Professional Documents
Culture Documents
Learning Objectives:
4. Explain the value of School Health Nursing for both students and personnel;
and
The terms community health nursing and public health nursing are often used
debates and discussions, definitions of "community health nursing and "public health
nursing. Public health nursing has frequently been described as the synthesis of
public health and nursing practice. Freeman (1963) provided a classic definition of
Public health nursing may be defined as a field of professional practice in nursing and
affect the community. These skills are applied in concert with those of other persons
engaged in health care, through comprehensive nursing care of families and other
groups and through measures for evaluation or control of threats to health, for health
education of the public, and for mobilization of the public for health action.
broader and more general specialty area that encompassed many additional
health).
In 1980, the American Nurses Association (ANA) defined community health nursing as
"the synthesis of nursing practice and public health practice applied to promoting and
The ANA (2013) has revised the standards of practice for this specialty area. In the
updated standards, the designation was again "public health nursing," and the ANA
used the definition presented by the American Public Health Association (APHA)
Committee on Public Health Nursing (1996). Thus, public health nursing is defined as
"the practice of promoting and protecting the health of populations using knowledge
Standards 1. Assessment
The public health nurse collects comprehensive data pertinent to the health status of
population.
The health nurse analyses the assessment data to determine the population diagnoses
and
priorities.
The public health nurse identifies expected outcomes for a plan that is based on
Standard 4. Planning
The public health nurse develops a plan that reflects best practices by identifying
Standard 5. Implementation
The public health nurse implements the identified plan by partnering with others.
Standard 5 A. Coordination
The public health nurse coordinates programs, services, and other activities to
Standard 5C Consultation
The public health nurse provides consultation to various community groups and
The public health nurse identifies, interprets, and implements public health laws,
Standard 6 Evaluation
The public health nurse evaluates the health status of the population.
the role of the occupational health nurse in workplace health management, a new and
exciting concept that is designed to improve the management of health and health
related problems in the workplace (1). Specialist occupational health nurses can play a
major role in protecting and improving the health of the working population in Europe as
part of this strategy. Occupational health nurses can also make a major contribution to
related to the
health of the working population. By helping to reduce ill health occupational health
and reduce health care costs. Occupational health nurses can also help to reduce the
externalization of costs onto the taxpayer, by preventing disability and social exclusion,
and by improving rehabilitation services at work. By protecting and promoting the health
of the working population, and by promoting social inclusion, occupational health nurses
Occupational health nursing in the Philippines traces its roots to Mrs. Magdalena
Valenzuela of the Department of Health (DOH). She instituted the Industrial Nursing
Unit (INU) of the Philippine Nurses Association (PNA) on November Il, 1950. Ms. Peria
chairperson. On August 19, 1964, Ms. Anita Santos of Jardine Davies was elected as
first president. She organized several continuing education programs and strived for the
passing of the constitution and by-laws governing the association, which was approved
on November 12, 1966. It paved way to the modification in name of the organization to
1970 the first annual convention was held. In 1978, the constitution registered with the
amendments, an article in the bylaws was created to organize a Specialty Board for
The way by which the occupational health team could classify occupational health
concerns in the workplace is to identify (1) health hazards and (2) safety hazards.
Health hazards are the elements in the work environment that can cause work-related
disease to the worker. Safety hazards are the unsafe conditions or unsafe acts that
significantly increase the risk of worker to be injured. The occupational health team
begins with risk anticipation and assessment by creating a job-safety analysis. This
could be done through reviews of records, process and equipment reviews, chemical
through methods. In this process, the hazards present, those who are exposed, and the
degree of individual exposures are identified, the occupational health team may
standards, trainings, job design, and the like. For example, a workplace where a
substantial level of noise is involved may need to implement job rotation policies to be
able to assure that no worker is exposed to the threshold limit (i.e., 85 decibels per 8-
emitting machines can be isolated with sound-proof walls, and dangerous tough
materials. Toxic chemicals could be substituted with alternatives, and their handling
that can decrease their exposure or susceptibility to occupational hazards (see Table
1. Occupational and environmental health nurses provide health care in the work
environment with regard for human dignity and client rights, unrestricted by
health nursing is dedicated to the promotion, protection and preservation of the life and
health nursing, clients may be defined as the employee, the employer and the
community. Therefore, the occupational and environmental health nurse has a unique
role in protecting the integrity of the workplace and the work environment.
Occupational and environmental health nurses have an obligation to treat clients fairly,
respecting their dignity and worth. While recognizing the existence of a vast diversity of
cultural beliefs and values in society, occupational and environmental health nurses
demonstrate respect for these beliefs and values inherent in their clients and
themselves and plan health care services for and with that client accordingly.
Occupational and environmental health nurses respect their clients' rights to autonomy.
Clients are
encouraged to participate in planning their own preventive and restorative health care,
and occupational and environmental health nurses are truthful in providing clients with
interests and well-being, nurses examine the short term and long term outcomes of the
nurses have the responsibility to be knowledgeable about their clients' rights. These
nurses.
participation in providing health services or when clients refuse care, the nurses may
not be exempt from protecting their clients' health and safety. Occupational and
with other professionals and community agencies to meet the health needs of the client.
Occupational and environmental health nurses are members of the occupational and
environmental health and safety team. Occupational and environmental health nurses
function both interdependently and independently in promoting the welfare of clients.
allowing the occupational and environmental health nurse to work with members of
other health and safety professions in the provision of care. Providing health services to
and
members of the occupational and environmental health team within the organization.
seek assistance and expertise from other recognized health professionals in the
provision of services. Occupational and environmental health nurses function within the
of the health and safety team as necessary. Occupational and environmental health
nurses have an obligation to promote adequate distribution of health care and nursing
resources to meet clients' needs. Occupational and environmental health nurses are
health nurses have a responsibility to observe professional codes and uphold practice
conflict resolution. The promotion of health and safety and prevention of injury and
illness at the worksite require occupational and environmental health nursing
Occupational and environmental health nurses have an obligation to maintain the trust
bestowed upon them by clients and to protect their clients' rights to privacy. Public trust
unauthorized access. Occupational and environmental health nurses act with intent to
safeguard the employees' rights. Written policies and procedures should guide the
computerized records.
knowledgeable about and adhere to the organizational, local, state, federal and
information. Employees are then protected from unauthorized and indiscriminate access
and disclosure of health and personal information. Confidentiality is crucial to the
4. Occupational and environmental health nurses, through the provision of care, strive
health nurses are representatives of the profession and demonstrate competent, ethical
the health, safety and welfare of clients. Occupational and environmental health nurses
strive to protect their clients and the profession from incompetent professionals and
policies to promote competent, ethical and legal nursing practice. Occupational and
environmental health nurses have a commitment to comply with the laws and
regulations that govern the workplace in an effort to provide workers with a safe and
healthful workplace.
health nurses are responsible citizens in the community adhering to all laws and
professionals, occupational and environmental health nurses respect their clients' and
society's rights to know and to receive factual information about potential and actual job
knowledgeable of community issues and dilemmas affecting health, safety and the
nursing practice, based on scientific knowledge, and recognize and accept responsibility
for individual judgments and actions, while complying with appropriate laws and
regulations that impact the del/very of occupational and environmental health services.
professional practice.
Occupational and environmental health nurses have the responsibility to strive for
licensure provides for protection of the public to ensure that basic professional
environmental health nurses are professionally and morally accountable for their actions
and compliance with nurse practice acts, standards of practice and other laws and
and environmental health nurses do not have the necessary skills or knowledge or are
unable to render services personally, the nurses have a moral responsibility to refer
to the ongoing development of the profession's body of knowledge while protecting the
rights of clients.
research. Research provides new information to improve and validate the tenets
designing studies, testing theories to guide nursing practice, utilizing and applying
build upon the body of knowledge that serves as the foundation for practice.
Occupational and environmental health nurses must strive to create and expand this
should respect and protect the autonomy, rights and privacy of the subjects. One
consent. Occupational and environmental health nurses have moral obligations to self,
their clients, the profession and society to conduct sound ethical research. Occupational
and professionals and to appropriately utilize research findings within their practice.
Occupational and environmental health nurses also contribute to the growth of the
profession's body of
within the practice of occupational and health nursing, and the publication of their work
health. Many of today's health challenges are different from those of the past and
include behaviors and risks linked to the majority of the leading causes of death, such
as heart disease, injuries, and cancer. The use of tobacco, alcohol, and drugs; poor
Education and health are interrelated. As earlv as 1950, the World Health Organization
(WHO) Expert Committee on School Health Services noted that, "to learn effectively,
children need good health." Studies have shown that nutritional deficiencies and poor
health in school-aged children are among the most common causes of low school
enrolment, absenteeism, poor school performance, and early dropout. On the other
hand, regular attendance in school is one of the essential means of improving health.
Education that provides children with both basic academic skills and specific
knowledge, skills, and attitudes related to health is vital. This aspect of education has
elementary schools, and 6.8 million to high schools (NSCB, 2013). This creates a
unique opportunity for the school nurse to make a positive impact on the nation's youth.
There are more teachers than health professionals in the country. Additionally, the
school health structure does not provide for one nurse per school. Generally, the school
nurse visits four to six schools per month, with each visit lasting for 3 days or more,
depending on the type of school, location, and population. Revisits may be done within
the month for follow-up purposes. This means that the nurse spends at least 3 days of
administration of first aid. Thus, the school nurse is responsible for planning and
conducting training programs for teachers on health and nutrition (DECS- I-INC, 1997).
During school visits, school nurses see students for a variety of complaints. Increasing
numbers of children are being seen in the school setting because they lack a source of
regular medical care. Through the education of students and teachers, counseling,
advocacy, and direct care across all levels of prevention, the nurse can improve the
In 2006, an estimated 12.8 million children aged below 15 years (44% of all the children
from this age group) were living in families that did not meet basic living requirements
based on their income (PIDS and UNICEF, 2007). Poverty is associated with decreased
or inferior health care and has been linked to serious health problems that result in an
increase in absenteeism and failure in school. The school nurse and, in the absence of
the school nurse, the well-prepared school teacher, serving as school health guardian,
can effectively manage minor complaints and illnesses, helping these children to return
to or remain in class.
There is a need for mental and physical health services for students of all ages in an
effort to improve both academic performance and sense of well-being. This section
provides an overview of school health and the role of the nurse in the provision of health
The evolution of school health services has brought about the development of a more
comprehensive school health program with the entire school community considered as
the client. This resulted to the inclusion of services for school personnel.
The definition of school health and what a school health program should be have
evolved markedly in the past 50 years. Traditionally, school health programs were
defined as covering:
The interrelationships, however, among these elements as well as the manner in which
they can reinforce each other were not given emphasis, either in theory or in practice
(WHO, 1997). In the Philippines, the first school health program required by law
consisted mostly ofschool health services with the passage of Republic Act 124 in 1947.
Entitled as "An Act to Provide for Medical Inspection ofChildren Enrolled in Private
Schools, Colleges and Universities in the Philippines," this law stated that it was the
duty of the school heads of private schools with a total enrolment of 300 or more to
provide for a part- or full-time physician for the annual medical examination of pupils
and students. The physicians were to render reports of their school health activities at
the end of every quarter of each school year to the Director of Health. The physicians
were placed under the direct supervision of the Bureau of health, the forerunner of the
With the changing roles and responsibilities of schools came a redefinition of school
health programs in the 1980s. "the evolving roles of the school nurse and the school
health team in response to the needs of school children and the other members of the
school community resulted in the expansion of the school health program to eight
components. In addition to the first three components mentioned earlier. five more
This new definition emphasized the need for an organized approach, implemented
schools' (WHO, 1997). School nursing covers the entire scope of the eight components
of school health programs. The National Association of School Nurses (in the United
health and safety; intervene with actual and potential health problems; provide case
management services: and actively collaborate with others to build student and family
In the Philippines, a holistic approach to strengthen health and nutrition among school
Nursing (RASHN), officially adopted through the Department of Education, Culture. and
RASHN is based on the philosophy that the academic performance of the pupils and
the instrudional outcomes are determined by the quality of health of the school
population and the communitv where they come from (DECS 1997).
The Department of Education (DepEd) Order 43, s. 2011 on the subject Strengthening
the School Health and Nutrition Programs for the achievement of the Education for All
(EFA) and Millennium Development Goals (MDGs) seeks to strengthen the School
Health and Nutrition Program (SHNP) through a seamless alignment of SHNP activities
with other key school programs, thus the title Integrated School Health and Nutrition
Program (ISHNP). It further states that the ISHNP is designed to maintain and improve