The intent of this position statement is to clarify the role and declare the value of the registered professional nurse in the school setting.
It is the position of the New York State Nurses Association that:
Changes in society, the provision of health care, education, and the family have increased the need and demand for school health services. New paradigms are evolving for school health services as school systems develop comprehensive school health programs to address the diverse and complex health problems of today’s students. The school population is no longer homogenous; it represents a more diverse population. Children come not only with different medical conditions, but also with different social and emotional needs. They represent all segments of our society and are part of a huge array of family constellations (Wolfe & Selekman, 2002). The registered professional nurse is crucial to the provision of the school health services for children with special needs, including children with chronic conditions and disabilities of various degrees of severity (Pediatrics, 2001).
The school nurse is the primary and often sole coordinator of all aspects of the school health system. The specialized practice of school nursing is chiefly concerned with improving the “well-being, academic success, and life-long achievement of students.” (ANA, Scope and Standards of Professional School Nursing Practice, 2001, p.1) The school nurse works to achieve this outcome by addressing all health-related factors. “School nurses, as active members of the interdisciplinary student services team, facilitate positive responses to normal development, promote health and safety, intervene with actual and potential health problems, provide case management services, and actively collaborate with others to build student and family capacity for adaptation, self-management, self-advocacy and learning” (ANA, Scope and Standards of Professional School Nursing Practice, 2001, p. 1). In an effort to capture the extensive role of the registered professional school nurse, the National Association of School Nurses (NASN) created seven roles to describe their practice. The school nurse: (1) provides direct healthcare to students and staff, (2) provides leadership for the provision of health services, (3), provides screening and referral for health conditions, (4) promotes a healthy school environment, (5) promotes health (6) serves in a leadership role for health policies and programs, and (7) serves as a liaison between school personnel, family, community and health care providers (2002).
The school nurse is responsible for providing a broad range of services, including the following eight components of a coordinated school health program (Marx, Wooley, and Northrup, 1998):
The ultimate outcome of practice for the registered professional school nurse is to assist students to be successful in the learning process. The ability to learn at school is directly related to the status of a student’s health. The multi-faceted role of the school nurse supports the physical, mental, emotional and social health of each student in the school setting. The school nurse serves as the health advocate for all school children, focusing on the promotion of healthful living styles and the prevention of illness and disability (NASN, 2002).
There have been significant legislative changes that have impacted on the role of the school nurse. The Rehabilitation Act of 1973 and the Individuals with Disabilities Act (IDEA) of 1975/1997 had the greatest impact on the school nurse’s scope of practice by expanding the definition of a “student” and requiring schools to provide services. Section 504 of the Rehabilitation Act prohibits discrimination on the basis of disability and mandates access to public schools for children with disabilities. This law mandates that accommodations be made and barriers removed so that children with disabilities have access to public programs, including schools and services (Wolfe & Selekman, 2002).
The New York State Nurses Association recommends that:
Approved by the Board of Directors on March 18, 1988. Reviewed and revised by the expanded Council on Nursing Practice on 8/13/04. Approved by the Board of Directors on September 15, 2004.
American Nurses Association and National Association of School Nurses. (2001). Scope and standards of professional school nursing practice. Washington, DC: Author.
Denehy, J. (2000). Measuring the outcomes of school nursing practice: Showing that school nurses do make a difference. Journal of School Nursing, 16(1), 2-4.
Marx, E., Wooley, S., & Northrup, D. (1998). Health is academic: A guide to coordinated school health programs. New York: Teacher's College Press.
National Association of School Nurses. (2002). Issue brief: Role of the school nurse. Castle Rock, CO: Author.
The role of the school nurse in providing school health services. (2001). Pediatrics, 108(5), 1231-1232.
Wolfe, L. C., & Selekman, J. (2002). School nurses: What it was and what it is. Pediatric Nursing, 28(4), 403-407.
For more information on nursing practice, contact NYSNA's Education, Practice and Research Program at 518.782.9400, ext. 282 or by e-mail.