A Legislative Perspective on the School Nurse and Education for Children with Disabilities in New Jersey

Article excerpt

Legislation concerning managing special needs children in New Jersey has evolved since 1903. Analysis of statutes from 1903 to date demonstrates an innovative approach for identifying and delivering services for the child with special needs.

A literature review demonstrates several referrals to management and care of chronically ill or disabled children in school following enactment of the Education for All Handicapped Children Act of 1975. [1-4] These articles dealt with the complexities of interpreting, planning, funding, and training competencies of school personnel to meet the requirements and intent of the law.

Likewise, several articles referred to the school nurse's role with children with disabilities. [5-9] Attempts were made to portray the nurse as a competent health care expert, facilitator, and manager on the school health, team. However, a total perspective in the progressive management of disabled children in New Jersey schools has not been illustrated. Well documented is the ambiguity the school nurse experiences past and present. [10-12] Overall, the school nurse has not demonstrated to the school system and to the consumer how nursing intervention makes a difference in the educational process.

The proposed act, "The Plan to Revise Special Education." gives New Jersey school nurses an opportunity to apply a community health framework for practice. Rapoport [13] describes public health as ". . . a continuum of activities to protect the health of the community." Leavell and Clark [14] organized these activities into three levels of preventive care:

"1) Primary prevention includes health promotion and specific protection.

2) Secondary prevention includes early diagnoses, prompt treatment and disability limitation.

3) Tertiary prevention focuses on rehabilitation aspects and efforts."

Nurses in school communities provide services at these three levels. Also, within this public health framework, the nurse is charged to become an advocate for children with disabilities in the legislative process and interpretation of the law. Finally, it poses an opportunity for the school nurse to articulate, document, and communicate interventions and outcomes and to become a competent manager on the school health team.

To capitalize at this crucial time before the proposal is enacted, it behooves nurses to develop a broader, more complete perspective of past legislation, interpretation, and delivery of service to the child with a disability. Thus, by analyzing legislative trends from 1903-1990, the school nurse may gain insight on future interpretations and delivery of services for a holistic approach to health care in an educational setting.

REVIEW OF PAST LEGISLATION

Five specific time periods reflect state statutes and amendments of the law of New Jersey pertaining to use of the nurse and provision of services for the disabled child.

Time Period I: 1903-1935

In 1875, language in the New Jersey Constitution directed legislators to provide a "thorough and efficient system" for the education of all children. [15] At the turn of the century, New Jersey was expanding into industrialization. Growth was intensified by immigration which doubled the population between 1900-1930. World War I resulted in a further population increase as the state plunged into the manufacturing needs of war. Industrialization and influx of people brought a multitude of health, educational, and social problems needing solutions. [16] Societal and legislative changes occurred to assist not only children in general, but in particular, the special needs child. Statutes from 1903-1935 demonstrate early attempts to identify and classify special needs children. [17] Special schools were opened. People labored for better provisions and understanding of these children.

New Jersey was one of the first states to recognize the value of school nursing in 1903. …