Academic journal article Journal of School Health

The School Nurse as Health Educator

Academic journal article Journal of School Health

The School Nurse as Health Educator

Article excerpt

Nurses who work in schools often are expected to provide health instruction in the classroom in addition to direct health care for students. School administrators, classroom teachers, and parents often assume that health care professionals, like physicians and nurses, possess the knowledge and skill required to be effective teachers of health education. Moreover, nurses often are asked to provide instruction about controversial topics that create anxiety for those classroom teachers without special preparation to address such health topics as puberty, human reproduction, sexuality, and sexually transmitted diseases, including HIV infection.

This article reviews the potential contributions of school nurses to school health education, and provides a framework to help nurses make decisions about appropriate roles to play in relation to health education.

Health education has been defined as a planned instructional program designed to influence positively the health-related knowledge, attitudes, and skills of students, preschool through grade 12, for parents and for school staff.[1] Health education in schools will be discussed in the context of the "comprehensive school health program' defined by the 1995 Interim Report of the Committee on Comprehensive School Health Programs of the Institutes of Medicines of the National Academy of Sciences as follows:

A comprehensive school health program is an integrated

set of planned, sequential, school-affiliated

strategies, activities, and services designed to

promote the optimal physical, emotional, social, and

educational development of students. The program

involves and is supportive of families and is determined

by the local community based on community

needs, resources, standards, and requirements. It is

coordinated by a multidisciplinary team and accountable

to the community for program quality and


Historically, health programs in schools included three components: education, services, and environment. Subsequently, an eight-component model suggested by Allensworth and Kolbe[2] was adopted by many school systems throughout the nation. Components of the latter model include health education, health services, healthy school environment, physical education, counseling and psychological services, nutrition services, parent and community involvement, and health promotion for staff.

A national study of school health programs, conducted by the Centers for Disease Control and Prevention,[3] focused on five components of school health programs: health education, physical education, health services, school food services, and specified school health policies. Data obtained from health services staff revealed a high level of collaboration and joint activities with those responsible for health education in the schools. More than 83% of responding states reported that health services staff were involved in joint activities or projects with staff responsible for health education; 69% of school districts reported collaboration between health services staff and health education staff. Similarly, data obtained from health education staff from states and school districts confirmed significant levels of involvement with health services staff: 75.5% for states and 49.2% of districts.[4,5]


Approximately 30,000 nurses currently provide services in the nation's 110,000 elementary and secondary schools.[6] Contrary to common opinion, the number of school nurses in the United States is not declining. In a study conducted by the University of Colorado,[7] more than 40% of the school districts reported adding nursing staff during the past year and only 1% reported having fewer nurses than in the past.

More than 95% of youth ages 5-17 are enrolled in school; 90% (48 million) attend school each day. …

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