Is School Nursing Really the "Invisible Practice?"

Article excerpt

When asked to write an article for Nursing Outlook on school nursing issues and trends from a state-of-the-art perspective, I was surprised when the managing editor changed the title from "The Practice of School Nursing: Patterns and Projections" to "The Invisible Nursing Practice."[1] After recovering from my initial surprise, I realized the former title was academically correct but unimaginative, while the latter peaked even my interest.

Publication of the article produced unexpected feedback including an invitation to keynote an annual state school nursing conference. Yet, to my amazement, no one has yet challenged the accuracy of the title. Does the title truly describe present-day school nursing practice? After rereading the article, I felt I qualified the "invisible" characteristics of school nursing noted by one investigator[2] as a result of the design used in the study. Perhaps my observation unintentionally explained away the statement as an artifact of scientific rigor thereby rendering it disconcerting though acceptable. Nonetheless, the title did evoke some interest and, therefore, may have produced some beneficial effects.

Underscored by the fact that in many areas school nurses are being laid off along with school counselors, librarians, and teachers, public education is in crisis across the nation. Many school districts are maintaining their school nursing staffs despite budget problems, but this effort is not usually newsworthy. Despite these setbacks, or perhaps because of them, encouraging signs suggest a groundswell of national bipartisan concern for the health and welfare of children.


In the 1990 report entitled Code Blue: Uniting for Healthier Youth, the 36-member National Commission on the Role of the School and the Community in Improving Adolescent Health presented a compelling picture of the needs of today's American adolescents. The Commission was sponsored by the State Boards of Education and the American Medical Association -- an uncommon alliance of organizations working together. In When the Bough Breaks: The Cost of Neglecting Children, the author -- Sylvia Ann Hewlett -- quotes from the Commission report: "Never before has one generation of children been less healthy, less cared for, or less prepared for life than their parents were at the same age."[3] This statement presents a strong indictment of the concern for and care provided to children today.

Likewise, the bipartisan National Commission for Children, chaired by Senator Jay Rockefeller (D-W. Va.), issued a comprehensive blueprint for improving the plight of the nation's young. However controversial some of the panel's proposals were, such as a $1,000 tax credit for children regardless of income, remarkable unanimity existed for its overall objective despite the ideological diversity of the panel's 34 members.

Representative Patricia Schroeder (D-Colo.), Chair, House Select Committee on Children, Youth, and Families, said recently, "Everybody is starting to get very worried about how America is filling up with dysfunctional families. You get enough dysfunctional families and you get a dysfunctional nation." She also observed a growing consensus of conservatives and liberals on Capitol Hill to give parents a federal tax break to raise the next generation.

The foregoing signs are encouraging and suggest growing political concern for children and families. However, this concern must be translated into actual support requiring coherent and collective activism by those who can vote for those who cannot by virtue of age.

While political events make headlines, it behooves those concerned with school health to do "more with less" by "working smarter" in the language of futurists and strategic planners. School nurses can take advantage of seminars, workshops, and conferences to acquire, update, and upgrade skills in areas such as program management and planning, information technology, health assessment, and collaborative research. …