this varied nursing setting, only one thing is a
guarantee: “Every day is different from the one before.”

- What is the work environment like as a school nurse?

 It’s no surprise that schools are the work environment for these nurses, but keep
in mind that there are many different types of schools to choose from. School
nurses working in preschools or elementary schools may have very different job
duties from those working in a high school or college setting. For example, nurses
who work with older students will have more responsibilities related to sexual
health education.

Nurses at any school should expect to spend plenty of time interacting with
students, both one-on-one with patients and in larger groups as they provide
screening or education. They also collaborate with other adults in the school
system, as well as parents, to ensure that students remain healthy.

School nurses also enjoy more predictable work hours than their hospital
counterparts, who may be called upon to work 12-hour shifts and odd hours like
overnights, weekends or holidays. A school nurse’s work hours will roughly
follow the school’s schedule.

Is school nurses essential in health care?

 Last Jan. 31 2020, the Department of Education (DepEd) came up with an
official statement on COVID-19 providing a directive to its personnel on
managing this health situation. Our school administration, staff members, parents,
and students must work together to promote and nurture a safe environment for
our students. Emergencies such as the COVID-19 outbreak in the school setting
are likely to happen. Those involved in the care of students must be prepared to
meet the demands of such emergencies.
The role of our school nurses, although small in number, is of vital
importance. They are leaders and integral partners of school staff and outside
agencies in developing comprehensive school plans/procedures for educating and
training staff, providing surveillance and reporting, and assisting survivors with
their immediate psychological and emotional needs; caring for students with
special needs; and ensuring injury prevention and proper evacuation, among
others.

To optimize student health, safety, and learning, the DepEd should mobilize its
school nurse workforce and harness them as health care providers who are
essential members of the leadership team from the district, regional, and to the
national levels. It can utilize their expertise in assessment, planning,
implementation, and evaluation, because our school nurses can provide valuable
insights on school campus emergency management such as prevention/mitigation,
preparedness, response, and recovery. We believe our school nurses play an
essential role in keeping our children healthy, safe, and ready to learn.

- School Nurse Organizations

If you’re interested in becoming a school nurse or would want to learn more,

check out these organizations, websites, and societies for school nurses:

 National Association of School Nurses (NASN) – Largest and widely

recognized association of school nurses. Its position is “To optimize student
health, safety and learning, it is the position of the National Association of
School Nurses that a professional registered school nurse be present in every
school all day, every day.”
 National Board for Certification of School Nurses (NBCSN) – Advances the
quality of school health services & school nurse practice. Their rigorous
credentialing sets the professional standard for school nursing.
 American School Health Association – The mission of the American School
Health Association is to transform all schools into places where every student
learns and thrives. They envision healthy students who learn and achieve in safe
and healthy environments nurtured by caring adults functioning within a
coordinated school and community support systems.
  The Journal of School Nursing – The Journal of School Nursing (JOSN) is a
bi-monthly peer-reviewed forum for improving the health of school children and
the school community.

Power point Presentation

file:///C:/Users/nfban/Downloads/GROUP-3-SCHOOL-
NURSING.pdf
 Many baccalaureate nursing
education programs emphasize
health education in community
health nursing and have content
on the process of developing,
implementing, and evaluating
educational programs.

As student population becomes

medically delicate these days,
educational departments and
establishments continue to take
consideration of employing licensed
nurses in school premises, particularly
delegating them in school clinics in
order to provide basic medical needs
among students and school personnel.
Photo Documentation of the group during
presentation
5 Item Activity

TRUE OR FALSE

1. An important role for nurses in all settings is Health Education.

2. Educational Departments and Establishments continue to rule out

employing licensed nurses in school premises.

3. The role of our school nurses, which is in greater quantity, is of vital importance.

4. School Nurses administer simple medication to students and also t if the

problems are serious.

5. National Board for Certification of School Nurses sets the professional standard
for School Nursing.

Answer Key

1. TRUE
2. FALSE
3. FALSE
4. FALSE
5. TRUE
Scores of Respondents to 5 Item Activity